beached

It's been a perfect day here, the kind that makes me want to go jump in the lake. So my roomie and I scoped out a county park with sand and sun and water. it was perfect. and while I was mulling over Elizabeth Elliot's words about her early missionary experiences with the Colorado indians, I heard a strange thing a few yards away. A big hispanic man in a hawaiian button-up put some plugs in his ears and began to serenade his beer at a picnic table. Intermittently, he would let out an elated, whiny sort of chuckle.

"I can't get through a page." My roomie had a tough time letting our live music remain in the background when a man fully decked out in a black wet suit with a huge white scorpion on his significant belly came into our view saying to his woo-ee, "Anytime I see water, I just want to get all decked out in a wet suit and jump in." Throughout our stay, he continued to woo his special friend with replaying of his latest video game victories. He laid on his side with his head propped up on one hand - feet in the water, head out, wooing her.

It was very Napoleon.

"I keep thinking of deer." My roomie was referring to our latest encounter with the security guard here at Evanston who told us that we need to drive really slowly right by the speed bump, because deer like to run out of the woods, "And if one of those hits your car, boy, yoo knoh, it's totaled." He sort of looks like a worn-out version of Nicolas Cage. He's got his hip shades. I think they're stolen from the fresh prince of Bel-Air himself.

Oh, the people.

excerpts of thought

"Reality, looked at steadily, is unbearable."
-C.S. Lewis; A Grief Observed

I'm so glad Lewis said that, because it's an exact articulation at what I've been thinking about a lot lately - the idea that true idealists have no chance of being happy unless they set their hope on Someday.

I find myself staring at the women doctors here. There's this one that is extremely gorgeous. Foreign, and has the most beautiful accent. The medical terminology just sort of rumbles beautifully out of her. I'd like to stare at her a lot. And then become her.

But I don't know about this doctor thing. Intellect doesn't usually work out so well for me. It gets me all screwed up. It seems like when I try to use it primarily, I just end up with more questions. No answers. And instead of finding out answers to answerable questions, I try to find answers to the questions that can't be answered intellectually.

I have been thinking lately about timelessness. That has a lot of significance, especially in the realm of the whole predestination/election thing. the absence of causality has huge significance. I just think there's no way we can comprehend fully not being bound by time...things not causing each other...there not being an existence of "before that, this." There is no before. There only is. and not even that, because our comprehension of is, means it's not was or will be. Even more baffling than timelessness is the concept of timelessness and timeness intermingling with one another. How can this be? So maybe it's not that God chooses us, and then we follow Him, and it's not that we respond to Him and then He presents Himself to us, maybe there's much more of a timelessness factor in the whole thing, even in our responses, that we can't understand, because we can't know how our actions and lives are judged and recorded in a world with no time. who are we really? well, in a world of no time, we are all that we ever were, all that we are, and all that we ever will be all at the same time. and we are doing all that we ever did, all that we are doing, and all that we will ever do all at the same time.
This changes my ideas drastically about election and predestination. it makes the debate obsolete in my mind. Does God elect people? And if He does, on what basis?
I can't know. But it has something to do with the enigma of "fair" and "timeless", two things that don't exist in our realm of understanding.

I've also been thinking about the relativity of adjectives. In my world of nursing students at PC, I'm pretty smart. But here, I feel dumb because I am dumb. All these words are relative. Size. Dumb, smart, knowledgeable, rich... How can words like that even exist alone? They don't mean anything by themselves. How the unseen powers must jeer at our evidence of pride by semantics. We know nothing of rich.

And how experiences define words. You thought someone was smart, but then you experienced someone smarter, and you look back, and you think the first person wasn't actually smart. You just thought they were smart. But now that you have a clearer picture of what smart is, the first person and "smart" don't mix.

This is why we have comparatives and superlatives.

all the colors of the rainbow.

Last day of the week today, and I'm whipped. My day on the floor was mixed with treasured moments and sleep. I didn't try to sleep, but powerpoints on policies and early mornings add up to sleepy afternoons.

I shaved a man's head today. He had a beautiful head of fine, brown, curly hair that was performing its last act by falling out in huge clumps from his scalp. No more. Crazy how life is, huh? Here is this head hauncho of some big corporation with a bald head and a raging infection in his lungs with no white blood cells to fight it. Struggling to breathe at times.

I guess he was crabby last night, giving the night nurse a rough time of it. I was surprised, because I've enjoyed working with him a lot. The nurse said something like, "You can tell he's in charge of a lot of things outside of here," he's flailing to grab control back. He was being really adamant about having his water by his bedside. Sometimes you have to fight for control, even if it's of your water.

I met a lady today named Tudy, and I thought that was weird. But she was nice.

His eyes were yellow, and I need to find out why. Lab hadn't done a liver function test. The liver takes care of bilirubin which is a byproduct of broken down red blood cells. Let's see... I think the liver "conjugates" it. Don't ask me what that means. I'm not saying that I know or that I don't know. I'm just telling you not to ask me. The liver turns it into bile, the stuff that makes your poop green.

So is he breaking down too many red blood cells due to fever? Does he have some sort of autoimmune thing going on? Is his liver not working? Is he just yellow because there's so little hemoglobin?

Another lady was red. I've never seen somebody so red. Graft versus host, I guess. That's what my nurse said. Sometimes when people get a bone marrow transplant, their body rejects it. They call it graft versus host. I guess it can turn your skin red and leathery. She's dying, but it sounds like she's been dying for a long time. She was just made a DNR today. Do not resuscitate.

In other news, I called the dentist yesterday. He said I have an abscess and will need a root canal or my porcelain cap is detaching and I'll need a new cap. Either way, he said I should just see a dentist here. And today, I met this lady who goes to a place where there's a bunch of dentists in an office. She said I could probably get in this week. Sweet. tooth.

Tooth is a weird word.

My shoulder is peeling. I picked rocks for eight hours in the sun one day, and I wore really good sunscreen. Except I missed a spot, and now that spot is peeling. Just one shoulder, and one spot on my shoulder. There's even a slight pale hand print where the sunscreen went.

I find myself longing so much for someone with whom I can talk about deep things in person. I miss Ruth. I just want to connect with someone, and so often, I think that the Lord isn't enough. How ridiculous. Isn't there a song about "more than enough". How slow I am.

still numbers here

It was my first day on the floor. I met my clinical coach with whom I will be working most closely throughout the summer. Today she was charge nurse. On a full unit at M, the charge nurse has a lot of responsibility, so I wandered around on the computer system researching various topics on the intranet for a large portion of the shift. I've been annoyed with all of the people spelling internet wrong. It just so happens that if they were to spell internet correctly, it would be wrong. This system is one that can only be used within M, thus intranet. It contains incredible amounts of information including research studies, definitions, disease processes, and drugs. We're encouraged to use this system for all our cares, especially as it pertains to drug usage, so that things are standardized within m. I also did some of my preliminary paperwork - a necessary evil.

I did get to care for a couple of patients, though. One had a rare disease called carcinoid syndrome. He had tumors in various places in his liver and abdomen, but his organs were functioning well. His main problem was the overproduction of a certain hormone which is a vasodilator. When your blood vessels dilate, a few things happen. This patient had a flushed face and palms. One of the most important manifestations of vasodilation is decreased blood pressure. His blood vessels were dilating so much that he had spells of extreme hypotension and experienced fainting spells.

His wife had nursing background, so after I told them that they were my first patients at M, she opened up a little bit. People are always making exclamations about how wonderful it is here. She went on about her husband's rare disease saying, "Put it in your stuff," meaning that I should make some print-offs about the disease and put it with my study materials.

His rare disease seems to be on the brink of treatment discovery. At the time of his diagnosis (within the last ten or so years), it was estimated that 1 in 400,000 had the disease and there were no drugs with which it could be treated. Now, he has been taking Sandostatin to curb his symptoms and to prevent what is called carcinoid crisis. The disease is now estimated to occur in 1 in 100,000. This man is scheduled this month to be part of a clinical trial to test new drugs for his disease under M's advice.

There are studies going on in every corner at M. In fact, because of a study that took place (during the eighties?) when my building was being built, there are no corners on my unit. Scientists wanted to see if straight corridors were better for nursing practice than a round unit. Although there are only twelve beds, there is no room one and no room thirteen, so my unit has twelve patient rooms numbered 2-14 surrounding the nursing station like cogs in a gear. I was told that there is no room thirteen in the entire M complex.

I was also told to take vitals in seven. It occurred to me that even though this is M, and everything pivots around individualized patient care, the patients are still called room numbers sometimes. I'm not sad about that. I think it's a coping mechanism. They have to be numbers sometimes.

Today after work, I wandered around for a little while waiting for a meeting to start. I was looking for a piano, and I found one being played by a man in a black suit. His tune was familiar, one of my favorites, in fact, Prelude in C# Minor by Rachmaninov. Incredible. I wandered around some more and found another piano just in time to be beat to it by a girl carrying her music with her. Oh well; there will be many more days.

I went to my meeting which was an orientation-type meeting to the health and wellness facility here. I was flabberghasted at all of the services offered for 75 bucks. That's all I'd pay for the full summer. If I was staying longer, my fee would be smaller, but since I'm temporary, I can't get the best deal. I have to mull over it for a couple of days, simply because it's nice outside. Everything is state of the art, though, and the services that come with membership are incredible. One of the services mentioned involved similar features to a twelve-week program that cost $300-600 at the local Y back home. Their slogan is something like, "healthy employees, healthy community, healthy world." They're hoping to start something worldwide right here that becomes an obsession: healthy living. The founder invented slim fast and donated 30 million or something crazy like that for this place.

I learned about a drug today that was taken by a patient undergoing what was called "aggressive salvage chemotherapy." I'm sure you can guess by the title that his chemo treatments didn't work the first time, so this patient and his doc opted to hit it harder with a second round.

My fake tooth is bothering me more and more each day. I find the pain to be about a 1 or 2 on a scale from one to ten, but my anxiety about it at a 6 or 7. I decided today that I will call my dentist's office and ask for his email address. I think that will be the best way to contact him.

My clinical instructor is great. She thinks out loud a lot; perhaps it is only for my sake. This might be the thing about her that I most appreciate thus far. I think I'll follow suit. I read a patient's profile today that mentioned something called "numb chin". "Numb chin, numb chin, numb chin," I repeated and started to laugh. She said something about a Chinese dish which I thought was funny. This symptom isn't funny, though. It's considered ominous. It has to do with the mental nerve. Maybe we're the ones going mental. The profile mentioned a couple of symptoms including the above mentioned numb chin and bilateral knee pain. The doctor explained how "of course" mental and/or meningeal involvement was suspected.

Of course.

Maybe someday, I'll look at symptoms like numb chin and bilateral knee pain and express something about it with the words "of course" attached. Anyways, I dove into my unending M resources. Maybe I'll get swallowed up by all of the information before I reach "of course".

Another day at M

Today, I ate breakfast with a bunch of people from Indiana. Then I took an extremely boring computer class. I wandered around a huge cafeteria for a while trying to figure out how to get and pay for the food I wanted. Here at M, there are separate cafeterias for patients/visitors and employees. Today, I found out that there are 30,000 employees here. That's more people than live in my home town and my college town combined.

In the afternoon, we toured the whole facility. Two separate huge campuses separated by several blocks. There's something people call a "subway" system underneath the buildings on each campus here, but the only thing subway about it is that it's underground. It looks like an airport, really, with long corridors decorated with extravagant art and architecture and specialty shops and food places all along the hallways on either side. Here at M, you can get and do almost anything you would need. There's a post office, a credit union, a barber/beauty shop, all kinds of clothing/gift shops, education centers, and libraries up to wazoo. Today, our nursing educator specialist told us that when she was in this program, she called her mom to tell her, "They have the world's largest nursing library here." I don't think I'll be calling my mom about that particular piece of information; each to their own.

I toured with the seven girls that are located on our sister units and the other two girls who are on my unit with me. We're referred to as "heme-onk, BMT", and I think it's fitting that this town has Canadian geese everywhere we look. "heme-onk" sounds like a sound one of them might make. Out of the 140 student nurses here, I have heard that thirteen are boys, and there are none on my unit. One of the patients - we'll call him grampa - in a waiting room of one of the units saw us all walking past on our tour. He made some grunting noises and then said something like, "Well, I thought I was on 'Deal or No Deal' for a minute." I did kind of feel like I was on the bachelor or something with all of these twenty-something girls dressed up with heels. I wore tennis shoes with my dress pants today, because I'm cool like that.

One of the girls in from Georgia kept taking pictures of everything. She said, "Yes, I'm going to be obnoxious like this all sumer long." After someone said, "That's why you have a memory," she pointed to her camera and said, "This is my memory," and then added in her very Georgia accent, "Mih who' fayemlee's gotta saee this." She says she's going to post them on Facebook, so I'll put them on here once I get them.

Today, I learned that this hospital was founded by the sisters of St. Francis of Assissi. I just read about him in A-town when I went to the library last week. The book talked about his early 1800's, I think, pre-conversion, extravagant life living like a rich guy, though his family was poor. Somehow, he had a lot of money and was intent on becoming a knight. He partied a lot and was always ridiculously generous to all of his money-wasting friends. Then, some point along the way, he asked a beggar to switch clothes with him and just stayed as a beggar - choosing to be poor, though he had been living an extravagant life. I don't know what happened after that, but it must have been significant, because he became a saint, and the people at M closely associate themselves with his lifestyle and values.

There is art on the ceiling in the children's hospital. One scene depicted a painted, blue pond with sculptures of duck and hippo legs hanging down. When a little one who is sick in bed is wheeled down the hallway, she sees this colorful curious-looking pond scene.

There is a bell in the waiting area of the radiation therapy clinic that patients ring to signify that they have just completed their radiation treatment series. Our nursing educator specialist said that someone had rung it so hard the day before that it fell off the wall and had to be remounted.
Things I have learned by default:
"Atrium" means there's glass windows somewhere.
When you want a panini for lunch, you have "go out there and through that other door."
There are beautiful, random grand pianos everywhere, and they are not off limits.
"Cold" is relative to where you grew up. So is "big".
There is no shortage of goosebump inducing sights or experiences here.

More later. Time to go out on the town.

Today was my first day at B. "Welcome to B," everyone kept saying over and over today. Sometimes it gave me goosebumps the way they said it.

It feels like it was actually a couple of days; we took in so much information and saw a lot of new sites. It's going to take a couple of days to get oriented, I think. There are a lot of firsts for me here. We'll take the city bus to and from work each day.

We've been treated like queens so far. People treat us as though we're something special and talk about the great opportunity we have to learn in a setting which strives to provide "the best nursing care in the world".

Today, the man who welcomed us read one of the applicants' essays about why we want to be at B. I could have sworn it was mine, and I think my face was getting red, but at the end of the story, it was revealed that it was his own essay from a number of years ago. Many of the people in charge of our orientation process have been in the program I'm in, and chose to stay with B through their years. He kept saying during his speech, "You were meant to be here."

I found out today that 140 applicants were chosen of 600. The chosen ones are from all over the United States here. It's kind of exciting to meet so many new people. I feel like I'm at a state sports competition with the way we've been treated and all the hype about us being so extraordinary.

I learned today that my unit for this summer is hematology/oncology, aka: "heme-onk", and BMT which stands for blood and marrow transplant (not bone marrow transplant like I thought). It's an overflow unit, so instead of only seeing oncology patients or hematology patients or BMT patients (each of those are considered our "sister units"), I get to see all three during my shifts. I was told that 60% will be hematology patients, 20% onc, 20% BMT.

We have quite a few people over us this summer, a nursing manager (who oversees all of the nursing goings about on the unit), a nursing educator specialist, and a clinical coach (under whom we will work directly during all patient-cares). I haven't met my clinical coach yet, but the other two people are nurses with whom I felt very comfortable. They were approachable and knowledgeable. I feel very relieved! I think that when things come up this summer that I need help with, I'll be able to address these people confidently and comfortably. My nursing manager played on a volleyball team with Miss Volleyball from my home town. Small world.

There are two girls in the same boat that I am on my unit. One is from Boston. She's going to school in DC at the Catholic School of America. The other grew up in Montana on a ranch "with cows, horses, sheep... all that jazz". Pretty opposite posts in the world. The one from Montana kept on saying, "Oh! I didn't know it would be this big of a deal. Wow. This is really big. Wow. This is really nice," all day long. It was funny to me. She also said that she applied for the position because that's what everyone else was doing, and didn't really know what was going on when she got accepted. I kept thinking, "You're in for a ride." She's small and blond and reminded me a lot of a girl I know from Maryland. Every time the girl from Boston was asked a question, it sounded like she was reading off her resume or answering a question for a beauty pageant about world peace. When asked about her hobbies, I think she said, "My involvement in the campus ministries at my school is a very important part of my life." She's very tall and red-headed and has a kind of loud presence about her. She was dressed like a city girl. I love this taste of diversity.

I'm pretty excited to be part of something that is so much bigger than myself. It's been easy lately to get wrapped up in the all of the things in my daily life and I feel like this is a chance to get out of myself. I feel small, and really big at the same time. Small compared to what's going on here - just a tiny piece of the B world. 6500 people on nursing staff, I think they said today. Big - I feel like a little bit of a big deal with the way they are treating us. It seems as though it's really just such a prestigious place that the people on the top serve the people on the bottom (me).

The people on our unit, especially our nursing manager, seemed extremely excited for us to come on board. She said that our arrival signifies the beginning of summer for them. She also said that all of the staff really feed off of our excitement and enthusiasm - that our arrival is a breath of fresh air for all of the employees.

Wow.

Really?

I haven't seen all of the facilities yet. But all of the ones I have seen are gorgeous. There is beautiful artwork and architecture everywhere. There are grand pianos just sitting around, and people just play them at any random time. I played one today while waiting for my roommate to finish her orientation process. It was a beautiful piano, and it was really nice to sit down and play in this huge hall.

Anyways, like I said, this is a pretty sweet deal - away from my normal life. Bigger than normal life. Bigger than feeling so sad about certain life situations. This is something outside of my personal life, and it's refreshing.

Our living arrangements are really great. the furnishings are nice, and a lot of people have said that they've just done some remodeling. Out by the dumpster, there's about twenty couches and other pieces of old-looking, shoddy furniture. Ours look very new and cozy and comfortable. I just got all of my stuff settled into my room tonight, and it's pretty much perfect. Just right for ten weeks of living.

conversing

i had a few conversations today, a painful one, one that brought me joy, and one in between.

the painful one: there is something between the us that conversed today - something keeping us apart that is big and impassible. time has passed, and a few conversations have happened, but both have left the degree of feelings undiminished; they haven't changed any of the pain. i cried throughout most of it. i confessed something i could not leave unsaid. i don't like being around this person, because looking at the impassible something between us hurts my eyes. it makes them water in pain. it is too real a reminder of what was and what is no longer.

the next was one with a girl who is my age and is going to get married at the end of the summer. we connect, and it is always fun to catch up with her. we are at very different places in our lives right now, but God is her keeper and mine. In other news, I'm glad I'm not getting married right now. Life seems so bleak there to me right now.

she talked about trying to figure out how to make a relationship work. and it stirred up in me thoughts along those lines. it's hard to make a relationship work. and the wonder is, "why do it, then?" but there's an urgency. there's something bigger than you sometimes pulling you toward someone, and it's unnatural to resist. it subsides with marriage, but hopefully doesn't go away after that. it's such a strange thing. two people who don't think the same or have the same communication or thought patterns end up together.

part of me thinks people should get married young. part of me hates that idea. people should get married young, because desires are so strong; it saves sin. but maybe it just saves it for later when you grow far away from one another and when your heart for the other is lost in time and lack of resources.

i'm glad she's getting married. she wants to be a mom. and her 'career' may be swallowed up by 'mom', but she's okay with that. I think it's likely that her aspirations for life have been wife and mom. I'm happy for her.

Only, I'm not there. i don't want to be swallowed up by wife or mom.

the other conversation lasted longer than both of the others. it was said, "i don't think you should 'end up' with anyone. it should be something you pursue with all your heart to the very last moment of your life."

that statement is a bit of a revelation for me. it makes those elusive next steps clear again. they become foggy so easily.