Monday, December 31, 2007

From these humble beginnings...
Came these...
and these...a deserving group of doctors, nurses, and EMTs got to knosh on still warm doughnuts we fried up on new years. Happy New Years to all ER workers! You deserve the best!

Thursday, December 20, 2007

Check out my buns!


Check out my beautiful french buns! As you know, it's been raining in LA and I have felt the need for coziness. So I needed to bake! I found a recipe for french buns that didn't take four days to make (although they may have been better if they had). These beautiful buns are the result. I got the recipe from "The Practical Encyclopedia of Baking". Sounds boring but has some wonderful recipes. Baking is just like cooking. You need to try it out one time, then tweak the recipe for your own taste.

The recipe said to put a "roasting pan" in the oven and then preheat to 450 degrees. It then said to add a cup of water to the roasting pan when I am ready to put the buns in the oven. I asked Noah to help me and gave him the job of pouring the water in the roasting pan. As soon as he started pouring in the water, the glass Pyrex shattered into a thousand pieces! Holy shit! We were both standing in the line of fire and I'm surprised one of us didn't end up in the ER with shrapnel injuries! After a long oven clean out, we started over and had success! I think the roasting pan with the water made the oven have more moisture as the bread baked thereby creating a more moist inside with a nice crispy crust.

Noah made a pan seared Lake Superior whitefish with pan sauteed brussel sprouts, radishes, and bacon. We watched "The Order of the Phoenix" and then he made roasted lamb loin with baby heirloom carrots and quinoa with hen-of-the-wood mushrooms. He is such a sweet guy. He loves to cook and has rarely made the same dish twice since we started our relationship. If I offer my help he will put me to work picking parsley or peeling vegetables. Otherwise he lets me sit at the computer sipping wine while he cooks. I feel bad because I rarely have the chance to reciprocate my knowledge for his. Sure, I've steri-stripped his surf induced foot lacerations and disinfected and bandaged many a burn. But he provides his gift to me on a daily basis. It's interesting that we both chose careers in the service industry.

If you have suggestion on how I could have made my buns a little lighter and fluffier, let me know. I would love to be able to bake better than my husband!

Wednesday, December 19, 2007

LA living...


It rained all day in Los Angeles today. That doesn't happen often. The ER was pretty slow, people don't like to come in when the weather is crummy (although I like it!), so only REAL patients came in.

A patient came in who had been visiting someone at the hospital. He dropped his car off at the valet (yes, a hospital with a valet) and decided to grab something out of the back seat. The valet driver was unaware of this and started to pull away, thereby running over the (now) patient's foot. Luckily it wasn't broken and the horrified valet driver came in to check on the patient. "Where'd you learn to drive? Britney Spears?" I asked him when we knew the patient was okay. Luckily, he thought that was funny, too.

A gentlemen in his 60's was brought in complaining of elbow and hip pain after a traffic accident. It seems this guy was on his motorcycle (imagine white haired, overweight dude finally living the dream of his youth) and had pulled into a parking lot. He came to a stop behind another car that had stopped as well. He looked behind him and saw an SUV pulling in behind him. He realized that the driver of the SUV was on her cell phone and was not looking his way. He panicked and tried to pull away but she hit him anyway and he "spilled" his bike and landed hard on the pavement. We discovered he had broken his elbow AND his pelvis! Ouch! The woman that hit him? Three words: Hit and Run. She took off without even bothering to see if he was okay. He was so shaken he didn't even have time to get her license plate. Puh-lease, people! If you drive an SUV, I'm sure you have insurance! Where is your regard for other humans??

Another young man came in after being in a four car pile up on the 405 freeway at rush hour. (Rush "hour" is from 4 to 7pm.) He told us that he had been in the fast lane going about 20mph (hee hee!) when the accident happened. No one was seriously hurt so all the drivers did the responsible thing and pulled off the freeway (instead of snarling up traffic while waiting for the cops to show up). They exchanged numbers and info and went their separate ways. For our patient, this meant calling a tow truck since his car was barely drivable. His friend drove him to a nearby police station so he could file a report. The police told him they would not take a report since he "could be filing a false report to scam his insurance company". Okay, okay, I'm sure many people have done this before (!). By now he is feeling the consequences of the impact and comes to us to inventory his bodily damage. We hear his story and immediately get on the phone to file a report to the police. Now, obviously, in LA, there are many different jurisdictions. The first number I call is to the West LAPD. They tell me that because he was on the actual freeway and not on an exit it is not their jurisdiction. They tell me to call the CHP (CHiPs, as in Ponch and John), otherwise known as the California Highway Patrol. I call the number and get a recording saying that if I have an emergency I should call 911, otherwise, have a nice day. The phone disconnects. What? So I call West LAPD again and tell the front desk officer what happened. He tells me, "The CHP hold banker's hours. They're closed by now". What? This officer was nice enough though and promised to call me back with another number. Fifteen minutes later he calls and gives me a new number. I dial it and it rings.. and rings.. and rings. No answer, no recording, nothing. What? I call back and someone finally answers. She sounds stressed and pissed. I explain the situation and she lets out a big sigh and asks, "They didn't call the police when it happened?". I tell her why they didn't and she takes my number and says she will call me back. She never called back. Luckily, this guy was not seriously hurt. A little whip lash of course. We discharged him with the number I had been given by West LAPD. I hope he was finally able to file a report. Having trouble getting a hold of the police is nothing new here. I've had several people tell me that when they dialed 911 they got a busy signal!

A young man came in after falling while walking dogs. (His profession!). His middle and ring fingers of his right hand were severely deformed. His fingers were dislocated. Imagine your fingers, in their normal position, and then twist the middle knuckles to exactly the opposite of where they should be. It's hard for me to explain without a picture. Look at your fingers on your right hand now and try to imagine the middle and ring fingers pointing 45 degrees to the right. Grossly out of place. Amazingly, this man was in good spirits, although complaining of pain. He received morphine intramuscularly and the physician's assistant did a nerve block before she "reduced" the dislocation. The funny thing is that he and his companion smelt overpoweringly of really good marijuana. Probably the reason why he was not freaked out. A good bong hit can make any major body deformity seem not so bad. I remarked to the physician that we should ask him where he got his supply because it was "the dank".


A young woman came in complaining of severe chest and back pain for the last two months. She had been seen by a GI (gastroenterologist) who prescribed her medications for gastric reflux with no relief. This girl was sick, you could just tell. (Before I had met her I happened to be walking behind her in the hallway and thought she was an old woman, the way she was hunched over.) Once she was in our exam room I hurried in to start an IV after the doc had seen her. Her husband was at the bedside, very nice people. She was in obvious distress. I started a 20 gauge in her arm and drew blood samples. I started an IV drip and gave her anti nausea meds and morphine. She was finally able to relax enough to lean back on the gurney. I was gathering up all my garbage and was headed out the door with her blood samples when my foot shot forward and I almost fell. I looked down and realized I had just skidded through a big pile of vomit! I have slipped in urine, blood, and shit so this only completed my nursing resume. Always the professional, I quickly recovered and, after disinfecting my nurse shoes and calling a janitor, I sent her blood specimens to the lab. Meanwhile, I'm laughing because it is pretty funny. After several more tests we finally discovered she was passing gall stones. Very painful! At this point, she was comfortable and ready to be sent home. As I was taking out her IV, I told her what had happened. She was embarrassed until I told her, what was only the truth, "Don't feel bad. It was the biggest laugh of my day!".

I love my job the most when people who are truly in need of medical help come in to the ER. I'm frustrated by bullshit complaints. It's hard to take someone seriously when they ask for a handicap sign (to hang in your car to be eligible to park in a handicap spot) for a broken toe. I sometimes wonder if some people have never been injured before. I try not to be hard hearted. I know a lot of emergency room workers have a reputation for being callous. But, I'm sorry, a broken pinky toe, while painful, should not warrant the request of a handicap placard. But, some people think it is necessary, or owed to them.
It's probably not just LA, but I know we have a special group of people here that expect (demand) a certain type of service. For me, the more you expect special treatment, the less likely you are going to get it (unless you are TRULY sick or hurt).

Rainy day in LA. Valet parking, hit and runs, 911 busy signals...everything you have heard about LA and more...

Friday, December 14, 2007

Where are your kids right now??


Had a day of rememberance on December 12th. Eighteen years ago (! Its been that long?!) I was in a car accident that really f*cked me up. And sometimes I feel like I should get over it and not think about it anymore. In fact, one year, with my sister, I declared I would not "celebrate" the anniversary anymore. It has been too long. But I can't not think about it. Granted, I'm not obsessed about it and blame all my shortcomings and problems on it. However, everyday, when I step out of the shower and catch a glimpse of my body in the mirror, I think about it. When I buy new clothes I think about it. When I wear a bikini in public, I think about it. When my back aches for no good reason, I think about it. It is a part of my life, who I am, who I've become. It shaped how my life turned out. It is why I became a nurse. It is why I can't help but cry when a patient is upset over an injury or a diagnosis. I feel blessed (not a big fan of that word but for now it fits) that it did happen to me because I like who I have become, regardless of certain quirks and behaviors I know have stemmed from it. What would I have become if not for it?

And I must give props to my poor family who endured this horrible time with me. My little sister, who was 8 years old, and no one really explained to her, properly, what was happening. My parents, who must have blamed themselves for it happening. And then to have to care for me, for almost a year, doing the job of nurses, while I recuperated. My big brother, who perhaps thought that he, as well, could have prevented it from happening. My older sister, who flew away from her newfound life, to sleep on the floor in my hospital room. I ask myself, what is worse? The physical injury or the emotional one?

The wonderful thing is that I can walk (and snowboard and exercise and dance and give my nieces broken-down-bronco-bruce-rides), I can eat (anything I want, is it surprising I married a chef?), and I can shit like a normal person (may seem like a trivial thing but it is not). I learned compassion and empathy. I learned pain and hunger. I learned disability and perseverance.

So I think I will continue to celebrate my anniversary, year after year, no matter how many years have passed. Because it reminds me of what I have overcome, what I have gained, and what I have to be thankful for.

Sunday, December 9, 2007

Took some time off..

So I took some time off from the NaBloPoMo. I loved to blog every day but it's also nice to have a few days off.

Had a crazy situation the other day.. We had a 21 month old come in with the complaint of vomiting for three days. This patient should never have come to us, it's not "Fast Track". Fast track means in and out. Not someone who is so sick they may need to be admitted to the hospital. But sometimes it happens. The doctor was upset that this patient came to us, especially because we are not a pediatric hospital. When we get pediatrics that are sick enough to be admitted we have to transfer them to a pediatric hospital. But it is hard to be a community hospital because people don't know this, they take their sick child to the closest hospital they can find. I don't blame them.

We had to start an IV on the poor little guy. Starting an IV on a child is always difficult. We have to basically hold them down while we stick a needle in their arm. They don't understand why we are hurting them. We are under the constant scrutiny of their parents who pay strict attention to everything we do.

A nurse from the ER who had experience in pediatrics came over to start the IV. At the bedside was the little guys mom and his 18 year old sister. We asked them to help. We told mom to stay near his face to talk and reassure him. We asked the sister to hold his legs so he wouldn't kick us. We have the kids arm and are attempting to access a vein. The poor kid is howling and twisting away from us. (I don't blame him). The nurse gets blood return from her needle and all of a sudden, the other nurse helping yells, "She's going down! She's going down!" I'm not really sure what she means and I turn my head just in time to watch the 18 year old sister faint. She falls backwards from the guerney and hits her head so hard on the floor that I'm still haunted by it.

I immediately crouch next to the sister (I find out later her name is Anna) and try to assess the situation. I stand up and open the door and yell, "We need some help in here!" I crouch back down and realize that she's not really breathing, the color of her face is yellowish/gray. I start rubbing her sternum with my knuckles. It's called a "sternal rub" and it's very painful. (Try to rub your sternum now. It's painful. I was digging into her.) One of the physician assistants came in and crouches down with me. Anna's color comes back in her face and her eyes open. She's confused and tries to sit up. We look at the back of her head and see a gigantic lump forming. Meanwhile, her mother is freaking out. "Ayyayeeayaayeeyayyeee!" Unfortunately, we still haven't gained IV access to the kid.

I grab a gurney and push it into the room. The other nurses get Anna up and into the guerney. She complains of a headache (I don't blame her). We order a head CT and give her pain meds and an ice pack for her goose egg. I can relate to her predicament, I fainted the day after Easter and ended up with a huge hematoma on my head. I know it hurts. I have to push the doc to give her stronger pain meds. He had originally ordered Advil until I pushed for something stronger. Sometimes I think doctors have never been hurt before.

We finally gain IV access to the little kid and get a CT on his sister. Nothing wrong with her except the hematoma on her head. We eventually sent the kid home after we gave him fluids and anti emetics. We sent the girl home as well.

Amazing what the body can do after seeing something crazy. I'm very careful now about making the family member sit down if we need to do something. These poor people, this is going to go down as one of the worst days of their lives...

Friday, November 30, 2007

Friday...is my Monday.

Worked today. Had a patient who sliced his arm open on a broken glass and the meat hanging out of his arm looked like beef chunks. Must I always compare things to food? I thought the plasma I infused into a patient looked like chicken stock, I once compared the smell of someone's burning flesh being cauterized as "yummy bacon", and I told a (heavy) patient who came in strapped onto a back board that she looked "just like a trussed up pork loin".

Not surprised...

Thursday, November 29, 2007


Had another fabulous dinner tonight. Drove out to our friends' house, Gina and Gavin, in Santa Clarita. It's about 30 minutes north of us (with no traffic, haha). We've had them over to our house a couple of times and now it was time to hang out in their 'hood. Gina and I made fresh pasta and had Noah cut it into papperdelle. Gavin made homeade bolognese with ground veal to go with our pasta. Noah made a salad with super fresh lettuce and a caeser-like salad dressing. Everything was so fabulous! We drank chianti, shared stories, and laughed a lot. They are some of the funnest people we have met since being in Los Angeles and we enjoyed every minute with them! Thanks G and G!

Wednesday, November 28, 2007

Spoiled rotten...


Another "off the cuff" meal from my chefhusband who simply asks "Are you hungry?" then proceeds to make another amazing meal. Tonight, halibut with a parsley bread crumb crust served with a squash puree, sauteed brussel sprouts, and black trumpet mushrooms. The other night at our dinner party someone asked me, "Has he made you this dish before?" I answered No, and realized he has rarely made me the same meal twice (save for our comfort dishes) in the six years we've been together. Someone else asked, "You don't eat like this on a regular basis..". Actually, yes, I do. Spoiled f**kin rotten..

Stayed at work an hour over what I was supposed to (13 1/2 hour shift!). Got caught up with a 20 year old patient who had bilateral corneal ulcers. (Google it, it totally sucks) The wonderful MD was so concerned for her that he made me stay overtime. I guess a small price to pay to help someone get the medications and follow up they need. We also cared for a young teenager who's leg was impaled by a pole (or rebar, I never quite got the whole story) and luckily did not shatter any leg bones. It's amazing how much abuse our body can go through and recover. The teen was a young man through and through, letting out stinky farts as we were working on him! Rinsed his wound out with a flushing device from the operating room, sewed his puncture holes up, then sent him home on crutches (of course he received plenty of morphine in the meanwhile). His poor mom...

Tuesday, November 27, 2007

*YAWN*...

Okay, okay, I gotta go to work. Will be getting off late so won't be able to post tonight. Not a lot to say right now. I made miso soup with tofu and udon noodles for dinner last night. Needed something light after our big dinner. Then I felt like baking (which I'm not very good at) so I made a lemon bundt cake. It turned out okay except when I flipped it onto the plate it broke. At least I had fun making it!

Hi ho, hi ho...

Monday, November 26, 2007

Dinner party success...


Had such an insane dinner party that I couldn't post in time... Here's what we had:

1st course: slow baked salmon with a salad of radish, cucumber, peppercress, and red wine dijon vinegrette.

2nd: chantrelle marscapone ravioli with petite onions and butter sauce with mache.

3rd: squab with cannelini beans and braised turnips and natural jus

4th: New York strip with pearl barley, sprouting broccoli and bordeliaus sauce.

5th: Buttermilk panna cotta with blood orange sorbeto and vanilla manderin tangerines...

Holy shit, my man knows how to do it!

Saturday, November 24, 2007

Work Schmork!


I didn't post yesterday and I will tell you why.. Work pretty much sucked. I'm not saying it was the worst day I ever had because I worked with some really good nurses and clinicians and truly that made a HUGE difference. Mostly what sucked about it was the fact that it was the day after a holiday and we were packed! I heard later that we saw the most patients in our ER than we had ever before. So the photo above is a tribute to the poor patients who I know waited a very long time. But it is also frustrating for us, as a team, because really, was the wait THAT long? I mean, come on, our longest wait time between being triaged and being put in an exam room was three hours. On the bigger scheme of things, is that very long to wait in an emergency room? I've waited in my doc's office for an hour and I had an appointment. So three hours when you don't have an appointment isn't so bad. Right? And another thing, at least our department is first come, first serve. The main ER sees people by severity of illness (and of course they are seeing the very sick patients). The patient's that see us do not have EMERGENCY situations! Sure, they may feel terrible, or have a laceration that needs to be sewn but it is not a matter of life or death. And in fairness to everyone we see them in the order that they walk in. Okay, enough ranting. Let me give you a random sample:

An elderly woman came in with her caregiver. Her complaint was thigh pain. She was put in an exam room by another nurse and as I walked by I hear her angrily yelling "Nurse, Nurse!" I walked in the room and asked, "Are you yelling? Do you need help?"

Her (still yelling): I haven't eaten all day and I'm a diabetic! I need to eat something!

Me (calmly): Why are you yelling at me?

Her (still yelling): I'm not yelling! I need some food!

Me: Are you asking me for something? Or are you just barking orders at me?

Her: I'm not barking! I need food! (Let me just say, at this point, that it was 4pm and she had plenty of opportuntity to eat before she got to the ER. And she had a caregiver. Why hadn't the caregiver given her something? And she didn't look to me like she was suffering from low blood sugar. She was just a crotchety old lady who was used to bossing people around.)

Me: Are you asking me to get you some food? (I wanted her to ask me, not yell at me.)

Her: Yes! Get me some food! (Note, she's still not asking, she's telling.)

Me: Let me get you some crackers and juice.

I leave the room and go to the nurses station. I look at her chart to see what she was here for and what her history is. The funny thing I notice is that her last name is "Barker". I brought her some food but check her blood sugar first all the same. It was completely normal. I feel sorry for that caregiver...

Another person that yelled at me yesterday had been waiting for over two hours. She was not actually the patient, she had brought her 18 month old son in who had fallen and had a big goose egg on his head. Us nurses were aware of the situation but because the little boy was active in the waiting room and acting normally for an 18 month old, we weren't stressing on having him be seen right away. All the same, we realized that it must have been hard for her to try to keep him occupied while they waited. We entertained the idea of getting them in before the other patients but didn't want to start a riot in the waiting room. We continued to see other patients in order. By this time we had all been there for almost 12 hours and our part of the ER was supposed to close. We realized that we were not going to be able to see the remaining patients. This woman and her son included. All of us were a little torn up about it. We asked the doctor if she would be willing to see them. She said no. I don't blame her (much) and I understand where she was coming from. If she agreed to see the patient she could be setting herself up for not going home for another hour or so. She already had other patients she was trying to finish up with. And the doctors and PA's work long shifts WITHOUT a break! No lunch or dinner break for a 12 hour shift. Imagine! So I had to understand why she said no. The other RN I was working with volunteered to do the horrible job of going into the waiting room and telling the patients that we were now closed and they would be returned to the main ER and wait to be seen there. The woman with the kid marched up to the nursing station and WENT OFF! Her fury was evident, her son remained a normal toddler. She would not take any of our explanations and continued to scream and cry in frustration. In the middle of her tirade, her son reached up and slapped her face! (Any of you with kids know they do this from time to time.) This did not help our situation any because it made her more pissed. The sad thing about this is that the doctor was present for this whole situation and could have said, "Look, let me do an exam quickly on your son." But she didn't and the woman walked away. I felt horrible for her but realize that at some point we have to stop seeing patients or we would never go home...

A big thank you to all the patients who were kind, understanding, and thankful for the care we gave! We worked our asses off!

Thursday, November 22, 2007

Store bought pie..

Yes, it was a day of store bought pie, canned whipped cream, and powdered gravy. Yikes! Luckily, Noah had made homeade cornbread and mixed it with roasted farmer's market turnips, carrots, radishes, and parsnips with sage, rosemary, and thyme. But of course it was fun hanging out with the family. Especially when they start drinking and indulging family gossip. Hysterical!

I missed my family today...

Wednesday, November 21, 2007

T-Day preparedness

Getting ready for Thanksgiving and luckily my chef husband is taking care of our obligatory dish for the family get together. We are headed to Diamond Bar to Noah's dad and (step)mom's house. Supposedly there are 20 people showing up. That is one crazy thing I learned early about Noah is that his family is large and extended. Every get together includes Noah's step family. I don't mean this in a bad way, it's actually kind of fun coming from a small family. And Noah's dad has been married to Maureen for over 25 years and she has children who have had children. The only irritating thing is that they are fully vested in the turkey, mashed potatoes, gravy, etc. I'm over that now. I'd rather be eating squabs and foie gras. Noah told his dad that we weren't going to show up if there was store bought pies. That's a tall order to fill with 20 people coming over. Noah made homeade corn bread and will roast vegetables for a cornbread stuffing.

I meant to get some "chores" taken care of today for our dinner party on Sunday. I woke up at my usual time (11am) and Noah had just gotten back from working at the farmers market. I offered to make him coffee and when I went to the sink, I realized the sink wasn't draining. Noah said, "Oh yeah, I noticed that last night." What? Last night? So here I am with a gigantic plunger trying to get the drain unplugged. Meanwhile, my normally wonderful husband was watching a surf contest on the net. Hello?! The day before Thanksgiving and we have nasty dirty water backing up in our sink! He volunteered (yeah, right) to go to the store and get some Liquid Plumber. Well, guess what folks, Liquid Plumber sucks and is a total no-no. I know, I know, it's made from horrible chemicals that are used for crystal meth manufacturing, but if it was gonna unplug our sink, I was gonna use it. I finally broke down and called the landlord. Help me! He sent over his plumber (Thank you Armen) and they used a motorized "snake" to break through the clog. The plumber lectured me about using Liquid Plumber. He said (In a very thick Latino accent so I hope I understood right), that I should NEVER use Liquid Plumber unless I want to eat away at all my pipes. And if I'm desperate, I should only use it if the drain is running slowly, not completely stopped. What stopped the pipe? I asked but never got an answer. But thank you, Tony the plumber, for showing up at the last minute to help me out!

Tuesday, November 20, 2007

To Lou!


This is a shout out to you, Lou! Happy Birthday, I can't believe you are 27... I feel like I helped raise you and now you have your own family to raise. Lookit you, on baby number 3. I'm amazed at what you accomplish everyday. You rule!

I Love you,
Your big sis,
Nomers

PS. This is seriously the only pic I could find of us together!

Monday, November 19, 2007

Nancy Silverton rules!

Had yet another amazing meal at Pizzeria Mozza on Highland and Melrose. Owned by Mario Batali and Nancy Silverton (of the La Brea bakery) its a laid back pizza place using seasonal ingredients. Noah and I stopped in around 3pm and sat at the bar facing the chefs and the wood fired oven. We started with roasted brussel sprouts with proscuitto bread crumbs and green beans with hazelnuts and dijon mustard. Unfortunately, I am picky and I feel like the green beans were undercooked. But the flavor was great. Then we had pizza (of course). I can never eat pizza anywhere else ever again. Noah ordered the chanterelle and onion pie and I ordered the house-made fennel sausage and spring onion pie. So, so good. We sipped half carafes of wine and watched the cooks make everyone's pizza and throw it in the oven with those big long spatula thingys. Then, all of a sudden, Nancy herself popped out of the back, surveyed the scene, then disappeared. What a woman! She decides she's going to learn how to make bread and, boom, La Brea bakery is born. She then decides, How about pizza?, and goes into partnership with Mario. (Who has yet to make an appearance at the restaurant). If you are ever in LA, make sure you stop in.

For some reason, I had a donut craving afterwards so we stopped by a local bakery. I'm not really a sweets girl so it was a first for me to stand in front of a large display case, trying to decide which kind of donut to eat. I think the last time I ate donuts was in Bend when I was in high school at Sweetheart Donuts (all you Bendites know exactly what I'm talking about!).

All in all, a great day off. Went to IKEA and picked out a bunch of plates and glasses for our dinner party next Sunday. Promise to take lots of pics to share!

Sunday, November 18, 2007

Cool weather food..

Cool weather? How about this? Shell some fresh cranberry beans...








Simmer up some carrots, celery, and onions with short ribs and merlot...








Add some fresh chanterelles and cipollini onions...










And cozy up under a blanket and tuck into this!

Six guilty things..

There is a fun girl I've enjoyed "getting to know" through blogging. Check her out at www.greeblemonkey.com/. She's just like me in the fact that although being "tagged" is fun, I'm still not apt to do it because I don't want to make anyone feel obligated to respond. So if you feel like it, do your own. If not, cool.

Six guilty pleasures no one would expect me to have:

1) I love Doritos! I know, my husband and I eat pretty much only "whole foods" straight from the farmers market and organic farms but I have a craving for Cool Ranch Doritos. I miss Monterey Jack Doritos I used to nosh on in my teen years.

2) I pick my lip. Lou, you understand.

3) Trashy mystery novels that all follow the same basic plot. Sexy yet vulnerable man, smart and beautiful woman falling in love over solving a murder. Helps me fall asleep at night.

4) In Touch magazine. Hey! Sometimes the brain needs to turn off for awhile, okay? Got a problem with that?

5) Cigs. Yes, I know I'm a nurse and know better but an occasional cigarette feels goood...

6) Babies. I realize that I have decided not to have my own children, but I could walk around forever with someone else's (sleeping) baby in my arms. They are so cute and soft and smell delicious!

Six guilty pleasures I wish I had the courage to indulge:
1) I want to play guitar and sing. In front of an audience. And make an album. And have people cheer for me.

2) My own cooking show. I know, I know, my husband is the chef and I really don't know anything but sometimes when I'm cooking by myself I pretend there is a camera watching me and I speak out loud with all my little tips. Heehee!

3) I have a fantasy that I'm on an airplane and someone yells "Is there a doctor on board?". No one responds so I say, "I'm a nurse." I save the persons life, of course.

4) Making a cookbook about my husbands food.

5) Being a incredible photographer.

6) The last one, you should all guess and relate, becoming a published writer.

Six pleasures I once considered guilty but have now abandoned or made peace with:
1) Made peace with the amount of drugs I've done in the past. I used to feel bad about it, but now I realize that I wouldn't be who I am without that experience.

2) Made peace with the music I listen to. When I first met my husband I thought some of the music I listened to wasn't "cool enough". Now I catch my indie rock husband singing along to Alicia Keys and Justin Timberlake.

3) Made peace with eating fois gras. Media hype made me feel temporarily guilty about this indulgence but now I'm a little more realistic. I eat meat. The meat I choose is as "humane" as possible. And I've watched video about the "force feeding" of ducks and it seems okay to me. (Please respond if you feel otherwise. I'm always open to opposing views.)

4) Made peace with masturbation. Need I say more?

5) Guilty pleasure I've abandoned: Starbucks anything. Don't need the calories and don't need to give that company any more money.

6) Abandoned: Eating junk food at work. Why did I eat See's candy at work? I can't stand See's candy! I only ate it because it was in front of me and I justified I "deserved" it because I was working so hard. No thanks...

Boy, that was fun! Try it out. It seems like work at first but then it makes you think about your life a little bit.

Saturday, November 17, 2007

Soo..


I've come to realize that a certain person that I work with is verbally abusive to me. And even though I have discussed it with this person, it still continues to happen. Without going into specific details, I'll just relate how it makes me feel by sharing a dream I had:

In the dream, a patient collapses right in front of me. I check the patient's pulse and realize she has none. With no one else around, I realize that I am going to have to "code" this patient on my own. I immediately start to do chest compressions and I know that I need to gain IV access. So, with one hand I continue my chest compressions, while with the other hand I somehow successfully start an IV. (Pretty much impossible, that's how I know I am in a dream). I recheck her pulse and realize her heart has begun to beat on its own again. At this point, other people arrive to help. I'm feeling pretty proud of what I've done until.. this abusive person comes up to me and starts critiquing my compressions:

"You are supposed to use two hands for compressions."

"I know, but I was by myself, and I..."

"And your arm wasn't straight, it was floppy. You weren't giving adequate pressure."

"I know, but the patient survived and..". In my dream, I am totally deflated and feeling shitty. Like, even though I got the job done, I didn't do it good enough. What the F*ck?!

Anyone out there have any solutions for me or any similar situations? I'm not a total pussy, like I said, I've already talked to this person about her behavior. Obviously to no avail. Without totally alienating her (I still have to continue working side by side with her for 12 hours at a time!) how can I change her behavior? And yes, I have already told my supervisor. No change.. Any ideas??

Friday, November 16, 2007

Ggrrrrr...(part 2)

Work sucked yesterday! And I have to go again today! We had a patient have a seizure in the waiting room, a patient who was suicidal, a heroin user screaming obscenities at us because I gave her a shot (does that make any sense to you? she uses a needle on herself everyday!), and a woman with incredibly infectious diarrhea that kept having "code browns" (shit everywhere except the toilet). At least I wasn't in the main ER where our bloody, screaming seizure patient went, also a 20 year old woman with some developmental problems came in complaining of abdominal pain and constipation. When the nurses got her out of her clothes they discovered an arm sticking out of her vagina. She was in the middle of giving birth to a breech (and dead) baby. She had no clue she was pregnant. Sometimes I want a new career that leaves me blissfully unaware of these things...

The best thing about my day? Coming home to my husband and laughing really hard as we talk about our day. I have the next few days off... Can't wait to relax, polish my new punch bowl, read, and putter around the kitchen. Only 12 more hours!

Thursday, November 15, 2007

Ggrrrrr...

I'm grumpy and don't want to go to work today! I'm working with someone who is lazy and that makes my day that much harder. Nothin' worse than a lazy nurse...hey, maybe I should buy her a t-shirt for christmas that says that...

Okay, deep breath, only 12 hours to go!

Wednesday, November 14, 2007

Score!!

I scored on a large punch bowl that came with 12 matching glasses!! 15 bucks! And I was surprised at how many punch bowls are out there second hand. I guess punch isn't as hip as it used to be but maybe its coming back in...

Worked the first of three in a row today. Good day all in all. I'm always surprised at the diversity of people that come in to a hospital. Like the DMV, everyone has got to go sometime. We helped a cashier at a parking garage who had gallstones, a wealthy psychiatrist who couldn't pee after a surgical procedure so we put in a catheter, a homeless guy who had been punched in the head (on his birthday no less), and a writer for a major TV channel who was on strike in the heat all day and now had a horrible headache. Just a sampling of my day..

Goodnight!

Tuesday, November 13, 2007

Goin' O.I.P. (out in public)..

So I've decided to go O.I.P. today. It's hard for me sometimes to face the general population on my day off but I'm going to do it! My adventure? I need a punch bowl for an upcoming dinner party. We are going to have 10 people over to our tiny apartment! I thought a nice self serve punch would take some of the burden off of me. But I dont want to buy a new one so I am hopping on LA's (meager) public transportation, Big Blue Bus Line 1, and hittin' some thrift stores! I hope to be the crazy lady on the bus singing to myself and cradling a punch bowl on my lap! Wish me luck!

By the way, it's disgustingly hot here today. The Santa Ana winds again just when I was wearing boots and scarves..

Hey Lou, wanna come over? Here's what we are serving:

Monday, November 12, 2007

Relic..

Check out my June 16th, 2007 relic post I finally decided to post..

Sunday, November 11, 2007

Help me be greener!


I need help! I want to go as green as possible within my budget! My husband and I have done a few preliminary steps: we share a car, I walk to work, we use a reusable bag(s) for grocery shopping, changed the lightbulbs, turn everything off at night, use 7th Generation (toilet paper, paper towels, garbage bags), planted drought resistance plants, and believe it or not, we stick with what I call "The Alaska Rule": if it's yellow let it mellow, if its brown flush it down. Unfortunately we live in an apartment that we have little control over. We can't change to triple pane windows and the stove is right next to the fridge! Aargh!

Help me out people! I would love to hear some more ideas so I can feel better about myself and help our planet! What are you doing?

Psssttt.....


I don't know what I did in this life or another to deserve my husband.

At this moment he is simultaneously:

*doing laundry (mine included)
*cleaning the kitchen (huge stack of dishes)
*cooking lunch (scrambled eggs, toasted baguette, pan roasted fingerling potatoes with his homeade salsa)
*handing me a steaming cup of coffee (just the way I like it)

While I simultaneously:

*blog in my pajamas (I woke up not too long ago)
*slurp enthusiastically at above mentioned coffee
*await breakfast

Back off ladies! He's mine!

Saturday, November 10, 2007

Squeekin' in...

Oh boy! Last second entry before midnight falls. I guess this counts as #2 today. Really brutal night at work. Can't believe that people complain about a wait in the ER on a Saturday night...All us nurses are eating bonbons and giving each other foot rubs while they are waiting to be seen about a cough...

Just a quickie, please...

I am so tired from work today but I had to jot this down:

Had a guy come in to be seen today in the ER for priaprism. If you don't know what that is take a few moments to look up the definition. Okay, this guy had taken and herbal supplement from 7-11 and had an erection for over 24 hours! Ouch!! And its very dangerous because the swelling for that long can cause damage to the nerves as well as the circulation. His penis was massively engorged and purple. The doc had to draing the excess blood using a fairly large bore needle. The lesson? Buyer beware.

Goodnight!

Friday, November 9, 2007

This counts!

It's 15 past midnight so this counts as my daily blog, right? If I am too tired when I get off work tomorrow then I rest assured that I have already posted today. Saw a Dali exhibit at LACMA today. Had no idea he collaborated with Walt Disney and put out a very cool cartoon. Check out "The Destino Project" at npr.com. Also, the movie by Alfred Hitchcock called Spellbound has a really cool dream sequence created by Salvador Dali.

After the museum my husband and I headed west on Wilshire back home. My husband went to Santa Monica Seafoods and bought some Tasmanian Sea Trout. He served it with pan sauteed broccoli romenesco, toasted almonds, capers, and baby onions. Totally insane!

Thursday, November 8, 2007

Blog LOSER!

Why can't I stay on task? Focused? I start a project and then it peters out. I have a half sewn pair of pajama bottoms gathering dust in my closet next to my equally dusty sewing machine that I had spent many a happy moment on churning out napkins and aprons. I have a half finished puzzle on my dining room table. I actually put a place mat (homeade) on it and ate dinner one evening. I have a fantastic idea for a children's story that is so close to being finished. I started it three years ago! I told my landlord I was going to paint the living room, a year ago, but still my walls are white. I was so excited when my sister turned me on to the world of blogging and yet I haven't written anything since September!

I think there is a couple of things at work here. One: I smoked a lot of pot in my youth. A lot. That's all I'm going to say about that. And two: Blogging is a way of socializing and I work so much with the public that sometimes I hide away in my house and don't talk to anyone, don't go anywhere, I don't even step outside. I peer out the window like some paranoid old lady, watching the world outside but never joining in. I have even been known to order my groceries on line and have them delivered! My only human contact is with the delivery boy. ( I haven't found out a way around that yet). So blogging feels like I have to make a human connection and I'm not always ready for that.

My sister has shamed me, (although I know that was not her intention), into paying more attention to my blog. I enjoy it, I feel good when I do it. And now she says that a whole group of bloggers are going to write EVERY SINGLE DAY!! I doubt I can do it but I will try.

Sunday, September 9, 2007

More tales...

I wish, I wish, I could take pictures at work! I wish I could tape record what people say to me. I wish I could video tape situations that only a nurse (and perhaps, cops) see every day. Example: a guy comes in with the complaint of "cut to buttocks". Further investigation reveals he was surfing and was cut with the surfboard fins (which are extremely sharp) about 2 cm away from his anus. We're talking in the butt crack. I guess the fin sliced through his swim trunks and, luckily for him, did not go so far as to slice his anus, or testicles for that matter. I had the happy job of holding his butt cheeks open while the doctor stiched him up. What ensued was awkward, forced conversation. Let me set the stage: Patient: lying face down on the stretcher, naked from the waist down, blue sterile drapes framing his buttocks, which are bathed in bright lights. Me: hands gloved in blue, spreading his butt cheeks as far as they would go. Doctor: 27 gauge needle dripping with lidocaine, sutures at the ready. My job as a nurse, is to not only help the doctor do what he or she needs to do, but to also help the patient feel comfortable. "So," I ask, as I make sure his cheeks are sufficiently spread apart, "do you live around here?" I'm desperately trying to fill the awkward silence. How many of you would be comfortable with your whole anus and butt crack exposed to total strangers? "Uhhh, yeah, I live in Marina", this poor guy responds. "Oh, that's a nice area", I answer. There is a couple of seconds of silence and then we all crack up, the patient included. I mean, how do you turn an uncomfortable situation into a "no big deal, we do this every day" situation?

I really try to encourage people to take pictures of their injuries. I realize that they are not always in the mood at the time because of fear, pain, etc., but I believe eventually they will want to remember their adventure. Most people have a camera on their cell phone so I suggest to friends or to the patient themselves to get a picture before we stitch them up (or put them in a splint). I was in a terrible car accident when I was younger and, at the time, I wouldn't let anyone take a picture but now I wish I would have. It's amazing what the body can heal from. And I also think that scars are a certain rite of passage as human beings in the human race.

A woman, my age, presented with the chief complaint of "bumpy cervix". We brought her into our special room for gynecological problems (we have a special bed with stirrups to do the pelvic exam). She reported having a "drugged out night" with a gentleman and the next morning felt lumps on her cervix. She wouldn't divulge exactly what drugs but told us she had a patchy memory of the night before. Every pelvic exam performed by a clinician needs to have a witness so I volunteered. I set up the usual equipment: lighted speculum, KY jelly, and various lab specimen collection devices. One of my favorite physician's assistant's was performing the exam. She's no-nonsense and extremely professional. The patient's leg's were spread and the PA had already inserted the speculum. I was ready to hand her whatever she needed when she looked at me oddly and said, "Hand me a forcep". I was not ready for this request at all and luckily found a sterile forcep in the cupboard. At this point my curiosity almost got the better of me. What the hell did she need a forcep for during a routine pelvic exam? I maintained my professionalism and handed her the sterile instrument. The PA reached into the womans vagina and pulled out...a latex studded cock ring. "What is that?!", cried the patient. "It's a cock ring", the PA calmly replied as she set the offending article in the garbage. For those of you who don't know, a cock ring is a latex "implement" that is placed around the head of the penis to enhance pleasure for both partners. Unfortunately, this woman's partner did not share with her that he was using one (my guess, small penis) and it must've slipped off at some point. He had to have known that he came off but was maybe too embarrassed to tell her he "lost" something. She couldn't wait to get on the phone and tell him what she "found". Yikes.

Friday, August 31, 2007

Living's easy..


Summer time. Squid, watermelon, cucumber, and cool glasses of reisling on the patio. What else do you need?

Monday, August 20, 2007


Summer is probably my favorite food time. It seems so fleeting... I get greedy with the heirloom tomatoes and corn. We buy every fig and soft shell crab we can get our hands on. I almost feel a desperation to eat as much as I can, while I can. I don't feel this way in the fall or winter. We spend many nights on the patio, with rose wine and plates of cool food. Farro salads with cucumber and tomato. Barbequed NY Strip and cold yukon potato salad. Seared pork with shell beans and beet puree. It's difficult spending time with non-"foodies". I was invited to a BBQ recently where the salads were from a bag and the ribs were bulk from Costco (shudder!)..Most people have lost sight of good food. It's always refreshing to hang out with people who know the difference between a roma tomato and a heirloom tomato. I just read a great blog from a chef's wife called dcw that inspired me to write more about my experience of being married to a chef. So hard to not be a food snob when my husband makes scrambled eggs and morels for breakfast before I go to work.

Another toughie on being a chef's wife: Making a reservation at a great new restaurant and husband knowing half the servers, managers, and other chefs who happen to have the night off and also dining at the restaurant. One of the most difficult things is that it's hard to get people to relate to my job. It's easy to talk about cooking...But what about nursing? Every great story I know is usually inappropriate for the dinner table. Pretty much inappropriate at any setting. So I let him have his glory while I stand supportive by his side, looking as pretty as I can.

Tuesday, August 14, 2007



Had a fantastic anniversary weekend! Stayed at the Culver Hotel in Culver City. You may not know that Culver City is a huge movie mecca. Sony Studios is here. The Culver Hotel was built in 1924 and the local newspaper headline said, "Newest Skyscraper!"; it's six stories! So many famous actors have stayed here. During the filming of The Wizard of Oz, 124 little people stayed at the hotel, sometimes 3 to a room, reportedly sleeping horizontally on the beds. All sorts of debauchery were reported to have happened during their stay. I was really excited because I had just watched "Gone With the Wind" for the first time and had learned that Clark Gable stayed at the hotel during the filming. I knew that the hotel had a special Clark Gable room but we couldn't afford it. They also have a John Wayne room (who was part owner in the 50's) and a Marilyn Monroe room (who stayed there several times while filming movies). When we checked in, they gave us our room keys and when we went up to the room we realized they had put us up in the Clark Gable room!! So we fucked, shit, and drank booze in the same room that Clark Gable did!!! How cool!

Monday, August 6, 2007

More fun in the ER!

So, this is the first time I will ever say this statement (and hopefully the last!): I was pissed on by a 300 pound transvestite. Yes, yes, I was. Not his fault, exactly. He, pardon me, SHE has Parkinsons and needed the help of two nurses to urinate. We pulled down her pink and white striped leggings and discovered that she had tucked her penis and balls deep in between her legs. So the other nurse began the task of pulling out folds and folds of skin. She actually asked, in frustration, "Where's your penis?". She finally found it and placed "Maggie's" penis into the opening of the male urinal. Now, of course we were wearing gloves and waited patiently for Maggie to urinate. "I think I'm done," she said. "You think??", asked the other nurse. "Are you sure?" "Yes, I'm sure." Not to sound like House, MD but never, ever trust a patient. The other nurse started to pull Maggie's penis out of the urinal and, like a newborn boy, as soon as "her" penis was pointed upwards, she shot out another huge stream of urine. It rained down on us like a golden shower. The other nurse and I both yelped and pulled our bodies backwards. But, being the professionals we are, did not let go of the patient. I felt hot urine hit my forehead and hair. "Are you hit?" I asked, as if we were in a war zone. "My arms!" the other nurse replied. We quickly pulled up Maggie's stretchy pants and ran to the bathroom to scour ourselves. We avoided eye contact because both of us wanted to laugh, and I knew it would only progress into the type of giggles you succumb to when you are absolutely not supposed to laugh; i.e. church, school, in front of a camera, and in front of a patient who truly can't help it. Poor gal, so out of control of her body on so many levels...

Sunday, July 22, 2007

What I've been up to



So Noah and I have been enjoying being "childless" **gasp!** and having a lot of fun being able to do whatever we want, mainly cooking wonderful food and taking small trips here and there. We explored the central coast of California and did some wine tasting. Noah took a job at a french restaurant called La Cachette. Kind of boring for him but at least he's doesn't have all the responsibility he had in his last job. We are enjoying summer's bounty...

We enjoyed a wonderful afternoon/evening about 20 miles north of Malibu on a beach that allows BBQ's...




We enjoyed a birthday party "behind the Orange Curtain" for my new sister in law and Gramma Lea. All the family came out to celebrate...






Enjoying life in all its small but absolutely significant moments! Missing my family, of course, but realizing the reason we live here!

Saturday, June 16, 2007

Another fabulous mini vacation...

A relic I felt worthy of posting now..
>



Went on another great vacation while Noah is on a work hiatus. We had a wedding in Los Gatos on Saturday June 9th so we headed up a day early and stayed in San Jose. The drive was about 5 hours; we enjoyed our iPods through the car stereo and stopped at a rest stop and ate Framani salami, d'affinois soft cheese, and hunks of sourgdough bread. We switched back and forth on driving duties, laughing when Noah did a funny South Park imitation "They took our joobbs!", and telling each other in a funny voice, "We're havin' fuuunnnn!"
Our hotel was modern and cool and we headed straight to the pool for the afternoon, drinking the champagne of beers (Miller High Life), and diving in when we got too warm. We had reservations at a Michelin 2 star restaraunt and called a taxi to take us there at 7:30. They sat us at a wonderful corner table and we didn't leave until 12:30! We ordered the tasting menu paired with wine; the food was amazing, the wine was equally, and at the end of the meal we met the chef who had actually met Noah at a bookstore some time back. Go figure..

Sunday, May 27, 2007

Another day, another dollar?

Just informed at work today that no one is receiving raises this year. What?! Is this legal? According to our CEO, because of the financial situation of the hospital, no one is getting a raise. Not just nurses, but, supposedly, all staff. I hate to say it, but I must confess, that I will not feel bad "padding" my hours. If I clock out at certain times I will suddenly be getting double time. The worst thing a hospital can do is hurt overall morale. That will not help the financial situation of the hospital. Please reassure me that other hospitals are going through strain...

Sunday, May 20, 2007

So hard to keep up...

It's so hard to keep up on all that happens at work (as you all know). Tonight we had this poor guy who was in his bathroom at home and the (cheap) framed mirror he had on his bathroom wall broke and fell on his calf while he had his back turned. It basically sliced through skin, subcutaneous tissue, fascia, and muscle on its way down. It was on of the gnarliest lacerations (if you want to call it that) that I have ever seen. The ER doc spent one and half hours and over 80 stitches to put his calf back together again. The doc was kind and gave him a milligram of Dilaudid to help him through his ordeal as well as several shots of 2% lidocaine. Can you imagine having part of your calf muscle sheared off by a mirror??!! Does that trump the seven years bad luck rule??

Thursday, May 10, 2007


God, what to say about our beautiful trip to New York? (Our new favorite city). Noah got fired (not so unexpectedly) on Tuesday night and as we sat up late night on Wednesday we realized we might not get another chance to take such a last minute trip since I conveniently had 5 days off in a row. We bought tickets on Travelocity at 2am for 3 nights at a modern, hip hotel in midtown Manhattan,. We flew from LAX on Friday morning and landed at JFK at 1 pm eastern time. We cabbed it to our hotel on 5th ave and 55th street. After a celebratory drink at our hotel lounge we took a cab to 5th ave and 9th street for 9pm dinner reservations at a restaurant Noah had read about called Cru. We have eaten at the top places in LA and this place blew them all out of the water. Food, service, ambience...it was all there. The maitre' de asked us where we wanted to eat while we visited and personally made us lunch reservations at Cafe Boulud for the next day. We flagged a cab (great thing about NYC, the minute you decide you want a cab, you wave your hand and there it is), and went back to our hotel. (Our cabby casually asked us in the quintessential NY accent 'You all seen Paris Hilton?').

The next morning we discovered the beauty of the subway system. All you need is a map and a $7 "fun pass" to get you anywhere on Manhattan all day long. We checked out the Union Square Farmers Market. The weather was beautiful, spring had sprung in New York and ramps, herbs, flowers, and people of all shades were out and about. We later headed to Central Park and took all sorts of pictures while saxophone players serenaded us and cherry blossoms drifted past. At 1:30 we walked to Cafe Boulud and ate an amazing ($150) lunch. The staff treated us VIP and Noah (typical!) knew the guy that was seated two tables away from us. Small world! We ate, for example, white asparagus veloute (soup) with vanilla oil and garganelle (a handmade pasta) with morels, snap peas, and english peas. Noah ordered sticky toffee pudding for dessert, I of course, didn't order any but they sent me three different types of house made ice cream. We walked off lunch checking out the neighborhood, then got ready for dinner. Dressed up and (of course) took the subway to the Madison Square Park area and had a cocktail at a place where Noah knew the chef. Then around the corner to A Voce for dinner, an new Italian place that is impossible to get last minute reservations but Noah "knew someone". Aaahh, the beauty of marrying a chef! I highly recommend it. After dinner we hit a rooftop bar that had an amazing view of the city...and then things got a little foggy. Way too much booze! We got the subway back to our hotel and at about 2am was eating hotdogs and schwarma at the nearest corner stand. Another great thing about New York...there is always something nearby that is open.

The next morning we headed up to the top of the Rockefeller Center "Top of the Rock" and was blown away by the incredible view. (See above photo.) We were to meet up with a great friend of mine that I hadn't seen in six years but she was driving in with her family from New Jersey and we weren't sure when she was going to make it in so we headed over to Greenwich Village to hang out. We got a call from my friend, Stacia, who said she had taken the subway in and on a whim got off in Greenwich Village. We hadn't told her where we were going and, wonderfully, we were 4 blocks away from each other. So we hooked up and had a picnic at a small neighborhood playground where her kids could play and we could catch up. Stacia is one of those one-of-a-kind friends that no matter how long you have been apart it feels like its only been a couple of weeks. So happy!!!

Still, the sun is shining in the city. I have blisters on my feet but don't care. We are spending way too much money but realize it's worth it. We fly out tomorrow and start to feel sad. We contemplate moving to NYC and then are realistic that all the beautiful things we see now would seem different if we weren't on vacation. It's such an incredible place with amazing things to see. The more we checked off our "to do list" we only added more. Go if you have the chance.

Thursday, April 19, 2007

Patient's that are absolutely bonkers..

Oh boy! Ran into some serious wackos tonight...(yes, wackos is a medical term):

A guy came in with a complaint of "out of Valium". On his chart he had listed a long, long list of medications he says he regularly takes, including heavy duty narcotics. But reports he has no regular physician. I asked him, "Where do you get your medications?" He answers, "The pharmacy". Brilliant. "No," I said. "Who prescribes your medications?" He says various Emergency rooms he visits. He has insurance, people! He has no reason not to have a regular doctor to prescribe! Instead he racks up gigantic ER bills because he is too lazy (or too drug seeking) to get a regular doctor. And you wonder why insurance is so f*cking expensive?! Blame assholes like this, working the system. Guess what? We didn't give him shit except advice to see a regular doctor.

A woman came in because she just had genital warts frozen off. She said she wanted information about cervical cancer. The PA asked her "Didn't your doctor give you information?" She said, "My doctor told me I was going to die in 3 to 15 years from cervical cancer." Okay... So we gave her information after telling her that she must have misunderstood what her doctor meant. When I brought her discharge instructions she asked me if she could volunteer at the hospital. I said she would have to call the volunteer department. She asked if she could volunteer on the cancer ward. "I don't know how it works but you can ask," I responded. Then she said, (obviously this girl was only hearing what she wanted to hear) "I want to work on the cancer ward so that I can learn about cervical cancer." Whoah, whoah! "You cannot volunteer on a cancer ward and quiz patient's about cancer!! Look on the internet, go to your doctor, the local library, whatever! But do not volunteer with cancer patient's to get info!" I called the volunteer office and left them a message that this woman probably wouldn't be a good choice.

A woman came in after being "assaulted" by the police. Her daughter had been pulled over for a traffic violation and had somehow ended up in handcuffs. The mother had showed up on the scene and apparently charged the police officers. They grabbed her arm and pinned her against the hood of a police car. The cops let both of them go eventually but the mother ended up in our ER in hysterics. "I'm a teacher! They can't do that to ME!" (Common elitist view) In an ER we are required by law to report, to the police, any assaults. So a sargeant showed up to take a statement and of course this woman flipped. "I don't want this man in my room!", etc, etc. I felt bad for the poor sargeant because he was not involved in the incident and he was just trying to do his job. And I have to give him props for being polite even though she was verbally abusive toward him. She refused to give a statement to him but did agree to sign a medical report waiver so that the police station would receive a copy of her chart. The police asked me to accompany him to the car where he had the paperwork. I walked them out to the police cruiser and this women would not shut up about the "travesty" that had occured to her and her daughter. All the policeman wanted her to do was sign a peice of paper. But she couldn't stop bitching and complaining. So I took her by the shoulders, looked her in the eyes, and asked her, "What is your top priority right now?" She immediately responded, "My daughter." I said, "Sign the papers, go to your daughter, and deal with all this bullshit tomorrow!" She got my point and left 10 seconds after signing the paper. So the poor sargeant and I had a good laugh over what a freak she was. Now, don't get me wrong. I understand why she was so upset. But if you had been there to hear everything she said and did, you might be a little more cynical. I tried to explain to her that she is in LA and the cops don't know that her daughter who they pulled over is "a sweet, smart girl who goes to UCLA". They just know some girl who was just pulled over is now not obeying their commands and freaking out. And they also don't know that the mother is a 2nd grade teacher just trying to protect her "mentally unstable daughter". They just see two freaky ladies trying to fight with them. My name was involved in the police report because I witnessed her refusing to make a statement and that the sargeant was civil to her. Hopefully I won't ever get involved but in this in this sue happy society, you never know...

Wednesday, April 11, 2007

On the other side of the bed: nurse becomes patient


It's always weird for a nurse or other health professional to get sick and (gasp!) become a patient. Suddenly subjected to giving over your body and put your trust in people you don't even know, then having to make decisions about your health (usually while under the effects of narcotics). Much like bringing your car to the mechanic and having to trust that they know what they are talking about and trusting their recommendations. Here's what happened to me on Monday night...

Noah and I had been having a lazy, relaxing day after entertaining his family for Easter the day before. I admit, I was a little hungover, but had been taking care of myself during the day, drinking lots of water, and eating good. It was around ten o'clock and I was on the couch watching TV. Noah was working on laundry and went outside to check on the laundry. (our machines are at the back of the apartment building.) After he went outside, I decided to grab some cookies in the cupboard. I rarely crave sweets but they sounded good. I walked into the kitchen, reached into the cupboard, and suddenly my heart started to pound in my chest. At first I just thought I had gotten up too fast and maybe my blood pressure didn't have time to catch up to the sudden movement, then, as my heart beat harder, I thought that maybe I was having a panic attack. I hadn't had one in years but you never know. Granted, all this thought process happened in maybe 2 seconds. Then, I was having an odd dream. I opened my eyes and Noah was standing above me asking why I was on the floor. Cookies were scattered about the floor. I was very confused. "I don't know why I'm on the floor. What happened?" Noah helped me up and brought me to the couch. I was covered in sweat and very pale. Noah looked worried. I kept asking, "What happened?". As my mind cleared, I realized that my tongue was swollen, I had bit it! Now it started to sink in. "I think I fainted!" Then my head hurt and I put my hand up and that's when I felt a gigantic lump forming. "You have to take me to the hospital right now," I told Noah but he was already in action, grabbing me a jacket and his car keys.

My head started to clear a little as we drove and I started to realize what a surreal situation this was. What the hell had caused me to black out and how had it happened so fast, with hardly any warning. And worse, how hard and fast had my poor head hit the kitchen tile to cause this enourmous misshapen lump that was growing on the back of my head? I still felt unsteady as we walked into the doors of the ER, my ER, where I know everyone. The ambulance bay was packed and I knew, and felt guilty, that the ER was busy. I also knew that I needed a CAT scan to make sure I wasn't bleeding into my brain from the fall. They got me into a room right away and got to work. I had to appreciate the nurses as this point. Already anticipating what tests the doctor was going to do and doing them but at the same time being caring and attentive, trying to make me as comfortable as possible. Of course I knew everyone and they were all shocked I was now on....THE OTHER SIDE.

I hate to say it like that but it is true. You have to have compassion and empathy as a nurse but at the same time you have to keep a little bit of distance. If you completely empathized with every single patient, all the hurt, all the sad stories, you would basically be an emotional wreck, unable to get the job done. To a patient it may seem uncaring, but it is a defense mechanism that all medical workers have. Nurses walk a fine line; yes, we want to take care of our patient's emotionally as well as physically, but, we must also save energy for all the other patients that come through our doors, as well as saving some for ourselves and our families when we come home.

So, even though I was "one of them", I did feel the "clinicalness" of the nurses, that is to say, I felt the subtle but still palpable distance as they went about their jobs. And I understand why some patient's complain about their nurse not caring or their doctor not caring. So I watched the nurses start an IV in my arm and draw blood, get an EKG, take my blood pressure, and get my paperwork started. This was them caring about me. Getting things done quickly and efficiently, so that I may start to feel better, find out what's wrong (or not), and then letting me go home with my husband and putting all this behind me. Making sure I'm not in pain, I'm warm enough, I have ice for my head. They cannot stay in the room and hold my hand and stroke my hair. But they can show me that they care about me by getting the job done. I think that is a big misunderstanding in our society right now. The role of nurse has changed, they have bigger responsibilities than ever before. And while some patient's think it is important for the nurse to hold the straw to their mouth while they drink, the nurse must also be getting the labs, running the tests, starting the IV's, giving the meds...you get the picture.

I went for a CT scan and, phew!, no inner bleed just a subcutaneous hematoma from the fall. (We were jokingly calling it my "hematomato" because it was visible from across the room, practically). All my labs were normal. My blood pressure was normal. My EKG...well, that's where it got a little tricky. The doc asked me if I had ever been diagnosed with WPW, aka Wolf Parkinsons White syndrome. It's a heart condition that can cause arrythmias. Well, no I had never been diagnosed with it. He said that my EKG showed only one of the two hallmark signs for WPW so that he wasn't ruling it out. But, like I tell all my patients, this is an ER and I would have to take my health in my own hands and follow up with a cardiologist. I was hemodynamically stable, my BP was normal, I no longer had a pounding headache (after 8 mg of morphine and 1/2mg of Dilaudid), so I was free to go home. That is another thing that people don't understand about Emergency Rooms. We can't heal you, we can't always tell you exactly what is wrong. What we can do is make you stable and comfortable enough to go home and take care of it later or, if you are really sick, we will admit you to the hospital where a more appropriate doctor, a specialist, can take the time to figure out the problem. People expect to walk into the ER sick and walk out two hours later feeling "all better", but that is not a reality and people need to know that.

So, I have taken a few days off work to let my poor noggin shrink back to size. I admit, I had a little post traumatic stress syndrome. I kept imagining what the sound of my head hitting the tiles must have sounded like. And I kept getting nervous when I was in the kitchen or the bathroom, I'd think 'What if I passed out right now?'. But so far so good. I met with my doctor today who is internal medicine. I have an HMO so I am not "allowed" to go directly to a cardiologist until I see my primary doc. He was very nice but also annoying. Doctors have these big brains and they don't rule out anything so as he droned on about possible seizure activity or heart arrythmias or thryoid problems, I had to tune him out. No sense worrying about a thing until it is proved it is actually that thing. My diagnosis? After being a tad dehydrated, I jumped up from the couch a little too quickly and vasovagaled. It seemed more dramatic than it was because I happened to bite my tongue and bruise my skull. But, like a "responsible" adult (and like going to a mechanic), I let him take a few more tests and am currently wearing a Holter monitor which records the electrical activity of my heart for 24 hours. I will follow up with the cardiologist on Tuesday, as recommended. Meanwhile, I'm taking it easy and thanking god I didn't land face first!!

Monday, April 2, 2007

Sunday suppers


We went out to eat twice today. For lunch we went to one of our favorite bistros in West LA/Brentwood called Literati II. Noah had been offered a job there but declined for certain reasons. It has become one of our favorite places to eat, the food is always good and consistent. Farmer's market driven and simple. Since it was Sunday, they were serving brunch. Noah had grilled asparagus with burrata cheese, prosciutto, and a walnut vinagrette. I had a bacon and broccoli quiche. We snacked on pomme frites with aoli, first. Very relaxing Sunday, 2pm. And Noah, being the insanely sweet husband he is, accompanied me to a fabric store where I bought some beautiful apron making material. (See above photo for the awesome finished product! Thank you Amy Butler!)

For dinner, we traveled to West Hollywood (pretty much the mecca of all great LA restaurants), and a place we only go when we are seeking out said great restaurants. We went to a place called Celadon, Noah worked with the chef a couple of years ago. The chef is half Jewish, half Japanese; the food "asian fusion". The food had great clean flavors, was fun, and the kitchen sent us some special dishes on the house. But probably not a place I would go back to. The decor made me feel like I was in Pier One. The service was great though. I was having really bad menstrual cramps toward the end of the meal, you know the kind, feels like you are starting to have contractions. (I say that in theory, of course.) Needless to say, I wanted to cut the meal short and go home and get in my jammies but I also wanted to have dessert. I asked if I could get "The Lemon Trio" to go but, alas, the server informed me it was not possible. Oh well. We paid the bill and started to walk out, me half doubled over my contracting uterus, when the server called us back. The chef had sent us the lemon trio to eat before we left! So, we sat back down and ate gratefully, my cramps momentarily forgotten.

Noah and I never feel guilty for these overindulgent days. Yes, we're taking in far too many calories, and yes, we are spending way too much money. But who cares? We are enjoying our time in LA, the sights, the food, the weather. We are enjoying our years of fast metabolism, low cholesterol, and healthy livers. We will probably pay the price later but for now we are loving our lives, loving food, and, most importantly, loving each other.

Saturday, March 31, 2007

Oh boy, another 12 hours done

A little sampling of the patient's I saw today...

A guy came in for a recheck of his buttock abscess. He was upset because we asked him to come back tomorrow to check it again. "I can't keep coming in for an hour everyday!" he said angrily. "Oh," I retorted, "would that be too much of a pain in your ass?". He paused, then laughed and agreed to come back in.

A seventeen year old girl came in with her mother. Her chief complaint was "I ate a pot brownie and now I feel lethargic and hungry." After the other nurses and I had a good laugh, I brought her to an exam room. She was covered in potato chip debris and couldn't make eye contact with me. Her mom looked equally embarassed. Our advice to her? Don't take what you can't handle.

A poor, harried mom whose toddler broke her nose by bucking his head backward into her face. Anyone who has ever had a toddler in their lap knows exactly how this could happen.

A perfect example of a nurse taking care of others needs before her own: A nurse came in with a painful, swollen foot after working two 12 hour shifts. She only came in to the ER after a doctor noticed her limping. We found she had two stress fractures in her foot (caused by an injury that developed into a fracture because she kept walking on it). Proof that nurses work too hard and don't get paid enough! And guess what, this was not considered a work injury! (What???)

On a serious note;
We received a young woman flown in from Nairobi after she had been treated for a gunshot wound to her abdomen. She was on vacation with her husband and was robbed in Tanzania. During the robbery, she was shot, with the bullet exiting through her lower back. As if this wasn't devestating enough, the 16 week old fetus she was carrying was killed. Yeah, fucking heavy. She came to us with a colostomy bag (a bag used to empty fecal matter when the intestines have been severely injured) but was, eerily and disturbingly, in great spirits. Obviously in denial. Who wouldn't be? It's hard, as a caregiver, to separate yourself from such tragedies. How do you relate to someone that has gone through something like this? And how to show compassion to the patient in the next room who is upset that they ate too many pot brownies and now "feel funny"? It's a delicate balance...

Wednesday, March 28, 2007

My nights as a domestic goddess...


I love to cook! My husband, a wonderful, professional chef opened my eyes to the fabulous world of food. A vegetarian for ten years when I met him, he has introduced me to ingredients and techniques I never knew existed. On one of our first dates I asked him to cook for me, it didn't have to be vegetarian. He made me a simple pasta dish with broccoli and spicy pork sausage. We sat on the living room floor of my small apartment eating from large bowls in our laps. I haven't been a vegetarian since.

On my nights off, I love to putter around the kitchen with a glass of wine, dicing and blanching and seasoning. I try to time it so that when Noah comes home from work around midnight, our dinner is ready to go. I watch cooking shows --not Rachel Ray or Emeril--but Nigella Lawson, Alton Brown, or a program on PBS hosted by Julia Child. I peruse Noah's extensive selection of cookbooks, usually guided by an ingredient I have at hand. Wednesdays is Farmers Market day. Noah comes home with all sorts of baggies filled with produce and I search them excitedly, picking one or two ingredients that I will base our dinner on. Today he brought home some Oregon morel mushrooms, asparagus, baby carrots, spring peas, fava beans, strawberries, and rhubarb. Spring is here! My favorite season for produce.

I went to the nearby seafood market and picked out a beautiful peice of halibut, wild caught from Alaska. I'm going to shell and blanch the spring peas, then saute them, with the morels, in shallots, butter, and a small amount of homeade chicken stock. I'll pan sear the halibut, put it on a white plate, then top the fish with the peas and mushrooms. I'll drizzle the juices all around the plate and add some chopped Italian parsley at the last minute to finish. This is how Noah taught me to cook. No measuring, no following a precise recipe, just taking what is in season and letting the simplicity of the ingredients create the dish.

Last night, I was heavily involved with a sewing project (simple but fabulous dinner napkins) and didn't want to spend a lot of time in the kitchen. I made a recipe that I learned on Nigella Lawson's show for times just like this. She seasons and rubs with olive oil two chicken legs (drum and thigh together) and places them in a shallow baking dish. Then she scatters a variety of chopped vegetables around the legs, chopping them to approximately the same size. For my dish I used potatoes, onions, unpeeled garlic, cauliflower, cremini mushrooms, and an orange bell pepper. But you can use whatever you have on hand, even apples, eggplant, broccoli, whatever. She tosses all the vegetables in olive oil and salt and pepper, then sprinkles dried thyme over everything. (I used herbs de provence.) I figured Noah was going to get home around 11pm, so I threw the dish in a 425 degree oven at 10:15. At 11:15, when Noah was already home and relaxing on the couch, the chicken was done. He taught me a trick to check if the chicken is cooked through: Put a small knife through the thickest part of the leg, then quickly touch the knife to your bottom lip (why there? I don't know). If the knife is hot, the chicken is done. We plated some vegetables in the middle of the plate, cut the leg apart where the thigh met the drumstick and placed that on the vegetables, then we drizzled the accumulated pan juices all around. The chicken was really tender and the vegetables were delicious, especially with the herbs. So easy, and it only took me about 5 minutes to chop the veggies and assemble the dish. I added the left over vegetables to scrambled eggs for breakfast this morning.

After we ate our dinner last night, Noah looked me in the eyes and said, "Naomi, you are a wonderful cook. I appreciate, and look forward to, coming home and eating a delicious meal with you. But...a man has got to have some sweets at the end of the day. You rarely make desserts!" He's right. I don't often crave sweets and I rarely order dessert when we go out to dinner. I prefer savory flavors. I would rather eat some cheeses at the end of a meal instead of something sweet. When we have ice cream in the fridge, I never touch it. Noah has the whole pint to himself. So, I am in the process of making some homeade vanilla ice cream and a rhubarb and strawberry compote. The cream, eggs, vanilla, and sugar have been boiled and tempered and watched very carefully and is now cooling in the fridge before I put it into our automatic ice cream maker. The strawberries and rhubarb will simply be cooked down with sugar and lemon zest until soft, then served warm on top of the ice cream.

I've got a lot to do tonight, finish my ice cream, start my compote, shell my peas...why am I still blogging?

What I do for a living...


I always walk through the automatic glass door entrance to the hospital with some anxiety. As I walk past the ER waiting room, I count the number of people in the chairs, hoping to gauge what kind of day I will have. How sick do they look? A mild cough? Are they holding a bloody towel to their hand or forehead? Does anyone look to be crying? Of course, I cannot hear them. My headphones are plugged firmly into my ears, hoping that music will calm me or wake me up, depending. I walk down the linoleum hallway in my comfortable nurse shoes, my scrubs, carrying a large bag filled with various snacks, and in my hand a cup of hot, sweet coffee, hoping these things will sustain me through the next twelve hours. I swipe my badge through the time clock and greet my coworker's in the Fast Track.

The Fast Track is a department that works directly with the main Emergency Department. We are a team of two physician's assistants and three nurses that see the non-emergent cases. While we take care of the migraines, the lacerations, and broken bones, the main ER can help the chest pain's, the strokes, and the drug overdoses. It's a pretty good system.

People come to the ER with non-emergent cases for a variety of reasons. Lacerations and broken bones make sense to me. I would go to an ER if I thought I broke a bone or needed stitches. But the other complaints baffle me. "I've had a cough for 10 days". "I've had neck pain on and off for a year". I always ask them, "Why did you come to the Emergency Room today?" I understand that some people do not have a doctor or even insurance. But I'm curious to know, why did they choose that today would be the day they decided to come in as an emergency? If you've had neck pain for a year, why not get it checked out six months ago?? My favorite non-emergent complaint of all time is the young guy who came in saying, "I smoked pot and then drank a Red Bull and now my heart is beating fast." My diagnosis: Can't handle his high. My cure: Sit him in front of the television with a bag of Doritos for an hour. He'll be fine. Instead, he pays a $500 fee just for walking in the door then the PA gives him another drug to help "calm" him which he'll probably just get addicted to. As he was walking out, I told him he shouldn't smoke the dank if he can't handle it. He said, "No, I'll just take this drug whenever I want to smoke pot." Great.

We do see a lot of drug seekers. Many claim they have been in car accidents or have migraines. This is usually a guarantee to get at least a shot of pain medication. But you get a sense of who is seeking and who is really in pain. The seekers will ask for their drug of choice by name and claim that they are allergic to over the counter medications or "those don't work for me". One kid who claimed he had been in a car accident asked me if I would give him a shot of morphine because he was "in such intense pain". He asked me this as he was spooning and snuggling in the guerney with his girlfriend. Ummm, no. Another guy was recieving a shot of Dilaudid (ten times stronger than morphine!) for his "migraine". He requested that I give it in his thigh (I would normally go for the glutes) and when I injected into his muscle he closed his eyes, started to massage his leg, and started making "OOOhhhh, AAAHHHH" noises like he was about to have an orgasm. He made me feel dirty.

But, today is a new day and as I put my bag away, check to make sure I have enough pens, some tape, alcohol swabs, and a pair of scissors in my pocket, I take a deep breath and greet our first patient with a smile. I know that in twelve hours I will walk out the door, tired, maybe a little bit sweaty, and climb into the passenger seat of mine and my husband's car. My husband at the wheel with a smile, a kiss, a "How was your day?". I can go home, put my feet up, sip a glass of wine, and comfortably discuss the day with my husband. We talk about his work....Oh, that's a whole other blog...