Monday, December 29, 2008

my small friends

Horton Hears a Who. It's about how the smallest person is important. And this guy who never talks invents this incredible music machine that saves his world. I have a friend who is small, and she doesn't kill bugs. I think there is a connection here. And because of her, I have also stopped killing bugs. It's also because of Saint Francis of Assisi. But about my small friend, she inspired me to start writing on my blog again, because hers is awesome. I laugh out loud while reading it. Also, she puts quotes on her blog posts. I think I will adopt that. She should probably hate me, because I am a copycat, and nobody likes a copycat - not since sixth grade. Maybe she will comment on this post, and then all of you thousands of people who religiously read my blog can read hers, too.

I stayed up until three in the morning talking to my sister-in-law last night. Today, she was really tired. I almost felt bad, but we had a good talk, so I think it was worth it. Hopefully, she can take a nap today. We talked about me mostly. I think she's been wondering how I've been doing for a long time. So I told her. I told her a lot of stuff.

I told her about how I love God and about how glad I am that my walk with Him is in His hands and in His time.
I told her about the friends I have that I love. I told her about how I want to heal people and maybe be a doctor. I told her about how I've given up on marriage and about how I'm confused about freewill and happiness. She says she thinks marriage can be ideal, because hers is. She said some smart stuff. She's married to my brother, Jason, and they have seven kids.

Everyone thinks that their nieces and nephews are cute, and I could talk about that for a long time. But I'll just mention it here, b/c sometimes you think other people's spewings about how their people are cute are uninteresting. You'll just have to take my word for it. These kids are cute. A compound sentence or two for each of them, from top to bottom. Tim smokes me in the shins sometimes; he's eight. Alivia and I went for a snowmobile ride, and she said it was the "funnest snowmobile ride in her whole life!" Andrea reminds me of myself so much that when she does some things that aren't the smartest or the kindest, I get frustrated with myself, because that's exactly what I would have done. I feel as though I can see all her gears turn. Adam means "man", and he is a little one. My brother told me that I combed his hair like a dweeb. I still think it looked good. I relate with Krista, because she experiences a wide array of emotions. She cries like her heart is broken and almost simultaneously wells up in this giggle from deep in her insides. Sometimes when she smiles, it reminds me of Garth from Wayne's World - a cute, sheepish little grin. She is very vocal and sings a lot. Marcie doesn't talk much yet, but she is an effective communicator. She has big eyes and likes to be upside down when I hold her. David is six months, and my dad held him upside down, too - from his feet. He does that with all babies. He says it makes babies smarter when they spend time upside down. He says it worked for his kids, so he has extrapolated that small bit of evidence to all of his grandchildren and nieces and nephews. His sample size for experimental data exploded.

And now, the long awaited quote:

"In my world, everyone is a pony, and they all eat rainbows, and poop butterflies." -Katie from Horton Hears a Who

I watched most of the movie twice, and I didn't even know there was a Katie in it. But I found this quote while looking for that one. You know the one - the one about how "even though you can't hear them or see them at all, a person's a person, no matter how small."

Wednesday, October 29, 2008

spurts like this.

It usually goes like this - in spurts like this. I write like a crazy person for a little bit, and then the bit subsides. I wrote a song this week...just like that; no big deal. It's a pretty sweet song, I think. But, then...I wrote it, so I would think that.

I read like this, too. In spurts, that is. In high school, sometimes Katelyn would make fun of me cause I'd be walking through the halls with my head down, furiously reading the pages of some book. That's all I'd do for about a week. Read.

I've also been watching Joan of Arcadia as if the tv is going to explode soon; my roommate has the two seasons on DVD. It's wonderful. It's been a coping/healing mechanism for me, actually.

Einstein quote of the day: "It is my view that the vegetarian manner of living by its purely physical effect on the human temperament, would most beneficially influence the lot of mankind."

Ever notice how you do something at night, but during the day
(not at day)? That would be really confusing to someone learning English.


I'm all alone here.
People all around me,
but none are mine.
Half mine, but time steals.
Half mine, but time steals away the other half, as always.
A beautiful man here,
a beautiful girl there - all half mine, but not for long.

Is the memory worth it?
I can't know this.
I try to solve this puzzle.
Is the memory worth the pain?

Kairos to kairos I move.
Recall only those lasting things.
Forget all the rest,
though others remember and wonder where my head is.

It's in the clouds.
It's in the kairos.
It's with You,
with each person for a moment;
it's with You - far away with You.

You know all these people,
here and there,
break off a piece of kairos,
stick it in my head.
Heads up! Where did time go?
They're all gone.
Tasted things are gone - forever eaten.
All but You: You never go.
You never do.

Tuesday, October 28, 2008

Here I Am Again

here I am again,
standing, kneeling. fighting, appealing.
here I am again,
waiting for the time to come; it's so slow.
waiting for the occasion when the day will go.

here I am again,

waiting for life to be innocent again.
here I am again,
waiting for the hunger to subside -
to get tired of being hungry for ugly.

here I am again
pouring over fascinating things
piquing interest into deeper somethings.
testing on this memorization,
waiting for the tallied marks, the imitation
of character, efficiency, work ethic,
but actually inductive reasoning, always inductive.
the small's a window with dark glass.

and here I am again.
seeing those things others say aren't real.
knowing them. believing them.
waiting for them to be revealed.

here I am again.
through these halls again
at this table again.
pondering life and time again.
this blank sheet always offering relief here.
this pen and that pen always offering release here.

here I am again,
casting an angry eye toward the glass, resenting it.
but no matter; its time will come
when the day will go.

here I am again.
seeing through this glass.
here I'll be again.
there I'll go again,
where dark glass cannot live
and the time comes for day to go now.

Tuesday, October 14, 2008

The Sands of Time Are Sinking: Anne Cousin

The sands of time are sinking, The dawn of Heaven breaks,
The summer morn I've sighed for, The fair sweet morn awakes:
Dark, dark hath been the midnight, But dayspring is at hand,

And glory—glory dwelleth In Immanuel's land.

Oh! well it is for ever, Oh! well for evermore,
My nest hung in no forest Of all this death-doom'd shore
Yea, let the vain world vanish, As from the ship the strand,
While glory—glory dwelleth In Immanuel's land.

There the Red Rose of Sharon Unfolds its heartsome bloom,
And fills the air of Heaven With ravishing perfume:—
Oh! to behold it blossom, While by its fragrance fann'd,
Where glory—glory dwelleth In Immanuel's land.

The King there in His beauty, Without a veil, is seen:
It were a well-spent journey, Though seven deaths lay between.
The Lamb, with His fair army, Doth on Mount Zion stand,
And glory—glory dwelleth In Immanuel's land.

Oh! Christ He is the Fountain, The deep sweet well of love!
The streams on earth I've tasted, More deep I'll drink above:
There, to an ocean fulness, His mercy doth expand,
And glory—glory dwelleth In Immanuel's land.

E'en Anwoth was not heaven— E'en preaching was not Christ
And in my sea-beat prison My Lord and I held tryst:
And aye my murkiest storm-cloud Was by a rainbow spann'd,
Caught from the glory dwelling In Immanuel's land.

But that He built a heaven Of His surpassing love,
A little New Jerusalem, Like to the one above,—
"Lord, take me o'er the water," Had been my loud demand,
"Take me to love's own country, Unto Immanuel's land."

But flowers need night's cool darkness, The moonlight and the dew;
So Christ, from one who loved it, His shining oft withdrew;
And then for cause of absence, My troubled soul I scann'd—
But glory, shadeless, shineth In Immanuel's land.

The little birds of Anwoth I used to count them blest,—
Now, beside happier altars I go to build my nest:
O'er these there broods no silence, No graves around them stand,
For glory, deathless, dwelleth In Immanuel's land.

Fair Anwoth by the Solway, To me thou still art dear!
E'en from the verge of Heaven I drop for thee a tear.
Oh! if one soul from Anwoth Meet me at God's right hand,
My Heaven will be two Heavens, In Immanuel's land.

I have wrestled on towards Heaven, 'Gainst storm, and wind, and tide:—
Now, like a weary traveller, That leaneth on his guide,
Amid the shades of evening, While sinks life's ling'ring sand,
I hail the glory dawning From Immanuel's land.

Deep waters cross'd life's pathway, The hedge of thorns was sharp
Now these lie all behind me— Oh! for a well-tuned harp!
Oh! to join Halleluiah With yon triumphant band,
Who sing, where glory dwelleth, In Immanuel's land.

With mercy and with judgment My web of time He wove,
And aye the dews of sorrow Were lustred with His love.
I'll bless the hand that guided, I'll bless the heart that plann'd,
When throned where glory dwelleth In Immanuel's land.

Soon shall the cup of glory Wash down earth's bitterest woes,
Soon shall the desert-briar Break into Eden's rose:
The curse shall change to blessing— The name on earth that's bann'd,
Be graven on the white stone In Immanuel's land.

Oh! I am my Beloved’s, And my Beloved is mine!
He brings a poor vile sinner Into His "House of wine."
I stand upon His merit, I know no other stand,
Not e'en where glory dwelleth In Immanuel's land.

I shall sleep sound in Jesus, Fill'd with His likeness rise,
To live and to adore Him, To see Him with these eyes.
'Tween me and resurrection But Paradise doth stand;
Then—then for glory dwelling In Immanuel's land!

The Bride eyes not her garment, But her dear Bridegroom's face
I will not gaze at glory, But on my King of Grace—
Not at the crown He gifteth, But on His piercèd hand:—
The Lamb is all the glory Of Immanuel's land.

I have borne scorn and hatred, I have borne wrong and shame,
Earth's proud ones have reproach'd me, For Christ's thrice blessed name:—
Where God His seal set fairest They've stamp'd their foulest brand;
But judgment shines like noonday In Immanuel's land.

They've summoned me before them, But there I may not come,—
My Lord says, "Come up hither," My Lord says, "Welcome Home!"
My kingly King, at His white throne, My presence doth command,
Where glory—glory dwelleth In Immanuel's land.

A Fish Knows

A powerful man stands in his office, looking through the glass that makes up his wall, down onto all of his factory. The workers scuttle around packaging this, examining that, putting price labels on all of his ware. Of course, all of this is only his in the sense that he owns all of it. He didn't actually make any of it with his own hands. But at the end of the day, he gets the money for it, no matter whose hands toiled over it. He gets the money. He's the big dawg.

His eyes shift to a worker who skins the back of his hand on a conveyor belt. He cusses. He steps away from the belt. His mouth is moving; he's saying something. Or is he yelling it? He makes hand movements with motions stiff and jerky. His face is turning another color. He points up to the powerful man's office which, in the way of two-way glass, blankly reflects a crude, warped version of the factory around him. He yells something toward it which the powerful man barely hears, but to which he does not respond. The irate worker can't see anyone, but he knows who's supposed to be up there. He knows his position, that is, if he's ever even up there. A few workers turn their heads, but mostly, they just keep working.

The powerful man keeps watching. A counselor comes soon and gently sweeps the man away. He'll come back to work soon. It's all just a part of the business, taking care of his workers so they can keep making him money. If the measures he's set up for such outbursts don't work, he'll end up firing the irate worker. He doesn't want to do that. He'll have to find someone else to take the worker's place to do his work. But, no matter, he'll still get the money at the end of the day, because he's the powerful man. The powerful man uses his power to get himself money. He's good at it.
* * *
His Sovereignty is easy lately. It makes sense. My whole God-view has been redone, it seems, but it's been over a long period of time, hair by hair. He gets the glory no matter what. He is omniscient. He upholds the truth, so the truth is upheld without question. And the truth is that He is the big dawg, that He is the only big dawg. So the only possible outcome is that His name will receive all the glory. There is no alternative. In the New English Translation, my favorite version lately, God says, "I am God, and I have no peer."

It doesn't have anything to do with us, really. We see our world differently from how it is. In our world, we are the center. We see everything from one perspective, our own eyes. Some part of our anatomy frames every view - an outline of our own eye orbitals, a nose down there somewhere. We're the origin. And we see how the world around us is affected by our behaviors. We see how others' behaviors influence the world we live in. This is all that we know. John Piper said: "A fish cannot know that he is wet. All a fish knows is wet." Just so, we are really not the center. God is the center; He is the origin. God will get all of the glory, whether we are cooperating with Him or not.

I think that's what the writers were talking about when they said, "The fear of the Lord is the beginning of wisdom." Your view is faulty unless you know who the big dawg is, unless you know that you're really not the center. There's a reason, though, that he says it's the beginning of wisdom. I'm convinced that it's because of love. Fear is the only response when we really get that God is supreme. But we know that perfect love casts out fear. And here is the bridge to this gap between two truths: His name, the one that gets all of the glory, is love. God is love.

Love gets the glory no matter what. Love is omniscient. Love upholds the truth, so the truth is upheld without question. And the truth is that Love is the big dawg, that Love is the only big dawg. So the only possible outcome is that Love will receive all the glory. And that is where we rest, where we dwell: in the paradox between trembling fear and sure love, all for the supreme benefit of His name. There is no alternative.

Sunday, October 05, 2008


I was watching this movie where these two guys were shooting free-throws. "1," the coach was shouting, "2, 3, 4, 10, 11, 12, 17, 18, 19, 27, 28, 29, 30."

That's not counting! That's not how it works. The movie writers were cheating. They were skipping through time, but do you ever
envy them?

The movies can just screw up time whenever they want. They can pretend, for a moment, that time doesn't exist, that it's not holding us all back and ticking as we decay. They can pretend that it flies by when it should and holds still when it should, that moment after moment occur instead of minute after minute. They can run through time as if it's kairological. There's a pretty good link in the title about that.

My roommate bought the tv series "Joan of Arcardia". I've been watching it a lot lately. God says something about humans inventing time in the show. I've been thinking about that.

I read somewhere that Einstein said, "When forced to summarize the general theory of relativity in one sentence: Time and space and gravitation have no separate existence from matter."

Do you know what that means? That means that if there exists a place where matter doesn't matter, neither does time or space or gravitation. That means that I can fly.

Monday, August 11, 2008

the war is over in Krakozhia

I'm at home-home for a few days. I've flown with my dad and scooted around with him on his Pee Wee Herman look-alike moped. I've made spaghetti squash with my mom and hugged her a lot. I've visited my brother and his kids and met his new one, David.

I also met my long lost cousin Nikko. When I was little, I remember looking at a particular picture of him and wondering and wondering all kinds of things about that little boy looking at me. It was really quite epic for me to meet him. He probably didn't feel the same way, but then, he probably didn't have my mysterious picture staring at him his whole life.

Tom Hanks is kissing some girl named Amelia in my living room. A lot of people think that The Terminal is a really boring movie. I think it's really funny. One of my favorites, actually. I love the part when the janitor sits in the food court watching people fall even though they are surrounded by "Slippery When Wet" signs.

Before I left, I checked my oil and transmission fluid like a good girl. I even put in some oil, and used the gas station man's disposable funnel to throw in a little transmission fluid for good measure. My trip to my brother's was pretty uneventful, except for some seriously slow traffic for about five miles just out of the cities, and a few checks on the side of the road to see if my bike was still as with me as it was when I was at the gas station.

So my brother said it smelled like burnt rubber when I got there. I had been smelling it for a little bit, too. I guess it wasn't the car ahead of me. I popped my hood and found oil everywhere, and an oil cap face up sitting on the head gasket, right where I left it. A little piece of junk was stuck in the cap; an exact imprint of the cap was cookie-cuttered out of the foam on the inside of my hood. I had forgotten to put the oil cap back on.

"That would explain the smell."
"Yeah. It would."
"Well, at least you won't do that again."
"No. Probably not."

So I called Dad like I always do when I have car troubles. I think this is the point when he usually feels out of control and frustrated. But it was ok this time.

"No big deal," Dad said. "You need an oil cap."
"Got that, still."
"Really? Lucky. And oil."

Jason's six-year-old knows that "vehicle" is a better word than "car" when describing "auto". I think that's cool. But I haven't hung out with tons of six-year-old's lately. I bet she can spell it, though, which I'm pretty sure is significant.

So Dad and I cleaned off my engine when I got home with Lightning Degreaser. Then later, my car sputtered and died right when my mom passed me on the highway. The timing was incredible. And my dad was only a minute away - something all you home-dwellers really take for granted. It is amazing that my car broke down while I was at home. stopped running for a second because we got water in the engine. It was an easy fix, but while all of this was occurring, the muffler finally let out its secrets after years of keeping silent. So, I got a new muffler, an oil change - "That's one way to change the oil." - and gas money from Mom and Dad. It's a good day when your car breaks down at home. It pays to be at home, but I'd come home even if it didn't pay like that.

I also got some bruises and a good, solid neck ache from when my uncle took me water skiing. I got up right away on one ski which I felt good about. I figure I'd better announce it here so that everyone can know how cool I am. But I wiped out three times, and he said that the boat uses more gas when you wipe out. He said I wasn't very cost effective.

My mom and I usually have funny communication breakdowns in the kitchen. We picked a spaghetti squash from the garden to cook for dinner. Mom said something about using bread for a back-up in case the spaghetti squash didn't turn out. She said that we could have spaghetti sloppy joes. I nodded, but that really confused me. Why were we having so many different things for dinner? Spaghetti sauce, sloppy joes, or just bread with spaghetti sauce, and spaghetti squash.

Did you know that spaghetti squash is a substitute for real spaghetti? You eat it with spaghetti sauce, I guess. And it's good. Home-grown, good.

My friend's in Serbia. He wants to come home, I think, but there's something stopping him. All kinds of junk stopping him. It's sad for me, because it would be nice to see him. But he's not sad. At least he says he's not. But one time, he didn't believe me when I told him I wasn't depressed. And I wasn't, mostly. It's the other part he guessed about. And I guess there's another part of him - the part that desperately wants to go home and feel at home there.

It's not always perfect at home. Sometimes things are hard at home, but it's always home. It doesn't matter if there's wars going on at home like in Krakozhia in The Terminal. There's still nothing to be afraid of. It's home. And it's good to be home.

Saturday, July 26, 2008

something i wrote that has music

swiftly now

The wind, the breeze,
the trees
all pass
as do other things.
Passing, fading, failing ideality.
And Your face
I can see now its crevices,
its scars of pain and tears of rain
that I knew not were there.

Your face swiftly altered shape
. from sweet to sovereign
. from soft to deep,
And I am swiftly running.
I'm so sorry that I'm running, still running - ever running.
Will Your arm be long enough for me?

Your face; I asked to see it
every tick-tock of this time illusion.
I had a glimpse,
and I ran away;
but I'm slowing down and leaning down to deeply drink again.

You'll take me back again?
You'll alter shape again.

Your face swiftly altered shape
. from sweet to sovereign
. from soft to deep,
And I am swiftly running.
I'm so sorry that I'm running, still running - ever running.
Will Your arm be long enough for me?

My heart
bleeds its emesis
aneurysmically and rhythmically and forcefully on all around me.
And suitors
whose pursuit of me
charge less violently than Your own of me
come with their ware.
I entertain them enough
to know that I am loved,
that I am beautiful and in control,
and I move out from love;
I've bluffed.

No commitment
lest my responsibility there call me a cop out on love
or on being sane
-or worse...ask me to breathe of both:
to sanely love,
a vast impossibility
at least for me.

Your face swiftly altered shape
. from sweet to sovereign
. from soft to deep,
And I am swiftly running.
I'm so sorry that I'm running, still running - ever running.
Will Your arm be long enough for me?

One more thing:
Sometimes, I look back...
Your face, closer still,
and steady-still and wondering,
"Little girl, where are you, and where are We going?"

Thursday, July 24, 2008

Can I tell you something?

Do you know? I love my job. Can you tell? I like going to work. Did you hear? I love taking care of these people.

I went to visit my Norsk today. He went to a different unit after spending some time in the ICU. He's pretty confused, seeing things, saying strange things; he looks pretty beat up, too. He has a tube coming out of the spot above his eyebrow to drain whatever might be building pressure behind his eye. He's got a gigantic clot of blood underneath his nose and a few cuts from surgery. But he's breathing easily. He's alive. He recognized me when I visited him. He held my hand and made that noise of recognition. "You work here, too?"

Haha. Oh, I love my Norwegian man. His wife is doing quite well. Sometimes she laughs at the things he says, cause they're so weird. Sometimes it's laugh or cry. When you choose to laugh, it's actually funny. She said she slept well last night. Rest for the weary. Who came up with that? Thank You.

I hung a red sheet up in my window, and it makes everything in my room warm and red. I am definitely going to make a habit of that. And we made it to sushi tonight. And it was good.

I'm trying to stay up a little because I have nights M,T,W next week. But I'm tired. It's only 11:30.

Wednesday, July 23, 2008

hippie love

I just watched that movie. Tristan and Isolde. He said, "I don't know if life was greater than death, but love was more than either."

I've been thinking lately that the only thing that matters in life is hippie love. I have a friend who said that I am wrong. He said the world needs hippie love and contraceptives. I didn't bother to correct him, because I think he knew what I meant. I wasn't talking about that kind of hippie love.

I just mean the kind of love that is accepting. You know those people...the ones that make you feel like you're okay before they even know anything about you. They just love you, even if you do drugs, even if your parents died, even if you think LSD will make you see God. Even if your personality stinks. Even if your armpits stink.

So maybe hippies didn't love like that. I bet some really did, though, even if they were trippy hippies.

Do you think so, Mom?

Monday, July 21, 2008

flight through fire

I'm listening to Fireflight right now, and I'm in love with them. It's a newly found love. I fell for this ploy at a Christian bookstore and bought them, because I liked one of their music videos. And then I didn't like them for a while. But now I love them. They're gutsy. And they're kind of hard for a band with a girl as lead. So I like that.

I've worked five twelve hour nights in the last week. Monday, Tuesday, Friday, Saturday, Sunday, 7p to 7:30a.
I've been taking care of a man. He has a really thick Norwegian accent, so he reminds me of my family and all of the old men back home that I love. He says, "Oa, yah." And I just die. I've become attached to this one. I'm scared. I haven't let anyone in like him yet. He has acute myelogenous leukemia. A lot of our patient population has that. That's what yellow man had. Myelofibrosis that turned into AML.

He's here for induction chemotherapy -that is, his first round of chemo. He's been complaining of this headache for about a week. It's recently developed into serious sinusitis. He looks like he got smacked hard in the eye with a shoe, but the problem is from the inside out. The surgeons came in before his emergency sinusotomy. "We're going to go in and scrape out your sinuses. We're going to find out what you got in there. It's either bacterial or fungal. I don't expect it to be fungal, but there's a chance that this infection could be. If it is, it is very likely that this infection will take your life. If it's fungal, we're going to be as aggressive as we need to be. There's a chance we'll need to take your eye. Do we have your consent to be as aggressive as necessary?"

"Yes. Right Darla?" She nodded her yes through tears, "Yeah."

And the bustle continued as we got him ready for surgery. He left our unit at about 8:30 PM. We got a call around 1 AM. Bacterial. The report was that it was bacterial. Good news? There's good news here, too? I guess there's good news here. Really good news.

His left eye is swollen shut now and he can't see anything out of it or move it, and the left side of his face is numb. They're thinking there's an abscess underneath there.
I don't know how that works, because he doesn't have any neutrophils. His CT shows some possible brain involvement, symptoms show definite nerve involvement. I heard something about the optic nerve.

I sat with him for a minute today after the ophthalmologist visited him. He tried so hard to see. He tried so hard to convince himself that he could see. But he can't see. I sat on his bed and held his hand and we had a little chat. I wish I could give the moment to ya'll, but I can't, really. We talked about how tough it is. We talked about how unexpected it is. We talked about how fast it's gone. It snuck up so quickly and has taken his whole face over, it seems. Can't breathe through his nose. Bloody mess. But he took a shower this morning before my shift was over. He looks like a million bucks. Funny, as if this load wasn't heavy enough, that's how much this is going to cost him.

I heard today that they're going to take him back to surgery to take his eye out. More grief. More coping. Death takes all forms. More difficulty breathing. It's all in his face, so breathing comes hard, especially after general anesthesia. Surgery has a way of screwing up your oxygen.

I wish I was working again tonight. I'd like to be there every night with him, making his wife comfortable, making sure his oxygen saturation stays up where it should be, making sure he's safe and comfortable. It's funny how I feel so much ownership, even though I barely do anything. He makes me want to be competent. Really, he makes me want control. But I have no control. None. He might die. And I might be there when it happens. He might struggle to breathe and die because he gets tired and gives up for a moment.

I've been talking to my mom a lot, and she said she was getting sick. And I got paranoid about it. I tried to just relax and be like, "kt. people get colds; it's cool. chill." But inside, I was feeling this urgency for her to stay in bed and drink hot fluids and be by her side while she sleeps. I hope my parents don't get sick. I'd be hyper-vigilant crazy nurse daughter who drives all of the nurses nuts, because they didn't string the tubing "right".

We got an admit just before I left this morning. A woman had come to the emergency room unable to speak suddenly and showing all kinds of CNS symptoms. She's had history of cancer, but I'm not sure what kind. I don't know anything, but this looks to me like brain mets (metastatic tumors to the brain). I had a friend in high school whose mom died of brain tumors. That's what she looked like. They looked the same, even physically. Her family hadn't slept all night. This is the beginning for them, and it's starting out with no sleep.

Somebody asked me if it gets easier - easier to take care of people who are dying. I don't know yet. So far, it's only gotten more rewarding. I'm still okay. I'm still very okay. Not even depressed, I don't think. Doing good. Just learning. But I'm scared for Norwegian man. If he doesn't make it, I'm going to have to figure some stuff out.

Saturday, July 19, 2008

This is what I do.

So, yellow man died of alveolar hemorrhage at another hospital. I just found out at work today. Wife and kids. Young kids. Acute myelogenous leukemia. This is what leukemia does. It steals your life. That man was my first real patient. I shaved his head when chemo hit. I guess he's dead now.

I can't tell you how strange it all is. I can try, though. He was young (late thirties/early forties), really good looking, in good shape. Competent and strong-willed like a man should be.

The numbers become people. I talked about numbers earlier. But the trouble is, when I think about each of these room numbers, I remember a person in that room who died. 2 is yellow man. 6 is the woman who died when we turned her. That happens sometimes. When you turn a patient, sometimes it quickens death. 7 is yellower man whose room smelled like mint. We put mint menthol in the room, because his necrotic tissue was really strong smelling. 14 is beautiful man, the one that looked sicker than anyone I'd seen yet. His dog came to visit here. And he said that he had a lifetime high after showering with a nurse. Then there was Candy. She died recently, too, and her face is ever etched in my mind. She made me think about the Father's love for us. Because she was so helpless. She was a mess. And we cleaned her up over and over and over. And you just had to love her. You had compassion on her so easily. It wasn't hard to take good care of her.

A man had "exploratory surgery" today. That means they can't figure out what's going on, so they open you up to try to find out. He had a bowel obstruction; couldn't poop. It wouldn't resolve. When they opened him up, they found cancer. He was full of cancer. So they closed him back up again. Six months to live.

There's some sort of comfort about people grieving and everyone knowing why. I can't describe it. People are crying, and it's normal. Nobody's telling you that you shouldn't cry. They're just letting you grieve. They're just being there when you're grieving. They're hanging out and getting you what you need, no matter what it is. Even if it's your dog. That's what nurses here do. That's what I do. I take care of the things they forget to take care of. I watch out for their bodies. I watch out for their families. I touch their hands or their feet. I clean them up. I help them fall asleep. I help them breathe.

Monday, July 14, 2008

but i'm lois lane

I walked into a grocery store with a group of friends, and a little boy of about twelve or fourteen was standing in the door facing me directly. He held a gun pointed at me saying he'd shoot.
"Don't do that; you don't want to do that." My calm surprised me, almost as an observer, as I gently and easily walked toward him as though there was no danger between him and me.
I think I must've been between sleeping and being awake, because the dream has a couple of endings. The next thing I remember was holding his face in my hands and kissing him the way his mother or his grandma would and giving him the most tender hug you can imagine. And he started crying with shaking heaves. I remember thinking about how I didn't know him a second ago, but now I knew everything about him that was important. And that's all he wanted the whole time. I knew that he was desperately afraid. And I knew that he needed love. And I knew that he wanted to be heard and known. And I heard him, and I knew him.
The other ending was that I came toward him, and like one too brave for the moment swept away the gun, only to have the boy shot in his own foot before the gun was gotten away. And somehow, he was in the hospital with sepsis from this gunshot wound. And there was only one thing to do, because he was going to die. At this point, I was a guy. I don't know how or when that happened, but I was definitely a man. Maybe it's because subconsciously, I can't handle the idea of a girl walking alone in a city looking for a homeless guy. I walked and walked through the city, over bridges, and I asked for his dad. And I found him. He looked just like the homeless guy in The Ultimate Gift. And I told him that his son was dying and took him to his son. The nurse asked him if he was the father; there were decisions that needed to be made. And the man said, "I'm no more this boy's father than this guy is," pointing to me.

And that's all I remember. But later that day, the washing machine made a loud noise, and I remembered my dream. I hoped nobody'd been shot and that I wouldn't have to play the hero. But I was okay with having to. Afterall, I practiced this morning.

In other news, I wish I could take that man up there out for a beer and a nice meal. And I wish I could just switch to a man for certain occasions like in my dream. Then I definitely wouldn't get married. I could be my own protector like Superman. Don't mess with Clark Kent; that's all I have to say.


Yesterday, I read my friend's blog. Like, the whole thing. One time he said he always thought I looked like Cate Blanchett, but I saw her in Indiana Jones, and she was really good at being ugly.

But after reading his blog, I felt extensively writy. Everything that I did seemed like it would make a really good blog. I'm going to write the things that I remember now. I went to this store by the place where I work. It was a ritzy place with all sorts of aesthetic kitcheny things that you could just stare at. There was a battle there, because I might be rich someday. And I couldn't help but hope for it so I could have some kind of aesthetic kitchen.

It was beautiful when I saw it. Salt and pepper shaker and a butter dish with a nice little spreader. They looked like metal instruments - sleek and simple and new. Perfect for tinking. And when I say perfect, I mean perfect. I try not to use that word loosely, because I think it's very rare that perfect exists, if ever. But no one under the age of old could have helped themselves. I felt, at that moment, as though I was born to tink that piece of aesthetic kitchenware. And the sound. I have goosebumps; and I'm not even cold. Or worse, I'm not even kidding.

That's when a foghorn interrupted my kitchen music. "Can I help you." But it wasn't a question. It was a definite reprimand. "That is stainless, and if you keep doing that, you're going to scratch it." I think she asked me again because she wanted me to leave. "Can I help you with something." She glared at me. I wanted to walk up to her and stick my nose right up to her neck (because that's where it would've naturally gone) and yell, "No! I'm POOR!" (with a "p" that would've made her neck wet) and then stay in the store for a long time just to spite her. But I didn't.
I said, "No. I'm just looking." She probably thought, "No. You're tinking and you're ruining all of my aesthetic kitcheny things." I lingered for another moment and then strolled out like Meg Ryan would've, with my nose slightly in the air, but my step still playful. At least, I like to think Meg Ryan would've done it like that.

I wish he would've said that he's always thought I looked like Meg Ryan. But then I would've fallen madly in love with him, because he was tickling my ears. So I guess the femi-nazi in Indiana Jones does the job just fine.


I made a friend yesterday. I have another friend that says that I'm good at making friends. She says that I just sit by somebody and say, "Hey, I'm kt," and then we're friends for life. I think she's right; that's usually how it goes.

But anyways, my friend Joe is in the same program I am in at M. He works on the floor above me. He works in the ICU. So when my patients get too bad for us to take care of (which is really really bad), we send them to his floor. He sees death more. And yesterday, he talked about it a little bit. He had a code on his floor, and he had to do chest compressions on this lady, and the family was wailing in the background, cause she was in her early fifties. And she died.

And he was going to leave it at that. But I can't handle that. Because there's more to it. There's coping with death. There's going to work again. "How are you?"

He went on to say that the next day, he just stayed in his apartment the whole day long and didn't really move. He just watched a little tv, ate a little, just sat there thinking. He said work was a relief when it finally came. Something to do. C.S. Lewis says that work is one of the best things in life. I agree with that. I get depressed if I'm not moving. And work is one of the best ways to move, because you accomplish something.

I worked at a state park for a summer, and I loved it. I worked hard every day. I felt really strong by the end of the summer, and I had the meanest farmer's tan. And my work pants were really dirty. I worked in the mud and in the dry dirt on sweaty, hot days, so you would take a shower, and the tub would be black. You had to make sure you cleaned it out so mom wouldn't have to clean it up. And there were always black boogers, and you had to be careful when you cleaned out your ears so you didn't push the dirty further in.

Usually after work, that summer, I would go for a run. Almost everyday, and it didn't matter how hot it was. I'd get my shoes on, get my tunes, and run to EastWest and Three Cord Wonder, my favorite pure volume bands. I'd listen to music about loves gone all wrong or being in heaven or seeing His face or something else that stirred a fire in me and run and run. I got pretty good by the end of the summer, cause I ran with Katelyn, and she said it was a good run for her, too.

And I was with my best friends at work every day. And we laughed until we couldn't move and would complain about how we'd lost all muscle control cause we were laughing so hard. We were stupid girls sometimes, but it didn't matter.

I think that's part of the reason I want to go to the jungle. I want to work hard. I want to move well and be strong like I was that summer. Even stronger.

There was this one time that I blazed a trail at that state park. My boss just gave me a tri-blade and said, "I want it to go from here to there." And I did it. And he came back later and said, "That's the best trail I've ever seen." My dad even got to see it. And he said it was a good trail, too.

I felt pretty good. I'm a good trail-blazer. I felt like that when I crushed beaver dams, too. I got sent on that mission by myself a lot. It was way out in the boondocks. Just me and the beaver dam and my awesome tools. I liked going out there alone better than with one of the guys. Cause they would say things like, "There's no way we're gonna get any more of that dam." or "We did everything we could." I
never felt that way. That's usually how it goes when I have to quit something. If I just had one more hour. Just think of how much more awesome it would be. I always felt like that when I counseled at camp. I just wanted one more day with so and so. She would gain so much more in that one day.

I was on weekend maintenance, and I was the only one. So I would get there by myself and get to do whatever I wanted, mostly, which usually consisted of mowing or fixing things. Sometimes they were the things that I had broken earlier in the week and didn't tell anybody about. Sometimes my boss would even forget to make a list for me. But it didn't matter, because I usually finished the list in a couple hours anyway.

This one time, I was mowing on the weekday, and I ran into a sign, and it fell over. The 4x4 was rotten right at the base, so when I hit it (kind of hard), it broke. So I hid the top of the sign in the trees, and fixed it on the weekend. The sign was about a foot and a half shorter when I got done with it, which I still laugh about. But nobody ever noticed. At least they never said anything.

Sunday, July 13, 2008

my old lady

I took care of this old lady a little bit ago. It makes me chuckle just thinking about it - her tiny frame laden with wrinkles. She talked in this teeny tiny little voice like she was four years old. Just picture whatever four-year-old little girl you know in an old woman's body. The light in the bathroom was on, and she said to me, "You can just close the kitchen door." She was confused. But she was grateful. "Why are you so good to me?" she asked us.

I've been taking care of another old lady. She's extremely easy to please. She doesn't ever complain. And she has a bit of what people call a flat affect. She doesn't really have much expression, and she takes a long time to answer questions. When she does answer, it's a slow, simple answer, like a farmer's wife might give. A doctor said the other day that it seems as though she's in the beginning stages of dementia. I thought that sounded about right. Sometimes she's so sharp and cracks the driest jokes you ever heard. And they're hilarious. Other times, she can't really tell you what she wants, and says strange things.

That's all.

Saturday, July 12, 2008

a block party and Jesus

I woke up really sad today. Not really for a particular reason; I just had sad emotions in my blood or something.

So Heather and I went downtown and wandered around like we always do when we want something to do. We were looking for this block party where bands play, because she won a free ticket. They were $25, so I couldn't decide if it would be worth it to me. So we parked and found it. We wandered around for a minute or two wondering where the ticket booth was. It looked free. Sweet. The band was playing "La Bamba."

That's when I noticed that there was a lot of rainbow stuff around, and I was starting to get suspicious. Then, Heather saw Ken and Barbie floating in this fountain on a piece of styrofoam. "Look; it's Ken and Barbie. That's kinda cool." Then she noticed that it wasn't Ken and Barbie; it was Ken and Ken. Barbie and Barbie were on the other side.

Uh oh.

Just then, a lady walked up to us and asked us why we were laughing. Heather said, "Because it's such a good day." And the lady continued to ask us if we were interested in offering our resources to raise support for the democratic campaign. We declined politely.

So we wandered around gay pride booths and democratic politicians. I got a free banana. That was nice, cause I hadn't eaten yet.

Then we decided that we should find the block party, since that obviously wasn't it. When we found it, we decided it wasn't worth $25 dollars. So we sat in the grass for a few minutes listening. Some security guards were watching us. Later, we went back to that spot, and our section of grass was barricaded off. I guess it was too free.

We decided to go to St. Mary's where there was a piano. I played two songs I've written recently for Heather and we ate taco salad. Then we went home and took naps. I woke up feeling slightly elated. I had "Oooweeeooo, I look just like Buddy Holly; Oh oh, and you're Mary Tyler Moore. I don't care what they say about us anyway; I don't care about that," in my head by Weezer. My friend Thomas and I sang that song at the top of our lungs while playing Rockband once. Maybe twice.

I also went to church today - the one with the British guy. He talked about baptism, and he forgot to talk about Romans 6, which was the scripture chosen for his sermon. So I was disappointed. But it didn't really matter, because I danced with Jesus. And remembered that this whole thing is His deal. He's the Good Shepherd. I don't have to have everything figured out. I don't have to be in extreme turmoil about life. He's got it, and He's got me.

Trusting Jesus

Simply trusting every day,
Trusting through a stormy way;
Even when my faith is small,
Trusting Jesus, that is all.

Trusting as the moments fly,
Trusting as the days go by;
Trusting Him whate’er befall,
Trusting Jesus, that is all.

Brightly does His Spirit shine
Into this poor heart of mine;
While He leads I cannot fall;
Trusting Jesus, that is all.

Singing if my way is clear,
Praying if the path be drear;
If in danger for Him call;
Trusting Jesus, that is all.

I played this song the other day when I was playing a bunch of hymns. And I thought, "What in the world does that mean? I've lost all grips on 'simply trusting'." And I thought about it all day and probably all the next. Because it seems like all of my friends are in the same place with me - suddenly finding themselves lost in this whole faith thing - toppled over by science or rationality or reality. I'm starting to think that this is what becoming an adult is...transitioning out of that period of life where it is impossible for ideality to be unattainable and figuring out if it's worth it to hang onto child-like faith. Things just aren't as simple as they used to be.

Monday, July 07, 2008

pictures of new things.

These are the girls I work with.
This is the day the old man grunted
and said he thought he was on Deal or No Deal.

This is a picture of me and some fruit.

This is me walking underneath an arch.

This is me in front of a no parking sign.
I think this girl's name might be Megan.

This is outpatient chemo.

Here's a picture of me flying.

The people who founded the place I work lived here once.

This is a bell found at an outpatient cancer treatment unit. The day before, someone had rung the bell so hard that it fell off the wall. As you can see, it was promptly remounted.

Ring Out
Ring this bell
Three times well
The toll to clearly say

My treatments are done
Its course has run
And I am on my way


I've been corresponding through Facebook with a guy I never met about God and science. And it's perplexing. It's interesting. He's smart and articulate. Extremely so, actually.

It was all pretty ridiculous. There was this group on facebook that I was going to delete from my profile, cause it was a dumb group. But there was a post on there...something like, "Why all the standard religious arguments are wrong." And I read it. And it was full of creationism deflated, causation defeated, and a disquisition of other such things by way of lofty and scientific and excessive, even exhaustive language. I didn't understand a lot of it.

But for some reason, I replied to it anyway. About language. I talked about language. I talked to a physics major about language with the disclaimer that I was a nursing student. :| How his language wasn't attracting who he wanted to attract. How if he wanted to really wanted to find a Christian who made sense, he'd have to learn their language and then combat on that level. He thought that was intriguing for some reason.

Really, it was sort of a cop out, wasn't it?

No matter; the dialogue wore on. And it was revealed in our discussion my journey with this whole God thing. The questionings during my freshman year. And I said something like, "I had an advantage over you in my make because I knew where I'd end up in my journey from the beginning."

And he caught the paradox and threw up a large contradiction which took me time to hurdle, even in myself. He called it intellectual dishonesty. He said that knowing your end before you get there is deceiving yourself. It's not scientific. It's not honest. It cannot be trusted.

I thought about that for a long time. Because he was right. Sort of. If you're determined to find something, you'll probably find it, even if it's not there.

But there's another kind of honesty. And the reply to him containing words such as "reflexive" and "honesty" is where our conversation waits intrigued.

He calls himself an apatheist. That is, he is apathetic about theism. Doesn't really care one way or another. But I think it's obvious that's not true. And I told him that. Why the harangue of it then? He said it really was true. Eh...I care. I care a lot.

Here's something I found while creeping on Munificent's myspace.

Humans, therefore, are also in a constant state of flux. Viewing individuals or societies as separate and distinct is to ignore the infinities of interactions that proliferate and rebound upon one another, like a pebble cast upon the still surface of a pond. Once disturbed, the surface fluctuates chaotically in a geometrically increasing fashion, and will never die down. For the pebble is not the only entity acting upon this motion; Brownian Motion caused by particles within the pond itself serve to maintain an increasing state of chaos; minute whorls of air kiss the surface arbitrarily, serving to further increase the loss of order. And as the surface continues to fluctuate it interacts with the air above it, feeds the unpredictable motion of atmospheric particles as the pond evaporates and simultaneously cools its surroundings. And as this progressive ripple of entropic increase propagates, we find that it will never end; an immeasurable amount of other interactions, from other entities, serve to increase the number of events acting upon any individual objects towards infinity.


Three people died on my floor this weekend. I took care of all of them.

One was even yellower than yellow man. He was mustard colored. His liver stopped working completely. And his fingertips were black and hard - necrotic tissue. And they smelled awful. He was unresponsive, but was breathing through a trach on his own. His family took him off curative cares. It's called comfort cares. And he lived for five or six days after that. They had begun to wonder if they had made the right choice. He died on his wife's birthday just after my shift was over and before my next one started.

The other man was one I talked about before - the sickest man I ever met. You know, if you're in the medical field, you hear people say, "I could just tell when I saw him; it was cancer." or "I knew he wasn't going to make it. He had that look about him."

I get it now.

He made it home before he died. That was what they all wanted.

I didn't get attached to the other lady. It's a good thing, too, because hers was the first and only body I saw dead. I was in the room when she died. She was on comfort cares, too, but her family wasn't around when she died. They had gone out to eat. And didn't come back for a few hours after her death and didn't answer their phones. She had been seizing all day long, the nurses think. Her eyes were rolling back and forth, back and forth, slowly, slowly, all day long. She appeared to be in a lot of pain. And we went to clean her up, and it all happened so fast. Body processes I won't tell you about. I was amazed at the nurses I was working with. They were incredible. It happened at six pm, just before my shift's end at 7:30.

That morning, I had been teary-eyed. Everything I was doing was making me cry. So I took a minute. I thought that's all it would take, but when I got in the bathroom, I couldn't stop crying. I was beyond the point where I could wash my face and look normal. So this girl opened the bathroom door - she didn't know I was in there. And she was totally cool with the fact that I was crying so hard that I was hiccuping. And we talked about death. Cause she's a nursing aid on that floor. Has been for like...three years or something. And I was a little more composed until I went in the room of mustard man with my preceptor to clean him up. And we talked about death more. Death process. Death paperwork. Family coping. Personal coping. Still wanting to come to work, even though there are hard things. And how getting through this and coping with this job says a lot about a person. "If you can do this, you can do anything," she said.

I'm okay, really. Yeah, I think I'm okay.

PS: Sushi fell through.


I've had a conversation recently with a friend of mine. He said that being grateful changes depressed people to joyful ones. Well, at least he said it worked for him.

I just got done reading a girl's blog. I don't know her, but she commented on here once. Maybe she'll read this. She wrote "26 things I love about my husband." Cause he's turning 26, I guess. Then she got to 26, and realized she couldn't stop there. She wrote 101 more. I guess she couldn't make herself stop at 126 either. And then she said it would keep growing. I read about 60 of them and then thought to myself, "Wow, she
is a writer."

But, maybe if I was as happy as she was in her marriage, I would've done the same thing - even being less of a writer. I'll start with 21, since I'm 21 and turning -well, my nephew was born on my half birthday: June 25th - turning 21 and a half and in honor of my newly born nephew. Does he have a middle name yet?

21 (and a half) Things I am thankful for about my life right now.

1) Having a nicely furnished place to live at a really cheap price for the summer.
2) Getting to work in one of the most prestigious hospitals in the world.
3) Having a really great clinical coach who knows a lot and who doesn't hate me when I mess up.
4) Being able to talk to my mom a lot. She makes me feel better.
5) Being able to care tenderly for patients and families of patients who are dying.
6) Knowing what I'm going to wear to work in the morning, slapping it on, and being ready in 25 minutes.
7) Being able to go grocery shopping with my roommate and buy food.
8) Going to church and finding God.
9) Elisabeth Elliot's writings.
10) Friends who think and share their thoughts with me.
11) Heather Burnham, my roommate. I'm not just thankful for buying food with her. I'm thankful for her in general. She knows me pretty well - all of my quirks, and ridiculousness - and she still thinks I'm okay enough to hang out with.
12) Natural peanut butter and milk. and oreos, I guess.
13) This period of my life. It feels new.
14) Emma Katka. and Ruthie Lee. I haven't really talked to them in a long time. I just am thankful for them right now.
15) That the old lady that I meet with back in A-town and miss a lot - Ruth Miller - wrote me a letter.
16) John Steer, that British preacher who has faith and wisdom.
17) The old man that I took care of yesterday who said to me, "I'm so thankful for the way you girls care for me. Thank you so much for being so good to me."
18) Another old man I took care of this weekend who didn't appreciate the cares he was getting at all and got mad when I didn't prepare his bottom teeth just right. He made me appreciate the other guy a lot.
19) My floor at work. I floated yesterday to another floor. It was awful. Things weren't organized or stocked or documented well. Continuity of care was almost impossible with the way that things were set up. My floor rocks!
20) My preceptor who helped me to cope with death.
21) Life. Living and breathing easily and fingers that move and have blood flowing through them. Being able to run and feel the breeze. Reading and learning and being active. I'm thankful that I have life.
uhhh...21.5) Fire o th fou o Ju an th fri th ca t vis m.

Wednesday, July 02, 2008


Here is an unorganized something.

I had a root canal. The whole experience made me feel like a little kid who had just pooped his pants. I had this huge rubber thing attached to my face exposing one tooth. And I couldn't suck in my spit, so I was drooling all over. And I couldn't talk. I kind of grunted to the dentist lady so she could suction out my spit. On the ceiling, which I stared at for a good majority of the 90 minute visit, there appeared a chart about the acidity and sugar content of various beverages. "Sip All Day - Get Tooth Decay". Crafty. It was interesting for about seven minutes. Then I wished there was some kind of art up there.

As I was feeling exposed, awkward and abused, I started thinking about going home to bed. And how ugly I felt. And then I started thinking about my roommates. They were going to go to the cities and help out their youth group. And I could ride along if I found a place to stay. Earlier, I had called my friend Matt, whom I barely know. "If I happened to come to the cities tomorrow, would I have a place to stay?" He figured he could work something out. But by this time, I was thinking, "I don't want to go. I want to go to bed."

And that's when I realized that if I went to bed, I would feel depressed all day long. And even though I didn't really know what would happen if I went to the cities, I figured it would be better than being depressed, so I hung out with Matt and his grandma in her big, old and wonderful house. And I laughed so hard I peed my pants a little.

In other news, yellow man might have cancer around his liver. He's not really that yellow anymore, though. He looks pretty good actually. Last week, I saw a man sicker than I've ever seen anybody. It was eerie. Cancer sucks. It hit me.

I met someone with what's called pure red cell aplasia (aplasia = no growth) a long time ago. This part has been a long time coming. He said that at the time of his diagnosis, sometime in 2007, I think, there had not existed 100 people diagnosed with his disease. It is that rare, and that poorly researched. And he was in a clinical study in order to test the efficacy of new drugs on his condition. It's a type of anemia (you could say anemia means low/ineffective red blood cells) related to the depletion of erythroblasts (the cells that make the red blood cells). A lot of times, when people have anemia, it's because something is killing their red cells or because their red cells aren't working right. This condition was different, because the problem was up higher, you might say, in the process of the formation of the cells.

I feel like life is coming around again. I catch myself smiling for no reason. And I like that. Also, I find myself telling the same stories over and over again, and asking the people around me, "Did I tell you this?" because I can't remember who I told and who I didn't. In fact, I was just going to write something about already mentioning red cell aplasia. I feel like I did.

After all was said and done, the dentist cost $600. But my tooth doesn't hurt anymore. So I guess someone would say that it was worth it. I haven't decided yet. I think dentistry would be a horrible job. Nurses make people feel better. Dentists make people feel worse. Doctors do too, sometimes, but for the most part, the people aren't awake during the worst stuff. It's not fun to feel your head vibrate as a drill goes into your tooth and feel the spatterings of tooth and smell the drill smell. At one point, my bottom eyelid went numb. That was a weird feeling. I'm glad I'm not a dentist.

I'm going to eat Sushi with a band called Bread of Stone today. Yeah...I'm that cool.

Munificent wrote to me. Did I ever tell these people about Munificent? I guess I'll have to save that for a later post, because at the moment, I'm using someone else's computer in someone else's house as I wash my clothes (and someone else's clothes) in someone else's washer and dryer. My friends let me use their house even though they're not here. I thought that was really nice. And I'm eating their popcorn. Truly, does life get better than this?

Tuesday, June 17, 2008

By Request

I was just asked today to "post some more cool medical stuff on your blog". I have intended to do this for a while, but tonight offers me the chance to do it. I am staying up late tonight in order to prepare for tomorrow's night shift. I was told that I should try to stay up late tonight, get up early in the morning, then take a long afternoon nap before my night shift. It was one of a couple of different suggestions, and I'm excited about it, because I love afternoon naps. Maybe this night thing will work out for me.

I need to set something straight. I completely messed up on graft vs host disease when I mentioned it earlier. I said that the body launches an attack against the graft. That's not true. It's the other way around, and I can't believe I missed this obvious thing. Stinking faulty memory.

Anyway, the transplant attacks the body. There's a couple of different ways to do bone marrow transplants. Autologous means that the patient donates his own bone marrow. It is freezed. His own bone marrow is destroyed through chemo treatments, and then his preserved bone marrow is re-introduced into his body. This type of transplant poses no risk for graft vs. host disease (GVHD), because the cells in the transplant are already accustomed to the cells in the patient's body. In fact, they are the cells from the patient's body. Allogeneic transplant means that someone else donated their bone marrow for the patient. Often, the donor is a close relative. This type of transplant involves the possibility of developing graft vs. host disease.

I met a woman last week who had just begun to develop GVHD. Instead of having a completely red body from head to toe, she only had slightly reddened fingertips. The soles of her feet were also red. She had not yet complained of any itching or other related complications. The nurses still seemed to react more sympathetically to this sign than the patient could understand. I think it's because the nurses know too well the path down which these symptoms suggest this patient will go.

Also, that one patient that was yellow...they did some liver function tests. His bilirubin was, indeed high, as manifested by yellowish skin. Also, his liver function was at less than optimal which explains his jaundice. I felt pretty good about this predictive observation. My nursing assessment skills are slowly coming around.

I also came across a rare skin disorder called calciphylaxis. It seems as though the process of this disease is poorly understood, but it involves the calcification of the skin. In this patient, as is typical, her condition presented with late stage renal failure, probably related to the kidneys' inability to filter out excess calcium. The significant thing about this disease is the necrosis of the skin. "Νεκρος" is Grecian for "dead". When cells die, that's usually not a good thing. In body tissues, necrotic tissue turns black. This patient had 3-4 inch patches of black tissue on the surface of her skin. This is an ominous sign, because it represents the beginning of calcification on her skin. Spots that had started that way have now progressed to 1-2 inch deep wounds five inches in diameter all around her trunk. I was amazed to find that she had only begun to recognize signs of this disease about a month ago. It has already progressed to form significant necrotic craters on her body. These wounds refuse to heal and will eventually cause her death. The patient was experiencing enormous amounts of pain due to her abundant open sores. Somewhere I read that she has a 45% chance of making it for a year and 35% chance of making it five years.

Treatment: pain medications, dressing changes and wound care, dialysis (which is basically a huge kidney; a patient's blood is filtered through a machine).

If you are grossed out easily (Allison), don't read this paragraph. Her wounds are treated with dressings saturated in acetic acid. That's the stuff that makes vinegar smell bad. Another option for treatment of this condition involves maggots - yes, maggots. The maggot larvae eat up all the bad stuff in a wound and leave the living tissue. This patient wasn't undergoing that treatment, which I was glad about.

This patient was, however, being transported to a "hyperbaric chamber" which involves exposure to oxygen at a high pressure, a much more appetizing treatment. I thought at first that "hyperbaric" related to a high amount of fat. "Baryophobia" is a relatively newly defined eating disorder type condition in which a patient is afraid of becoming heavy. Also "bariatric" relates to obese patients. However, the root is Greek again, "βαρο-": weight. It relates more accurately to pressure. So, hyperbaric oxygen therapy relates to exposure to pressurized oxygen.

I had my first reporting off experience sometime last week. At the shift's change, each nurse records significant information on each of her patients for the nurse who will take them. Hearing report everyday is a continual reminder that each profession has its own language. There are so many acronyms on these reports. I've heard a lot of people refer to this phenomenon as B language, but it reminds me of the military. There are also random numbers thrown around like confetti. However, even with my limited knowledge, I'm able to decipher what most things are, and my unlimited M resources help me with the rest.

RMG - something metered glucose, aka: blood sugar
UCI'd - urinary catheter indwelling, aka: patient has a foley

During these reports, I kept hearing the nurses say "rie-ghers". I knew that it was something that happened during a neutropenic fever by context (neutropenic fever is when a patient who is low in neutrophils, a type of white blood cells, gets a fever. This is a big deal, because it is a sign of an infection which the patient is ill-equipped to fight), but other than that, I was a bit puzzled. "Rie-ghers" is spelled rigors. "Oh! 'rhig-ers!" I exclaimed to my nurse. I know what those are - the shake that accompanies a chill.

In other news:
I went to the dentist. They took an x-ray and told me, "Yeah, you definitely have an abscess in there." So I'll need a root canal. I'm scheduled for next Thursday.
I got paid today. Woot.
I signed up for that healthy living place. I did a couple of aerobics type classes. One was called Zumba and I followed an African American trainer in some crazy dance movies. At one point, she said, "Now show me your shimmy. You just move your shoulders and let your accessories follow."
I am self-proclaimed "less than dumb" nowadays at getting around this place I call a city.
I found out that I have some camp friends that live here. I'll probably meet up with them sometime this week.

Frederick M. Lehman: The Love of God

  1. The love of God is greater far
    Than tongue or pen can ever tell;
    It goes beyond the highest star,
    And reaches to the lowest hell;
    The guilty pair, bowed down with care,
    God gave His Son to win;
    His erring child He reconciled,
    And pardoned from his sin.
    • Refrain:
      Oh, love of God, how rich and pure!
      How measureless and strong!
      It shall forevermore endure—
      The saints’ and angels’ song.
  2. When hoary time shall pass away,
    And earthly thrones and kingdoms fall,
    When men who here refuse to pray,
    On rocks and hills and mountains call,
    God’s love so sure, shall still endure,
    All measureless and strong;
    Redeeming grace to Adam’s race—
    The saints’ and angels’ song.
  3. Could we with ink the ocean fill,
    And were the skies of parchment made,
    Were every stalk on earth a quill,
    And every man a scribe by trade;
    To write the love of God above
    Would drain the ocean dry;
    Nor could the scroll contain the whole,
    Though stretched from sky to sky.

Some more CS

"Not that I am in much danger of ceasing to believe in God. The real danger is of coming to believe such dreadful things about Him." -A Grief Observed

He is certainly different from what I thought He was, but the reality of Him makes me love Him more. He's real and tragic and He's not so cut and dried.

Dynamic. This word kept occurring when I first started in nursing. Everything seemed to be described as dynamic.


adj. also dy·nam·i·cal (-ĭ-kəl)
    1. Of or relating to energy or to objects in motion.
    2. Of or relating to the study of dynamics.
  1. Characterized by continuous change, activity, or progress: a dynamic market.
  2. Marked by intensity and vigor; forceful. See Synonyms at active.
  3. Of or relating to variation of intensity, as in musical sound.
He's dynamic. Ever personal. And that's important, because we're persons. And as persons, time is constantly changing us. and so while He is unchanging Himself, His goings about with us are ever changing:

He is disciplining Father. He is tender abiding presence. He is articulate and clear. He is a voice waiting in silence. He is ever ready for the moment at hand. He is strong and displays that He doesn't
have to be present, that we might be melted that He is. He is the lion and He is the lamb.

"dontcha be doin that cheerch hop"

A little bit ago, I wrote this:

This weekend I went to a couple of church services. One was bad news. But the Saturday night service was beautiful. C. John Steer, a British man from the Spurgeon Seminary in Great Britain spoke at a Saturday night, college-oriented service. He spoke on the end of John 12. Verses 20-36.

"We would see Jesus." - gutsy Greeks which Jesus responded by speaking about His death and the agony thereof. His sermon touched my heart in a tender place. Jesus let them see Him, but He showed them a specific part of Himself. He showed them His agony and death.

Do you see, O little one? Do you see what the cross is? Do you see the bitter agony of separation? This is the cross. I have shown you the cross. Do you see? Do you see Me? You want to see me, but do you see Me? This agony, this terror, this difficulty of soul - do you see? This is My story of beauty. There is nothing so beautiful - this terrible story.

This man presented another thing - something about faith. He claimed that the people that lived then didn't hear God's voice for one reason: they were not expecting it. He said, 'If you don't believe something happens, you have to have an explanation for it when it does happen,' and 'God speaks and we miss it.' I have thought about this so many times. Whenever somebody articulates something I have been thinking about for a long time, I feel a deep sense of relief that somebody else is on the same page, that somebody else thinks those thoughts.

I keep thinking about this verse in Matthew. 13:58 "And he did not do many miracles there because of their lack of faith." This verse, and a few like it seem to be proof that the people's lack of faith have a direct role in the amount of miracles Jesus performs.

The second sermon seemed almost to be a perfect rebuttal of this british man's eloquent, faith-filled words. Sunday morning, I walked into a big church - lots of full pews. My particular pew was packed, and I wished for a little more elbow room. The music started and was upbeat and cheesy and had too much treble. There must be a place for this, but it's not my personal preference. I couldn't help but laugh out loud while thinking about the synchronicity of this music, Kathy Trocolli, and my friend Zach Backstrom from camp's clapping dance. We even sang a song we did for closing ceremony at camp. Classical.

Then the preacher came out and began his discourse on prayer. His point was that it's difficult to pray, because we think it doesn't really matter - God's going to do what He wants anyway. And when we pray, we don't get what we want. Then he went on to define and explain six reasons we should pray anyway. I don't think he really believed most of them - not deep down - and it came through in his preaching.

I found myself watching random screenplays in my mind: I punched this man's medium sized belly, and he puked out all his unbelief. I threw tomatoes at him, and upon impact, they exploded all over him. I went through a vast array of options for ammunition that would allow for "splat". Pumpkin guts were my personal favorite. I think I should become a millionaire by inventing a super soaker that spews out pumpkin gutbombs. I could call it Gut Pumper. Or Putt Gumper.

I wanted to give him a good talking to, and my finger would shake at him, and I would whip out my best black talk, "Boy, you gotta believe! You gotta have faith! And you gotta get out of spoiled America!"

He told a story of obvious miraculous healing. Actually, I think it was a situation in which a missionary in a foreign country brought another missionary (who just happened to be dead) back to life. His response was, "I don't know what to do with that. I certainly never expect to ever hear a story like that in my life again."

And perhaps that is the very reason he won't.