Flesh and Bones:Tales of a nurse and a chef's wife

A long overdue shout out to the hubby...

2010-12-18T22:29:00.000-08:00

First of all, my husband is a chef professionally but still LOVES to cook at home. It's a shame when other chef's say they don't have the energy or desire to cook at home because they do it all day. Noah visits the farmers market every week and knows the farmers by name. They give him free goodies to bring home. He isn't afraid to try something he doesn't recognize or has never worked with. We don't eat anything out of a box or a can (except San Marzano tomatoes) and haven't eaten fast food in years. Our pantry is filled with canned goods from the summer: Tomatoes, pickles, salsas, peaches, peppers, jams, olives, and jalepenos. Bottom line: we eat well.

He may whip up a little afternoon brunch on our day off. Cranberry beans, corn, hericot verts and croutons, all topped with a poached egg and served with a rose out on our patio.

For dinner, it might be scallops and lightly deep fried vegetables with an eggplant puree. (This was in the summer, of course)

He is an artist.....

...and food is his medium.
He's not always so fancy.... Cooking for my family while visiting in Portland.

His fried chicken and potato salad we bring with us to Dodger stadium is STOOPID! (That's a good thing)

He makes desserts too.. (of COURSE he made the biscuits from scratch. Thanks mom!)

This is a typical scene in our kitchen: pots a'bubblin away on the stove, the rear one is chicken stock that we freeze into ice cube trays then throw the cubes into whatever we need it for, salmon we got from the seafood market down the street, a chantrelle mushroom waiting to be sliced... it always smells SO GOOD!!!

This is the result:

So I've done all my bragging for now. I'm just so proud of his talent and his passion and feel blessed he shares his knowledge (and meals!) with me. He's also pretty darn cute..

Portland (might as well be called Heaven)

2010-07-22T22:22:00.001-07:00

Gorgeous, lovely Portland. Of course we got there when the weather was on its best behavior so it seems like its the most fabulous city of all time! This is the Marriott on the river. Our view from our balcony, for a ridiculously small amount of money. Thank you honey!

We hit up some Asian markets for seafood (Noah is picky so we went to three different places) and he decided on some live shrimp and whole striped bass.

We had so much fun with our nieces and nephew! They all have their own crazy personalities. Noah hadn't seen the kids in almost two years!

Me: What time is it?

Isadore: Half past a monkey's ass according to his balls!

Me: (see photo)

The fish just before it went on the BBQ. Mom looks so cute in the background.. Anticipation!!!

Fresh sardines! Mayan loves these so it was a special treat for her birthday...

The man and his grill...

Serving it up!! Crazy, kid yelling, everybody talking, noisy, fun dinner with the fam!

Downtown Stumptown

Karaoke was so much fun! No embarrassment just beltin' it out. The kids were naturals!

Sing it George! He did "Twinkle, Twinkle" and No Doubt's "Hey Baby".

Nice move, Uncle Noah. I didn't know you liked Lady Gaga... (Look at George hugging the girls from behind)

George and Uncle Noah singing some Johnny Cash. George liked to walk around the "stage" with his mic.

Noah loves this photo!

Late night with Aaron Woo. Regrets we didn't take photos when we had lunch with him, Karen, and Ethan.

Spending some quality backyard time with Gray. Ate egg sandwiches made from his chickens eggs and helped save a woodpecker from being pecked to death!

Too short, too short.......

Work is just an annoying interruption of my real life....

2010-05-20T21:27:00.000-07:00

I'm falling in love with Southern California. The more I explore the history and the neighborhoods the more I become enamored! On Tuesday Noah and I had tickets to the Dodger game (it was Andre Ethier bobblehead giveaway night!) so we decided to go downtown first and explore a little. I have a architecture book of LA that we frequently tote around with us on our adventures. One spot downtown that I really wanted to check out was the Bradbury building built in 1893. Plain on the outside but inside.... Oh wow... mouth hanging open in awe.. Pictures just don't do it justice. The film Bladerunner was filmed here if you want to see it but aren't planning on visiting soon...

Downtown LA is filled with these treasures! A lot are in disrepair but some have been restored by smart people that we thank profusely! Look at this gorgeous building.... It's a theatre in the theatre district (now the sketchy jewelry district) built in 1931.

After our tour of downtown we headed to the "Art District" around 3rd and Alameda to check out this new sausage place called Wurstkuche. All the food was house made: sausages, kraut, buns, mustards, ketchups... Yum, yum! And they have tons of great beer on tap. I can't believe I didn't take a picture of the sausage. Only this cute guy...

Next we took a cab to Union Station to get on our free shuttle to Dodger Stadium. We stopped at the bar called Traxx to have a cocktail. Union Station is an amazing place. All sorts of people coming and going; very much an airport feel but with an old school vibe....

Oh joy!!! The anticipation of a ballgame, the gorgeous view from the stadium: downtown, Chavez Ravine, palm trees. I love this place!

We sat in the cheap seats and loved it. We had a great view of the field and we were surrounded by super nice fans and people just out to have a good time. Obviously the weather was nice...
Not only did we score a bobblehead but the Dodgers put on a great game and won!!! Dodger stadium is my Disneyland...

Palm Springs and the Salton Sea....

2010-05-03T23:50:00.000-07:00

Noah and I love to stay a night or two in Palm Springs when we get a chance. We found this quiet hotel with small kitchens and a big BBQ by the pool. We've stayed here close to 10 times now. It's kitschy and affordable and rarely has kids staying. Nice and quiet...
What gave it away that only retired or childless couples stay here? Yes that is a shuffleboard court and yes, we've played several times. Always with a cocktail in hand...
There are several fruit trees on the property including figs, limes, lemons, olives, and this heavily laden grapefruit tree. The owners don't mind if you pick and use the fruit.
Noah looks pretty relaxed.... We lounge by the pool for hours reading magazines and jumping in every 30 minutes or so. We made our own bloody mary mix and made bloody mary's with pickled okra. We've decided it's a "healthy" cocktail.
Aaaaaaaahhhhhhhhh!!!!!!!!!!!! Not only are we drinking healthy but as you can see I am exercising as well.
We love our little kitchen. (It's probably bigger than our kitchen at home!) It has a large fridge and a two burner stove. We precooked baby back ribs then threw them on the grill to finish them off.
We drank a cold white wine, listened to music, let the night air blow in...

Radishes, asparagus, and fava beans...
The next day we headed south east and stopped at Shield's date stand. They've been growing dates since 1923! We had to get an ice cold date shake.
Don't miss the sex life of dates movie that plays continuously while you're slurping down your shake!
Next stop was the Salton Sea. In the 40's and 50's this was the place to go: "the Californian Riviera". Then it became super polluted and too salty and fish started to die off in staggering numbers. From what I read about it I thought it was going to be gross and stinky but to our surprise it was beautiful. (I didn't jump in though!). But for all it's beauty it was a lonely, desolate place. The small towns around it were nothing but dusty old trailer parks. We spontaneously started talking in a redneck twang...
In a town called Bombay Beach, population 326, we found the local watering hole: The Ski Inn. (As in waterski, I suppose.) We parked between the locals cars and made our way into one of the best dive bars I've ever been in! (And I've been in a lot). The owner was behind the bar pouring drinks, the walls and ceiling were covered in dollar bills, and there was about 4 or 5 regulars sitting at the bar, nursing their drinks. Their heads all swiveled around as we walked in and Noah wasted no time chattin' them up while I ordered us budweisers that were served in cold mason jars. We ordered a cheeseburger and a grilled ham and cheese sandwich with fries. The cheese was processed slices and there was a jar of pickled eggs on the counter. We bought a can of "Fish Assholes" to support the local volunteer fire department. The local at the end of the bar kept calling us "Santa Monica" as in "Hey, Santa Monica, where are you headed after this?" It was a blast!

Of course we had to tape a dollar to the ceiling. It feels good to know we have a little shrine of our own at the Salton Sea Ski Inn.
Oh California! The more I get to know you, the more I love you!

My job is not okay...

2010-03-16T22:20:00.000-07:00

Imagine this: In one room you are taking care of a patient who is dying. A patient who is only 62 years old. Your mom, your friends mom. She's is dying right before your eyes. You do chest compressions when she goes into cardiac arrest, she's intubated and on a breathing machine. You give her several doses of epinephrine and atropine every time she arrests (five times so far!)! You start a chest tube. She came in talking, saying she didn't feel well the past couple of days. How many times can you code her? Enough. She dies. The family weeps, it's horrible, it's tragic. You hug them, you cry. Then you have to finish your shift. You have to go into a room with a patient complaining of a headache. They want your attention, they want your sympathy. HOW? How can I feel compassion for you???? Your headache is stupid, it is not important. How do I do this? How do I feel compassion for your headache when someone just died right in front of me!?

2010-03-04T22:08:00.000-08:00

We decided to grill a whole fish tonight. Thank you, oh dear sweet red snapper, for giving us your moist flesh. We treated you with the utmost respect and reveled in every sacrificed morsel. It helps to eat "whole foods" to remind us exactly what we are eating. We had some leftover fennel stems and fronds and lemons so Noah stuffed those in the cavity.

Our trusty habachi... we've used it for years on our small patio and it easily fits in our trunk for a beach trip.

The skin got stuck on the grill, but not too bad, and the smell was amazing! (Maybe not so much for the neighbors but f*ck them!)

Noah braised spring onions with black trumpet mushrooms. Then he crisped up some fingerling potatoes to serve alongside. Chives and tarragon finished it off. So good!

Spring has sprung in SoCal...

2010-03-04T00:59:00.000-08:00

So Noah went to the farmer's market today and came home with strawberries and asparagus!! Spring is officially here in Santa Monica. I went back and forth on what I wanted to make. I always have this problem on Wednesdays... he brings home so much beautiful product that I want to use everything. But I reigned it in and decided to do simple. After a thorough inventory of our "larder", I hoofed it to the store for buttermilk. Then I pulled out Julia Child's Mastering the Art of French Cooking (a la a recent popular movie) and looked up hollandaise sauce. I took the beautiful asparagus and peeled them then steamed them. After making the hollandaise just as Julia suggests, we poached some eggs and crisped up proscuitto in the oven. Here is the result:

It tasted sooooooo goooood!!! Then I made shortcake biscuits using a recipe from Alton Brown (he never lets me down!) I macerated the strawberries in lemon juice and sugar then made Noah whip up the whipping cream with powdered sugar and a drop of vanilla extract. Exquisite!!

My 35th...

2010-02-25T00:29:00.000-08:00

We had so much fun on Noah's birthday downtown that we decided to do it again for mine. Downtown LA always seemed like a place you never went unless you worked there. But there is a budding society and it makes it seem like we are visiting another city. A vacation 20 minutes (or an hour and a half) away (depending on traffic, of course!).

Our first stop, Bar 107. Big ol' Pabst served in an old school dive bar!

3pm. Downtown LA. PBR's. Camera. Love it!!!

Next, we walked a couple of blocks away to a a wine bar called The Must. They served tator tots with cheddar cheese sauce. And really strong Raaaaaaayyyy Neeeaaaarrrrrrr Beeeeaaaarrrrr!

Noah drank an Old Milwaukee and we snacked on a warm, soft pretzel with a fabulous mustard.

They had a bunch of board games and card games for public use so we channeled our Hawaii vacation and played some Uno. (Of course I thought of you Lou!)

Next we walked a couple of blocks to The Redwood Bar and Grill (a pirate bar, Arrghh!). This was the view outside the door...

Lately, I've really been into Journey. More precisely, I've been OBSESSED with Journey, especially with Steve Perry. So on my bday I wanted to sing "Journeyokie". We snuck in a pint of Jim Beam and sung our hearts out!

'Through space and time

Always another show

Wondering where I am

Lost without you'

-Steve Perry

Thoroughly toasted and ready for some good food, we walked/bussed to Church and State, a fairly new place on the outskirts of downtown. Downtown is a sketchy place to walk around: one minute you are in a gentrified neighborhood, the next skid row.. Yikes! But we made it okay and shared a prix fixe menu for $39.

Amuse bouche: english pea veloute with smoked bacon

Raw oyster and poached shrimp

Duck breast with lentils, brussel sprouts, and orange duck sauce

I forgot the dessert because I don't really like dessert...

We took the 720 home, straight down Wilshire. Barely had to wait, stopped at the HMS Bounty mid-wilshire, halfway through the ride. Got bought a drink by a regular, chatted it up with an Asian Jew and a gay guy. Fun, fun...

Noah's LA birthday adventure

2010-02-04T17:41:00.001-08:00

For Noah's 36th birthday, I wanted to go to take him to the French countryside, tour off the beaten path bistros in a convertible and spend nights in quaint little bed and breakfasts. But we couldn't afford that. Hawaii? New York? Palm Springs, for gods sake? Nope, our budget would not stretch that far. So I decided to take a small vacation in our own city. It's easy to do in LA, a place where every country is represented in some neighborhood. After some thought I thought it would be fun to discover the essence of old Hollywood, the LA of the 30's, 40's and 50's. Oh, and I wanted to booze to be included somehow. So I researched lounges that have been open since the 30's. Here's what we found:

I thought it would be fun to forget about driving and trying to find parking. LA's public transportation is atrocious but we found a way to make it work. After buying $5 day passes for the metro (good on buses and the rail) we hopped on the Big Blue Bus #10 to downtown.

It took us about 25 minutes to get downtown. The ride was comical, the personalities of the bus driver and other riders kept us entertained. And in true LA commute fashion, the bus got cut off, had to slam on the brakes, and we came together as a small bus riding community by flipping of the offending driver. What fun!

We got off downtown near a rail connection and did our first underground foray of Los Angeles. The cleanest and most beautiful of subway systems! I'm shocked more people don't take advantage of such a convenient way to get around the city.

Our first stop was in Hollywood. Naturally, something was being filmed at a corner diner and we had to fight our way through lights, electric cables, crew, and heavily perfumed and make-up'd actresses. Pretty cool to see the Capitol Records building.

Our first stop, The Frolic Room, conveniently located right across the street from our rail stop. We meandered along the star studded sidewalk and made our way into the tiny, dark bar. There was one other patron and the ageless, petite woman behind the bar was making him some Jiffypop on a strange, undulating hot plate. She was delighted when we told her what we were doing and gave us ideas of other bars to visit. The Frolic Room was opened in the 30's and was a hang out of the "Black Dahlia" and Charles Bukowski.

Inside the bar with the birthday boy. I love taking low light photos. And of course there are always signed head shots and photos of the owners with various celebs prominently displayed.

A quick bus ride to the next stop: The Formosa cafe. It was opened in 1934, the back half is made out of a trolley car, and legend has it that Frank Sinatra spent many nights here pining over Ava Gardner.

A view of the trolley car (sorry about the blur!) The bartender was really friendly and knowledgeable. The cafe is around the corner from Warner Brother's studios so all sorts of industry types have spent lots of time here.

This was Elvis Presley's favorite booth. He donated several Elvis-likeness liquor bottles which are displayed in the case above. An Elvis shrine!

We took the rail back downtown and our last stop (after having a great dinner at a new restaurant in Japantown called the Lazy Ox Canteen) was Cole's. It boasts having invented the French Dip.

We ordered Bombay Sapphire martini's and the bartender wasn't having it. He made us martini's made with an old school English gin. A fabulous end to a great birthday! A relaxing bus ride home....

New fancy digs..

2009-12-10T01:06:00.000-08:00

The new and improved ER has passed inspection and we are ready to move in next Thursday! So exciting to be able to move in to a new building with new equipment. (No more call lights that are a 3 foot string of gauze attached to the one that was broken 5 years ago). New moniters, new computers, and 2 trauma rooms! I know there will be some growing pains but I'm really excited! I'll try to take some photos to post soon.

Our best hiking day yet...

2009-11-19T20:04:00.000-08:00

Decided to revisit a hike we had done last week but take a detour up to Magu Peak. I told Noah that I wanted to be at the trailhead by 1pm. I woke up at 1230! Not a great start. Our plan was to do the hike and time it so that we finished by 430 or so then we wanted to BBQ at our favorite beach, which is just down the road, and watch the sunset. We got to the trailhead at 2pm and started up. I was so tired I wanted to quit at the beginning. But the trick with hiking is that you just keep putting one foot in front of the other. Don't look ahead, just keep plodding. My hard work was well rewarded! Check out this summit view looking down on the Pacific Coast Highway.

The views were panoramic! We couldn't even fit into the photo how much ocean we were looking down upon.

We finished the hike just around 430, just how we planned. We drove the short distance to Sycamore Beach and fired up the BBQ. We had brought a gargantuan porterhouse and Noah had put together a coleslaw with napa cabbage, apples, parsley, and watercress with a creme fraiche and red wine vinegar dressing.

Noah manning the grill with the sun going down behind him...

Gorgeous sunset, gorgeous man...

We split a bottle of Santa Barbara Winery pinot noir and ate while we watched the sky turn a hundred different colors. We could see lobster boats bobbing in the distance, a guy was paddling around on his surfboard, seagulls were trying to check out what food we had to offer, and the only other people on the beach were BBQing something that smelled delicious. What a great day!!

Sunday laziness..

2009-11-15T23:01:00.000-08:00

I love Sundays! I always ask for them off. I think working on Sundays is a sin; not because of God but because it's the one day that all responsibilities are put on hold. No banks, no bills, no appointments or obligations. I also happen to LOVE football and it starts at 10 am and goes all day. What a great excuse to lay on the couch all day and drink beer. *Heaven!* Even better is that my husband, while not obsessed with football, is equally enthusiastic about food and cooking. So while I sloth on the couch, he is busy with all the amazing produce he picked up at the farmer's market the day before. I don't know how I ever ate at any shitty restaurant. I am so spoiled rotten that I have an amazing chef cooking for me every day. And he likes it!! He's perfectly happy puttering around in the kitchen while I lay on the couch watching TV. Disgusting, I know. Here's a typical conversation:

Noah: Can I get you anything?

Me: Another beer would be nice.

Noah walks over and hands me a cold beer, takes away my empty, kisses me. He goes back to the kitchen and continues making food.

Me: Can I help you do anything?

Noah: You are perfect doing what you are doing.

*Sigh!* What a great guy! A few minutes later he hands me this:

Pan seared chicken thighs, lettuce, figs, parsley, and blue cheese in a shallot vinaigrette. Yummy. So in return I baked chocolate snickerdoodles which he had for dessert with a big glass of milk. We played cribbage on the patio this afternoon and shared a bottle of Pinot Noir from the Santa Ynez valley. He's fallen asleep while I type this, it's super cozy in our apartment, smells good. Aaahhhhh, I love lazy Sundays!

More hiking fun

2009-11-10T18:54:00.001-08:00

I'm such a lazy person. I hate to exercise and I only do it if I'm motivated to fit into a pair of pants. I always feel great once it's done but I'm bitter and pissed during the actual act. So about a month ago I went on a hike with some friends near Santa Barbara. I couldn't wuss out and I couldn't quit. And, by god, I liked it! So Noah and I have been doing some hikes. I bought a book about hikes within two hours of LA. Noah and I chose some easy ones. The great thing about hiking, and being able to stick to it, is that there is a reward. The summit, the vista, the waterfall, whatever. It's easier for me to have a goal to walk towards. And my wussy ass will walk harder and longer if someone is with me; I won't quit earlier if my pride is at stake. Pathetic, I know, but it has proved to serve me well.

On Monday, Noah and I chose a hike close by that advertised a waterfall at the end. I pretty much figured, in these dry days, that we would miss a spectacular ending to the trail. But it was fun all the same; we hiked through an upscale neighborhood with gargantuan houses, then hit a well used horse trail and meandered through a canyon. As we got closer to the end we saw a small creek along the trail and the waterfall at the end was just a trickle. None the less it was pretty and satisfying.

The view down stream was equally pretty and we imagined how amazing this spot must be after a few days of rain...

Noah decided that this hike wasn't challenging enough for him so he did push ups every 15 minutes or so. Very cute...

The next day we chose a hike out of our guide book that was rated "easy". It was timed at 2 1/2 hours so we thought it was perfect given our late start. We drove up a windy road outside of Malibu and drove through a few small neighborhoods of crazy big houses with even crazier big views of the ocean. The trail brought us down into a wooded, shaded canyon. It was easy to begin with. Then we started climbing out of the canyon, both of us out of breath, and having to take a few water (and pee) breaks. This view was looking down into the canyon we had just hiked out of:

This was basically the summit and I am pooped! I feel tricked by my guide book that said it was "easy". But the view of the ocean, Catalina Island, and the opulent homes was well worth it.

The sun was starting to set when we got to the peak. We started to worry that it would be dark by the time we got down. Thoughts of cougars and rattlesnakes danced through our heads!

We made it to the car with some light to spare. It was rewarding and calorie burning and we treated ourselves to a huge steak, quinoa and yams when we got home!

It's been awhile...

2009-11-05T17:53:00.000-08:00

It seems like it's been so long since I logged on to the 'ol Blogger site. So many things have happened: the usual life, coupled with crazy shit. It is pretty amazing that life just keeps going on and on. The first and most emotional thing that happened to me in my absence from Blogger is that a friend of mine died. Sharon was 35, has two kids ages almost 2 and 4. She has a wonderful husband, Brice. I went to her wedding, she went to mine. We worked together at the pub, I thought at first that she didn't like me. She was so pretty and had her shit together. I was just trying to get my shit together. She accepted me unconditionally. She was so sweet, such a nice person. We partied together, worked together, even shared a boyfriend at one point! After I moved to LA, she always called me, even visited once with her newborn, Wesley. In March of this year she told me she hadn't been feeling well and was losing weight. She always had a trim, sexy body. She couldn't afford to lose any weight. I flew up to visit her in April, she had been diagnosed with "abdominal" cancer and was getting ready for a round of chemo. After a hard fight, and the realization that nothing could be done, Sharon died on September 29th. I was blessed to spend time with her a couple of days before she died.

Sharon was so beautiful, inside and out. In the picture below is Melanie Lagalo, Sharon, and me. We had so much fun together, going through the phases of our lives, but still connecting.

When I went to see Sharon just before she died, Melanie and I had a chance to reconnect, rediscovering our friendship and remembering the good times with Sharon...
Then I drove up to Portland and hung out with my sister and her kids. What a great time! The girls are awesome and I got to meet George, circa 1 year old. He's soooo cute!

My parents live in The Dalles and my mom took us to a scenic overlook complete with a park for the kids and a gorgeous rose garden.
I fell in love with the Los Angeles Dodgers! We were given tickets and had a blast cheering them on. Too bad they couldn't get past the playoffs. Next year, next year!
A couple of weeks ago we were privileged to attend Noah's nephew's wedding in Santa Barbara. We stayed in Carpenteria for two nights. The wedding was gorgeous, as was the couple.

On the way home from SB we visited McGrath farms. Noah has been a big fan for a couple of years. They had end of summer tomatoes and zucchini as well as fall shelling beans.

For October we carved pumpkins...
Spooky!!!
I returned to Santa Barbara on my own to visit with Melanie who was visiting some old friends. We went on a great hike in Montecito.
And, as per usual, Noah is constantly involved in some sort of food project. Most recently, curing his own olives.

We hiked Calabasas Peak. It took only an hour and we timed it perfectly to watch the sunset.
Good times, so far, in 2009. I miss Sharon so much but, just as she would want, I appreciate the beauty of the world surrounding me.

San Fran trip...

2009-07-22T23:01:00.001-07:00

Boy, do I love San Francisco! Beautiful view, great food, great weather (luckily!), and an insane transit system. It's a five hour drive from our house. Pretty painless although we decided we would rather add on some extra time and take the 101 instead of taking the 5 which is brutal! How gorgeous is this view??!!

We stayed at our friend's house in South San Francisco (thanks T and J!). It was super easy to grab the BART into the city. We never waited over ten minutes to catch the train and it was really simple to figure out. LA is really lacking good public transportation. Look how cute Noah is with the BART pulling in behind him!

Once the BART dropped us off, we walked everywhere! Philz coffee (where every other coffee shop should bow down at his feet), and then hopping on the bus if we needed to zip across the city.
Of course we went to the Ferry Building and hit Hog Island Oysters. Such a great view and consistently good food. These were local sardines with a blood orange cream sauce.

Kumamoto's and Pacifics: the aftermath. Sipping on good white wine.

San Francisco has a very different vibe than LA.

So not only did Julie make us some great cocktails in "The Bar"....

but she made us this beauty to oooh and aahhh over....

Jonah and Annie also blessed us with a beauty, Seamus. (pronounced Shay-mus). He's 11 weeks old.

Jonah, Annie, Seamus, Noah and I walked down to Dynamo donuts in the mission. We ate 4 different flavors. The two best were apricot and powdered sugar and maple with bacon. Sounds weird, tasted great!

Noah's buddy Bob works downtown at a place called The Salt House. We ate poutine: french fries topped with bechamel and pork. Yummy!

Us at The Salt House.
A random shot of how cool SF is. On the bus with a pinata....
We visited Ray Potes, a friend of Noah's who is an insane photographer. He does "street photography". Check out his website: www.hamburgereyes.com
Noah's buddy Bob. He showed us a really good time. Had drinks at the Elixer in the mission and dinner at Front Porch. Southern Style...

We finally found the Chicharonnes! Locally produced pork rinds. Yum-mmy!
For some reason I found this scene very beautiful and very San Francisco. Homeless man catching a few Z's in a used book shop.
Noah and I scored an edition of "The Joy of Cooking".
We hit up Scala's near Union Square. Noah is friend's with the chef, Jen Biesty. This was a super sexy dish! Raw salmon and caviar with creme fraiche...
We left the city on Wednesday and drove through wine country. We tasted wines at Qupe and then had dinner at Los Olivos Cafe. We lucked into a wine tasting from Alta Maria and got to meet the wine maker. Insane wine!

More activity in the kitchen...

2009-07-16T20:18:00.001-07:00

Noah is testing out pizza dough for his soon-to-be restaurant. The dough rises in the fridge for a slower development. The result is lots of air bubbles and cavernous, chewy dough. He topped this one with an egg, prosciutto, green olives, and herbs.
Eggplant, coppa, feta, and mint.

Prosciutto, pickled peppers, and parsley. Look at the bubbly, golden crust!

The salad he served with the pies: romano beans, yellow wax beans and lima beans in a shallot vinaigrette.

A classic caprese.
I came home from work on Wednesday night and found Noah making these: tapioca with peaches, blueberries, and candied lemon zest.
One for my list of things I can bake: ginger bread cookies! Chewy and soft...

It's a miracle!

2009-07-09T18:28:00.000-07:00

I actually made something successful with yeast! Focaccia!!!

Oh boy...

2009-07-03T02:09:00.000-07:00

Rumor has it that the Michael Jackson memorial scheduled on Tuesday is going to bring so many people into the LA area that all the ER's are staffing up preparing for the influx. I'm already working four of the next five days and they've asked me to come in on my day off. No thanks.

Aaahhh... Sundays!

2009-06-28T21:10:00.000-07:00

Noah and I both woke up with a hankerin' to MAKE SOME FOOD! We had so many projects in mind we were stepping all over each other in our tiny kitchen. The first thing I did was make strawberry ice cream. My custard turned out perfect and I got to use my chinois (twice!) to strain the custard then strain the seeds from the strawberry puree. I jumped out of the kitchen to make room for Chef Noah and his fried chicken. He soaks it in buttermilk first to tenderize the meat, then he serves it with a mixed green salad (so we don't feel so guilty about eating fried food).

Another side dish he made, (while simultaneously doing everything else) was sauteed purple baby artichokes, green beans, and garlic.

For dessert, Noah used some pastry dough he had in the freezer and baked it with fresh figs and strawberries. We served it with my strawberry ice cream.

More yummy lunches at our house...

2009-06-27T19:16:00.001-07:00

Noah keeps bringing home these amazing, gigantic porcini mushrooms and grilling them on our grill pan. They are so meaty I don't even miss any other protein. Here he creamed corn, pan sauteed baby artichokes, and used amaranth as a garnish. "To make it look pretty for you," he said. We paired it with a Qupe chardonnay blend and ate al fresco on our patio.

We made pickles!

2009-06-25T01:26:00.003-07:00

Our lovely dill pickles with mustard seed. So easy, so fun, can't wait to bust into the first jar! I like food I have to wait for. We are so used to instant gratification but food is so much more satisfying when it has a history. Like a slow cooked meal that takes all day to cook and you get to smell it everytime you walk in the house. It just tastes ten times better....

Gettin' ready for the big initiation!

2009-06-20T23:21:00.000-07:00

Last Wednesday I woke up to get ready for work and I had a feeling. I grabbed my stethoscope and my EKG quick reference guide and stuck them in my back pack. Sure enough, when I got to the hospital I was told the ER charge nurse wanted to see me. They were short staffed and asked if I could fill in. I usually work in the urgent care area and have never really been "trained" to work in the main ER. I was nervous of course. They deal with critical patients, I usually deal with sprained ankles and lacerations. But, I'm a realistic gal and I know that it's time for me to step things up. I accepted!

They gave me four rooms to take care of. Luckily not the trauma bay or the chest pain/stroke rooms. It started out kinda slow so I was able to ease in gradually and find my way around. I think sometimes we take our regular job for granted: how easy we find things, how we just automatically know where to grab for things without actually thinking about it. Another FABULOUS part was that I had a secretary to put in all the orders for me, make phone calls, copy shit. What a load off! I also had at my fingertips a tech who did all the EKG's, hooked patients up to the monitors, and did vital signs. And volunteers who brought patients' blankets, water, food, the phone, answered questions... Wow! And to top it all off a charge nurse who had no patient's of her own, she was just there to lend a hand, a float nurse who also could lend a hand, and 5 other RN's as backup. There were Physician assistant's (PA) seeing patients and easing the doc's workload. AMAZING! All I had to do was focus on my nursing skills and assessment. (What a concept!)

I jumped in to help other nurses, I especially wanted to get my feet wet in Room 2 (the trauma room), and help with the really critical patients. How can you go wrong when you've got so much help and support around you? I helped stabilize a septic patient who ended having 7 or 8 attempts at intubation that lasted over an hour. He never coded but in my selfishness I kinda wish he had so that I could've assisted. It was sooo cool to see the teamwork of the whole ER team: nurses, techs, RT's, PA's, MD's, secretaries.... You can't save a person's life if one of these elements are missing.

So, I'm doing an actual preceptorship shift on Monday where I will follow an experienced nurse and have her teach me the ropes. (Thank you Tina!) I asked them to give me the hardest "pod" so that I may see and experience as much as I can. (Check future blogs for my complaints on how I went down in flames and how much working in the ER sucks...)

So kudos to all you ER nurses/docs/PA's/techs/secretaries/volunteers that do this everyday. I'm impressed, awed, and bow down at your feet.

Hubby's got a bliggety-blog!

2009-06-19T10:30:00.000-07:00

Check out Noah at:

http://figsandconfit.blogspot.com

By the way...

2009-06-14T02:32:00.000-07:00

Oh, by the way, if you are going to bitch slap your 67 year old wife, wait until you get home and don't do it in front of a bunch of ER nurses...

Aaahhh... wine country!!

2009-06-14T00:18:00.000-07:00

Spent a fabulous day/night in the Santa Ynez valley north of Santa Barbara doing wine tasting by myself. I had so much fun!! I drove up the Pacific Coast Highway on Sunday morning to the 101 past Santa Barbara and then up the 154 to Santa Ynez/Solvang. Cranking the tunes, singing at the top of my lungs, the ocean a constant companion to my left. I did some wine tasting at a couple of wineries before I checked into my hotel. At Sunstone winery I ran into a girl I went to high school with and we sat in the sun, sipped wine, and chatted for almost two hours. She is also a nurse and was visiting the area with her boyfriend. So good to see you Heather! I really enjoyed our time together!

75 degrees perfect, lavender was in full bloom...

Met some friendly locals at The Hitching Post while eating steamed artichokes and grilled quail...

Checked out the vintage motorcycle museum (dreamy sigh)...

Loved my hotel room with the fireplace, a glass of local wine, and fresh out of the hot tub...

And spent the next day dining and wining in Los Olivos...

I LOVE to travel by myself! Of course it would have been so much more fun with Noah but I enjoyed the interaction with people and the feeling of independence of exploring a new place all by myself. I brought home a lot of bottles of wine to share with stories behind each one.

The Swine flu..

2009-05-12T20:41:00.000-07:00

I've been a nurse for over 5 years and I got my first patient complaint. Over the swine flu. This patient said, and I quote, that I was "the worst nurse of all time". WOW! Of all time... That is saying something since there has been nurses in this world since who knows when. And I'm sure that the nurses that have gone to jail for murdering people are pretty bad, sooo...

Here is how it went down: This woman came in complaining of fever, headache, general malaise, etc. She looked miserable. I was sure she was sick. I asked her if she had taken Tylenol for her fever. I rechecked her temp. I brought her water. The problem was that she was convinced she had swine flu. I took a nasal swab that tests for Influenza A. If the swab is positive for flu A then we send a second swab to the Public Health department so they can test if for swine flu. Her nasal swab was negative. Which means she does not have the flu, let alone the dreaded swine flu. (BTW we haven't had any positive flu swabs at our hospital yet.) For some reason this woman was still convinced she had swine flu. She demanded Tamiflu. I told the MD that the patient had a lot of questions that I couldn't answer, that she was demanding Tamiflu and I felt the doc should go talk to the patient. Instead the doctor just handed me a prescription for Tamiflu to give to the patient. So I went into the room (for the twentieth time) and gave her the prescription. "Are you going to fill this for me?" I told her we could not but that she could get it filled at any pharmacy. She said, "No pharmacies carry this. This prescription is useless!" She threw the prescription on the floor. At this point, I had had it! I told her "You are right! The prescription IS useless! Because you don't have the flu!!!" I went on a tirade about how the media is causing hysteria and that if she educated herself then she wouldn't be so anxious. I told her that if the media covered the 36,000 deaths a year from regular influenza we would be in a panic every winter. I further went on to tell her that she should get over herself, I was sorry she felt bad but she would get better and she wasn't going to die. (Pant, pant)

Oopsie!

The NEXT DAY I got called in to my supervisors office. The woman had written a scathing complaint letter. She claimed that I had called her a bitch to the other nurses. My supervisor asked, "Did you say something to the other nurses?" I couldn't remember. I might have. I've called a lot of patients bitches under my breath. Did I this time? I really couldn't remember.

The best part was that I was given the opportunity to read the letter that was sent back to her. It was written by the MD that runs the ER. He didn't even mention me in the letter. He told her that she was given "the standard of care" by the ER. He did not play into her hysteria, thank god. I feel bad that I lost my cool but this guy had my back!

Is there a patron saint of nursing? Because I need someone to have faith in when I am tested by these people....

ER shorts...

2009-04-23T19:52:00.000-07:00

It's a true symbol of burn-out when I stopped finding my day-to-day interactions in the ER amusing just down right annoying. And I stopped writing about them because they have become so commonplace that I seem to no longer find them bizarre. But all the medical "professionals" out there know that we see people at their worst/best/confused/angry/etc. and how could that ever become boring?? A random sample:

A 30 something woman came in saying she had "lost" her tampon and could we get it out for her. I think I've said this before but the vaginal canal is a cul-de-sac and things don't get lost. I think people are not comfortable enough with their bodies to explore them when something is wrong. Stick your finger up your vag and feel if anything is there!! Save yourself $500 bucks... By the way, we looked and found no lost tampon or remote or anything else...

A woman came in BY AMBULANCE for a toothache she had for 2 weeks. A toothache. Let's picture how this happened: Wow, my tooth has been hurting for 2 weeks now! I've had it! (Beep-boop-boop: calling 911) Hi, 911? My EMERGENCY is that my tooth hurts. Can you send out some highly trained professionals in an expensive am-boo-lance to pick me up? No I'm not bleeding to death. No I don't have chest pain. Yes I'm breathing fine. Can someone come get me? My tooth hurts too much to drive myself. I'm with a friend. Can she come?

I'm not kidding. We gave her pain meds and then she asked us if we could pay for a cab home for her and her friend. And she wanted us to order her dinner (doesn't your tooth hurt?) and give her socks. Oh, this was her third visit for the same reason in the last 2 weeks.

A frequent flier/drug seeker smoked a cigarette in the bathroom. Thank god he didn't smoke it in the exam room. All that oxygen flowing from the walls? BOOM!

I am so over the stupidity....

Noah's new job...

2009-03-29T00:07:00.000-07:00

After 6 months of blissful unemployment, my house bitch finally accepted a job. A hotel down the street is refurbishing and added a 50 seat dining room. Menu gets to be of his own creation. Big bonus! They have a pool I get to hang at. Bonus. Noah can ride his bike to work. Bonus! They gave him a separate blackberry strictly for work. Thank God! No $450 phone bills.

Set to be open mid April or so... Will keep you posted.

PS: Noah is asleep on the couch right now and said "A two percent occupancy rate? Business is down!"

Me: Occupancy for what?

Noah: The helicopters.

Me: The helicopters?

Him: What are you talking about?

Exactly!!!

I hate cancer...

2009-03-12T00:38:00.001-07:00

You're in my thoughts every day Sharon.

Hawaii!

2009-03-10T15:19:00.000-07:00

Spent my 34th birthday in Hawaii on Oahu's North Shore. Famous for surfing and lovely beaches like this one...
Our first day. Noah taking a dunk in Waimaea Bay.
Wearing a bikini in February! Life in Hawaii is rough...

Our little cottage for ten days. Shaka brudda!
A rare moment of us in public with other tourists. Tried to avoid them like the plague!
This is how we spent most of our time. Nobody on the beach but us!
The main reason Noah came. This is the famous Bonzai Pipeline surf break. Watching this Noah said, "I've been dreaming about this since I was twelve". Look close inside the wave and you can see a boogey boarder. It really shows how big this wave actually is.
The falls at Waimeae Bay Botanical gardens. You can swim in the freshwater pool. A scene in Lost was filmed here.
Some kind of ginger. There were so many flowers and plants to ooh and aah over.
The view I was oohing and aahing over!

Los Angeles and the failing economy

2009-01-18T00:04:00.000-08:00

I know that crime is a daily occurrence here. It has been for years. After all, we are the 2nd biggest city in the US. But I have always felt a little sheltered from it living in Santa Monica. Sure, we have crime but I usually feel pretty safe in our neighborhood. We also don't have a lot of crime victims come in to the ER.

So today I got a nice eye opener when we took care of a doctor that works at our hospital who had been robbed and beaten in downtown LA. (Yeah, I know, who goes downtown??) He had driven to the jewelry district at 230 in the afternoon on a Saturday. Broad daylight. As he was locking up his car he had his fanny pack (slight snicker here. Fanny pack?!) slung over his shoulder. A man grabbed his fanny pack and then punched him full on in the face and ran. The doc didn't have a phone (it was in his fanny pack) so got into his car and drove all the way to our hospital. He reported his cards stolen and was told by the credit card company that one of them had already been used at a downtown gas station convenience store.

(What wrenches at my heart strings a little bit is that even though this doc knew he was bad off, his eye was swollen shut and he was rapidly losing vision in that eye, he drove all the way to us. He could have gone to several closer hospitals but he went to where he felt safe, felt at home. His own hospital.)

We thought he had a ruptured globe. We all waited anxiously for the CT report while the eye doctor examined him. Luckily, his eye was okay. His retina was bleeding, his orbit was fractured, and he had a laceration under his eye but he wasn't going to lose his eye. Can you imagine how one moment could change your life forever?

What really spooked me was that this doc is not a small man. He doesn't look "weak" or "vulnerable" in any way. If it can happen to him, it can happen to anybody. And even worse, what if this robber had a gun? Yikes. The LAPD came to take a report. They said that the gas station store had got the guy on surveillence tapes when he bought things with the credit card. So maybe they'll catch him... but if you've ever seen those grainy tapes they probably won't.

I hate to think that we should be worried about our safety every time we go out. Or even in our homes if we forget to lock the door and some crazy person decides to home invade. And what really scares me is that this stressful economic time may drive some people to commit crimes they normally wouldn't. Desperation causes people to do desperate things.

Sorry!

2009-01-10T01:27:00.000-08:00

I apologize for my last rant. I was very tired and frustrated. I'm taking a much needed vacation in February so I will be able (hopefully) to decompress. Our ER is also trial running a new system that allows labs and xrays to get started while each patient waits when we don't have available beds.

I also admit that I have put myself into this situation because of the department I work. We are SUPPOSED to see the less urgent patients. That's my job. I can't get upset about the non urgent complaints. They pay my salary. I just get frustrated that people can't look around them for a moment and see how busy we are and that other people are just as ill.

Also, I have come across many wonderful patients and their families who are kind, complimentary and appreciative. I need to focus on them and not let the "squeeky wheels" upset me.

So, once again, sorry for my cynicism and bitchy attitude...

In case you'd like to hear a story or two...

A woman came in who thought she had "lost" a tampon. She had her period about 3 1/2 weeks before and she noticed an "odor" coming from her vagina. Normally we don't take this complaint seriously. The vagina is a cul-de-sac and things cannot be "lost" in it. Especially something as big as a tampon. Normally they just have a vaginal infection. She told us she had just had sex with her husband the night before. So, I set up all the equipment for a pelvic exam and I included a sterile ring forcep, just in case something needed to be pulled out. I got busy with another patient and was suddenly bombarded by a putrid smell coming from Room 3. Her room. The smell got so bad that another nurse sprayed an equally obnoxious perfume to try to mask the smell. The PA came out of the room a few minutes later and told us that she had pulled out a blackened, shriveled tampon that reeked to high heaven. The poor woman was obviously embarrassed. But why didn't she just reach up there herself and pull it out? Tampons don't get stuck, they don't get lost. And, sorry to be crude, how in the world did they have sex with that putrid odor emanating from her vag?? We put her on antibiotics to make sure she didn't get any kind of infection and sent her home, with her husband....

A man in his sixties came in by ambulance with an ankle injury. There was a little bit of a language barrier but what we understood was that he had simply twisted his ankle walking. I took the splint off and saw an obviously swollen, deformed ankle. His pulse and color were good and he could wiggle his toes without any problem. I wanted to get his foot elevated on a pillow to help prevent swelling and as I was about to lift his leg he said, "I do it". He lifted up his leg and his whole foot just DANGLED from the ankle. I don't feel sick to my stomach often but this time I did. His foot was flopping all around on its own. GROSS! Xrays showed that not only did he have a bad ankle fracture but it was also dislocated. The crazy thing? The guy felt no pain. He was like a superhero or something. He didn't require any pain medication even when the MD "reduced" his dislocation. Which means pulling it back into place. Most patients require conscious sedation (basically knocking them out). I would. The MD put it back into place, we splinted it, and he went home on crutches to follow up with an orthopedist in the morning. Either totally bad ass or totally stoic...

Flu season again?

2009-01-05T00:53:00.000-08:00

Well, the little respite we had for the last two weeks over the holidays is over. The ER is packed once again with every type of patient: the actively dying all the way down to the paper cut. I don't know what it is!? For some reason after the holidays, people are just banging down the doors to be seen in the ER. On one hand we have people who are really, really ill. Did they just hope that their illness would go away? Or did they just try to ignore it to celebrate with the family? On the other hand, our ER is packed with people that aren't really sick at all. But for some reason, they decide that an EMERGENCY room is the place to go when they've "had stomach pains for 3 months and my doctor has given me every test and can't figure it out". Well what the hell are WE going to do? Or back pain for 7 months. Or a cough for two years. Why THIS weekend, people??? Why??? We have SICK people to attend to!

I apologize for my tone but I am so frustrated right now. The last two days were absolutely horrible. I've been yelled at, cursed at, told I was stupid, slow, and accused of not caring. All the while my shirt is soaked with sweat, I haven't peed or eaten in 8 hours, I've started 15 IV's (with blood cultures), and listened to every patient tell me how sick THEY are. I suppose they didn't notice the 15 other sick people waiting in the waiting room. I've had people come in at 4 in the afternoon and then throw a fit that I won't feed them because they "haven't eaten all day!!" Why is that my fault? They've had all morning and afternoon to eat and now I'm the asshole because I won't stop my NURSING duties and get them something to eat. Do you want the pain medicine you've been asking for for the last hour or do you want me to get you a fucking turkey sandwich? Your choice.

All the docs and nurses kept asking (when we were slow), "Where's the flu? How come we haven't seen any flu patients?". Today was a torrent of headaches, bodyaches, fever, etc, etc. All signs point to the flu but guess what? Their flu swabs were all negative. So some crazy virus (that is probably just a very virulent cold virus) is making its way through the populace. The worst thing about it is that yes, it feels shitty, yes it feels like you're really sick. BUT, it is a virus and there is nothing we can do for you. We can give you advil and tylenol to get the fever down, we can give you fluids, we can let you rest. Or, you can do all of this at home for about $2540 cheaper. In your own cozy bed, with your fave jammies, watching your best comfort movie, and eating chicken noodle soup. I don't blame these people for feeling a bit desperate because they feel so ill, but PLEASE, PLEASE don't come into the ER and yell at the staff that you are the sickest person and need to be seen RIGHT AWAY! We are not impressed. Are your lips blue and you can't finish a sentence? I'm impressed. Blood pressure in the toilet and heart rate sky high? You're getting seen right away. Rectal fever so high you are so lethargic and can't complain about the wait? I'm carrying you to a room myself. Have enough energy to come and yell at me about how sick you are? Fuck you! It frustrates me to no end that the people who aren't urgently sick will whine and complain and totally disregard the fact that their are people much sicker than them, waiting in the same waiting room, and demand to be seen first. What, buddy? You didn't notice the elderly lady, pale, having a hard time keeping awake, thats putting off heat like a baked potato? You still think your cough for two weeks takes priority? What about the 6 year old with the arm so broken it looks like "W". Still think your cough is that important? AARRGGHHHH!!!!!!

I need to calm down... I think I've got serious job burnout. One more rant and then I'm done. This is a perfect example of the entitlement people think they have. A patient comes in after falling off his bicycle. He's got hip pain and it could possibly be broken. Okay, I'm paying attention. But the wife is all over us. "He's an MD. He's an MD." She's calling all her doctor friends to get them to call us. (By the way, he's a psychiatrist.) While we are taking care of him our code system alerts. It's a buzzing noise over the PA system and it alerts our ER docs and nurses that a patient is dying. The code team drops what they are doing to attend to this patient. Our hip patient's wife asks what the noise is. I tell her, "It's a code. Someone is dying". She's quiet for a few minutes and then she asks, "When are they going to turn off that annoying noise?" Man, I wanted to punch her. I wanted to say "When the patient dies, they'll turn it off. Will that annoy you less?". Whatever happened to our humanity? I feel like I'm losing mine...

Please let this never happen to me!

2008-12-20T22:45:00.000-08:00

A patient came in complaining of left ear pain. A common enough complaint. I brought her to her room and decided I was going to take a peek inside her ear with the otoscope. I was looking for ear wax so I could flush it out before the doc came in to see her. The otoscope has a light and a magnifying glass to look through. I placed it in her ear canal and what was looking back at me? A HUGE cockroach! Still alive, wiggling its antennae, and backing away from my light. The woman was saying "Ow ow! Something's moving in there!" I was shocked. I looked right at her and told her about the cockroach.

Even worse, we couldn't get it out! The PA was trying to pull it out with clamps but it kept backing further into the ear canal every time we put the light in. She finally ended up pulling off the head but leaving the big ol' exoskeleton and guts. We tried to flush it out with water but it didn't work. We finally called the ear, nose, throat specialist and he told us that cockroaches are the hardest to remove from the ear because they have little pinchers on their legs that they dig into skin with. She had to meet him at his office where he had specialty microscopic equipment to pull it out. Poor lady!

For the rest of the day, every time my ear itched, I freaked out.

Overheard in Los Angeles...

2008-12-19T00:49:00.000-08:00

A 4 year old came into the ER with a laceration above his chin but under his lip. (You know where I'm talking about?) So he does really good while we glue him and a nurse says "You did so good Santa is going to bring you lots of presents!"

He says: "Oh, I'm only getting one present".

Nurse: "Really?"

Kid: "Yeah, the economy is really tough this year".

Hahahhahhahhhaaa! That is friggin awesome!

Just in time for the holidays!

2008-12-10T00:03:00.000-08:00

Check out zoomtozoom for some fabulous holiday gift ideas!

Work stuff...

2008-12-07T00:45:00.000-08:00

For some weird reason we have been (gasp) quiet these last few weeks at work. Is it the economy? Maybe people are waiting until they are really sick before coming in to the ER. Some good news, we will be moving into the new wing next August and our nurse educator is providing us with some much needed classes to deal with the more urgent cases that our department will be handling. I'm glad to be stepping up my education but also nervous... Sick people make me anxious. I know that sounds weird but it is basically performance anxiety. I don't want to make a mistake. I also get upset when really old people come in and we are expected to do all sorts of invasive procedures to prolong their life for another day, week, month?.. It's hard to deal with families that are not ready to say goodbye. I understand it, it just upsets me.

I wish there was a nursing specialty that just dealt with teenagers. As annoying as they ~~and their fifteen friends~~ can be, I find that I really connect to issues of injury and body image. It is important for me to share my experiences with them just to let them know that they "are not alone". It was something I thought about while I was in the hospital at the age of 14. I truly believed that no one could possibly know what I was going through until I met an RN named Gary who shared his story with me, and spent time with me talking about other things besides my injuries. We had a 17 year old girl who broke her right tibia (the big shin bone) after a collision with another soccer player. Her parents were fussing over her and she acted ~~teenage style~~ annoyed with them. I was able to understand both her point of view as well as her parents. She was going straight to surgery and I spent time with her and her mother discussing not only what to expect right after surgery but also the weeks and months to come. She seemed to cheer up after our talk and afterwards her mother gave me a huge hug and kiss and thanked me for sharing my story. Believe it or not, nursing is often a thankless job and this show of appreciation got me a little teary eyed.

The best thing about work right now? Being able to ride my scootie to and fro. The ride there relaxes me and gets my mind focused, the ride home allows the wind to whip away the annoyances ~~the smells~~ and the stress. So much fun.

FYI: There is a real phenomenon known as the "Throckmorton" sign. When a male patient has an xray of his pelvis area, his penis will be "pointing" to the side of pathology. Meaning: if he is complaining of left hip pain his penis will be pointing to his left side. Hysterical but mostly true. Check it out on Wikipedia.

Mmmmm.... Fall.....

2008-11-26T00:01:00.000-08:00

Oh I love it when it starts to get crisp ~~65 degrees~~ outside and all the fall vegetables are at the farmers market. It's hard to pick a favorite season for food but fall is in my top four (haha). I just love the feeling of being all cozy in the house with something roasting away in the oven while stray dogs and the homeless sniff hungrily at our front door. A big hunk o' meat slow braised while its lovely fat drips all over root vegetables is my idea of a last death row meal. Pure comfort food. I am blessed to have a hubby who visits the farmers market every Wednesday and he is the first to let me know when certain produce have made their grand appearance.

An Ode to Fall Vegetables!

Persimmons! You soft, sultry, musky orb! I'll let your juices drip down my chin and arms while I suck you standing over the sink.

Chantrelles! Your meaty and silky flesh caresses my mouth with a sensual familiarity.

Carrots! Your sweetness is only enhanced by the caramel you produce on a hot pan. Your tender flesh enhances any meat.

Radishes! Your fiery nature is mellowed to a sweet succulence you willingly give when roasted in a hot oven.

Brussels Sprouts! Your sweet and tender interior defies your sketchy reputation.

Okay, enough, enough. I'm getting silly. But truly, isn't fall fabulous!

Some lovely carrots and radishes from Jaime Farms...
Fresh Mahi mahi...

Seared mahi with carrots, radishes, and lambs quarters...Celebrate Fall!!

A tribute to my lil' sis!

2008-11-20T15:06:00.000-08:00

My little sister is turning 28!

We've had such fun years together! She was my little buddy. Six years younger than me, I took her under my ~~somewhat tattered~~ wing and taught her everything I knew. I don't ever remember her being a nuisance like a lot of little sisters are and she always had such a good sense of humor with my teasing!

Leah and I had plenty of quality toilet time together. Not afraid to share in one another's bodily functions! (Still not).

I think this was my 19th birthday. Leah made me a hand painted ~~green bud container~~ box. I wish I still had it! Leah, you were only 13 in this pic! My god! Had I already tainted you with bong hits and booze? You seemed so grown up then but I look back and think "FOR SHAME! FOR SHAME!"
Leah in her punk rocker stage. Note the rabbit in the background that she handed-down to me!

Bachelorette party after she met Blake. The book title was an apt foreshadow of good things to come.

Watching my sister get married!

Of course, she was right there with me for my marriage a few years later.

I freakin love this photo!

I can never repay Lou for the gifts she has given me...

...and my husband!

So here's to you, Lou! Happy birthday!!

Fave baby items...(mamanomad post)

2008-11-19T23:42:00.001-08:00

My sis posted on her blog about fave baby products. Now I am no baby's mamma but I get down with the Ergo Baby Carrier. Not only have I been on many a field trip with my sis toting one tot or another in this carrier but I realized I helped cook a Thanksgiving dinner toting a sleeping baby on my back. No way I could have done this without the Ergo!FOOTnote: Check out the Padraig slippers! (number 2 on fave products!)

Scootie!!

2008-11-17T21:23:00.001-08:00

Look at this beauty!! A Piaggio BV250. Gets 60+ miles to the gallon and hits top speeds of 75mph! I can't believe I bought it! It's an automatic (no messin' with a clutch or gear shifter) but it's heavier than I thought. Noah got many chuckles watching me get all sweaty trying to maneuver it in and out of tight places.
Getting geared up for the ride! (Scared out of my wits!)
Riding someone's else's motorcycle for practice was one thing; taking off on my own (expensive) brand new bike was a whole different experience. It will take some time but hopefully soon I'll be riding like a pro!

And yes, to anyone asking the question: I have all the necessary gear. ATGATT: All The Gear, All The Time!

Motorcycles and apple pie.

2008-11-12T23:20:00.000-08:00

I passed my motorcycle class!! Which means I can go to the DMV, take a written test, and get a motorcycle license. Then I can go buy my scooter. As much fun as riding a motorcycle is, I just don't feel safe doing it here in LA. I'll just zip around from work and the grocery store on my scooter.

For some reason, maybe the cool weather, I got the hankerin' to make an apple pie. I had never made one before but the apples are beautiful right now. I haven't had good luck with baking but tonight I pulled this out:

It turned out really tasty. Two successful endeavors in one day.

Moto, baby...

2008-11-11T18:33:00.000-08:00

This was the first day of my riding class, learning how to ride a motorcycle. I've probably been talking about learning since I was 21 or 22. I realized that if I didn't do it now I probably never would. So this sweet ride is what I rode today at my class. Super comfortable... No "crotch rocket" for me. I felt super awkward at first, like learning to drive a car for the first time. It seems like there is so much to remember: the clutch is controlled by your left hand, you shift gears with your left foot, and gas and brake with your right hand. It's a lot to learn but, oh baby, when I'm making those turns and shifting into 3rd gear (as high as they will let you go) it feels soooo gooood! The more practice I got, the more natural it felt and I understand why people are so passionate about motorcycles. I am a realist and will probably not buy a motorcycle while living in LA. A scooter is fine for me. But when we leave this (god forsaken) place and live somewhere where people are a little more cognizant of other drivers, Noah and I will be cruising our bikes up and down the coast... So much fun!!

Why it sucks to be a postal worker...

2008-10-28T00:48:00.000-07:00

The charge nurse from the ER calls me and says she is sending over a patient who has come from an Urgent Care center. "She's chopped off the top of her finger and she's got the finger with her".

Well, that sounds exciting. I get everything ready in anticipation. A bowl of ice, some saline solution, a ton of gauze and IV stuff. The patient comes in with her hand wrapped up and a cardboard box. I get her settled, make sure she is not in pain (the urgent care had properly medicated her), and eagerly open the box. (Wounds, to me, are like unwrapping Christmas gifts. I can't wait to see what is underneath the bandages.) The box holds ice packing and, in a small plastic bag, the tip of her finger, from the knuckle to the tip. It's pale but properly packed. I set it aside and begin to unwrap her bandages from her hand. She turns her head away as I get to the bloody end and there it is: a chewed up stump at the end of her middle finger. So cool.

Here's the story: She's a Filipino lady who works at the post office. Apparently, they keep their stamps in a locked safe. It's big and heavy duty. She is closing the safe and before she can pull her finger out of the way, the safe closes on her finger. On instinct, she pulls her finger away and realizes that the tip is missing and blood is gushing out of her little stump. Her co-workers are alerted to her distress. Problem is, they can't find the tip and realize it must be in the safe. So they have to have her tell them the combination so they can open it and retrieve it. The tip is retrieved and sent with her to the urgent care. (They sent her to an urgent care because it is a "workman's compensation" claim and must go through their affiliated care provider first. Another glitch in the medical/insurance system.)

I must say I totally respect the urgent care for their appropriate handling of the "body part" and the fact that they contacted a hand specialist and told him to meet the patient at our facility. It was successfully (so far) reattached right in the exam room. Kinda surprised he didn't have to take her to operating room. We of course gave her proper pain medication as well as prophylactic antibiotics.

I hope she is doing well. I think she is lucky that this injury occurred at her federal job and she will be completely taken care of as far as bills and compensation go. I see so many partial amputations from illegal immigrants that never claim it as workman's comp because they are not legally employed by the company. I even had one guy leave without telling us, his partially amputated finger still dangling.

101 uses of a carrot...

2008-10-25T01:44:00.000-07:00

A patient came into the ER with the complaint of "something stuck in my rectum". His story was that he was "impacted" (meaning hard stool is stuck in the rectum and regular poo can't get by). To solve his problem he decided to insert a carrot to dig out the offending hard poo. Well, the carrot got away from him and lodged itself so deep that he was unable to get it out. The doc who examined him is this cute little Asian girl who looks all about 14 years old but is a fabulous doctor. She told us that she attempted to retrieve the carrot with forceps. Unfortunately, once something is lodged in the rectum, a vacuum seal is created, making extraction difficult. She tried to pull out the carrot, just to have it sucked back in. She tried again to pull it out and once again it got sucked back in. This happened about 5 times when the man turned around (imagine him on his hands and knees) and said, "Just pull it out already!". Appalled, she said "What do you think I'm trying to do?". For god's sake, did he think she was just pulling it out and pushing it back in for fun?!?

She realized she could not get it out on her own and called the GI (gastrointerologist) specialists. Basically they performed a lower endoscopy which entails putting a rubber tube complete with a camera up the rectum to pull out the offending object. After two hours of trying they were unsuccessful. They even tried to burn holes into the end of the carrot to get a better grip. No dice. What they were successful at was taking photos of the carrot.

The decision was made to send the man to the operating room. Poor guy, I saw him sitting outside his ER room, slumped shoulders, looking so defeated. And he looked like a regular guy, not like what you might imagine. I felt sorry for him. I read the operative report the next day:

Patient was placed in the lithotomy position. (On his back, legs bent and spread wide open, much like getting a gynecological exam.) Medications were given to relax the muscles. (The rectum is just a nice, tight muscle). Spreading devices were used to open the orifice as much as possible. Reaching in with a special clamp, the surgeon was able to remove the carrot in its entirety. All 13 inches of it.

Do I believe his story? Not really. Do I feel bad for him? Absolutely. Maybe just a fetish gone wrong. His paperwork said he was married. Did he have to explain to his wife why he spent over 8 hours in the emergency room and accumulated a gigantic bill? Maybe she already knew... Does she do the grocery shopping????

Last minute weekend!

2008-10-21T20:28:00.000-07:00

Had to plan a last minute weekend to get out of town. I'm so burnt out on work right now. Every little irritation seems ten fold. Noah has also had a hard go of it at his job. Economy is slow so his bosses are up his ass about every little thing. So we decided to drive an hour and a half to the sleepy little seaside town of Carlsbad just a little north of San Diego where Noah spent a lot of time as a kid.

We get to our hotel room and try to decompress as the sun starts to set outside our room.

I've never liked when people took pictures of the inside of their hotel room but we had this amazing light coming in off the patio.

Our view from our patio. So serene and calming. The funny thing about this hotel is that they had all these "activities" for people to participate in like "Bingo at 7pm in the library". I felt like Patrick Swayze was going to be offering mambo lessons on the veranda at 4pm.

Hung out with Noah's friend Chris who still lives there. Both avid surfers. Noah got to surf while here. It makes him so happy!

Of course, Noah continued to work.

But we had so much fun and a much deserved break from La La Land. Back to work tomorrow of course...

Guns...

2008-09-30T00:03:00.000-07:00

I was not raised in a family that had guns. A little surprising since I grew up in Alaska where people had shotguns in a rack behind their heads in their pickups. We had neighbors that hunted and brought us elk and caribou meat. But my parents never owned their own. (That I know of.) Noah was raised by a single mom that also did not own any guns. So where am I going with this?

We had an earthquake not too long ago that kind of freaked me out. It got me thinking about earthquake preparedness and how stupid I would feel if "the big one" happened and Noah and I had nothing. So my big project lately is getting ready for a disaster. We cleaned out our closet of some shelf space and got to work. We got the usual: water, batteries, and non perishable foods. Simple enough, I thought. Then I tried to imagine what it would be like with no electricity or gas and no fresh running water and I got a little Y2K. I went to REI and bought candles, a huge box of matches, water purification tablets, and a camp stove with tanks of propane. I stowed our important paperwork in one waterproof container. Noah and I have stashes of cash in small bills in different spots in the apartment. I stocked up on basic first aid supplies including antibacterial solutions, large amounts of gauze, butterfly bandages, and ace wraps. (Also some first aid supplies I won't list but believe me, I'm prepared for anything).

So Noah and I were feeling quite contented and prepared. Then one night we were watching the news regarding the latest hurricane disaster in Texas. One story focused on the fact that people were looting and stealing from other people and that the option of calling the police (on phones that no longer work) was not an option. One woman told the camera, "We are our own protection right now". Well, that really freaked us out. We live in LA. A lot of people live here. A lot of weird, crazy, unethical people. We already have a lot of crime. Multiply that tenfold when people are desperate. So we've decided to buy a gun.

We are trying to do it as smart and responsible as possible. I won the football pool at work and used the winnings to sign me and Noah up for a gun safety class. Next Sunday, we have one on one training and will get to shoot five different guns (three handguns, two shotguns) in a safe environment with a professional to teach us. We wanted to get a feel of different guns to guide us in our "home protection" purchase. We have spoken with several of our friends who either grew up with guns or were trained in the military. The overwhelming response is that we should buy a shotgun. Number one, if anyone were to come into our house uninvited, the sound of the shotgun being "pumped" usually drives the bad guys away. The sound is unmistakable. Number two, if it comes down to actually having to fire it, accuracy is not an issue. Noah and I do not have children and in four years have never had a child in our home so that issue is negligible. Also, gun cases come with locks on them that can only be opened by whoever knows the combination.

Chances we will actually use it? Less then 1%. Feeling super protected just in case? Priceless.

Thoughts?

Charlie Tuna says no...

2008-09-28T22:36:00.000-07:00

Had a disgustingly busy weekend in the ER this week. And so many of the people really needed attention, unlike a lot of our "Santa Monica wounded" who could wait a day or two to see their doctors. We had our share of abscesses, broken bones, lacerations, and abdominal pains.

The worst thing I had to witness this weekend was horrible parenting skills. I know, I know, I am not a parent and shouldn't tell people how it should be done. But, I saw some horrible behaviors from children and their parents and I saw some incredible kids with their equally incredible moms and dads. Whenever I see children panicking and scared, I always try to imagine what it would be like for me to bring in my nieces with a deformed arm or a gash on their lips. I would be super protective (what I call the mama-bear or papa-bear syndrome), so I allow people to be upset and cry if they need to. I even allow people to be rude and aggressive, to a point, because they are just trying to protect the little people that they love so fiercely. But, there is a point where I draw the line...

A 4 1/2 year old was brought in by his dad and grandmother. He ran into a coffee table and had a gash on his forehead. It definitely needed stitches if it was going to heal properly. Sometimes we can use tissue glue but only for superficial cuts and the outcome is not as "aesthetically pleasing" as stitches. And when it is on your face, well, most parents reluctantly agree to the stitches. Yes, kids are scared. Yes, they cry and try to bargain their way out of it. And yes, we put them in a papoose, hold their head still, and try to console and distract them while the doctor pokes their "owie" with a needle. It totally sucks for the kid and us. We hate it but as adults our brains can process the fact that sometimes it hurts more to make us better in the end. Kids can't think this way. They are terrified.

Anyway, the dad of this poor kid prefaces this encounter by telling us that his wife is a psychotherapist and grandma is a behavioral therapist and they want this to go as smoothly as possible so that their kid "doesn't hate hospitals as an adult". What a way to set yourself up for failure. It seems that the thing parents fear the most for the kid seems to happen. Little Johnny (that's what I will call him) was obviously used to running the show. The dad had requested that the wound be closed by a plastic surgeon. One was actually already on his way because this little old lady across the hallway had partially amputated her finger. (More on this story later.) When the plastic surgeon showed up, he decided to sew the kid first and get it out of the way, so that he could spend more time re-attaching the finger. He also had the OR waiting on another partially amputated finger in the ER. I go in to assist and Little Johnny is throwing a huge temper tantrum. Again, nothing I haven't seen before. But what I didn't count on was the dad and grandma allowing him to kick and scream and threaten to bite us. The plastic surgeon finally told the dad that he refused to sew up Little Johnny. This was a first for me. (The plastic surgeon told me later that he could not, in good conscience, waste any time (while dad and grandma tried to placate and bribe) on a non-emergency while he knew two fingers could be lost). The dad and grandma decided to start blaming me and the rest of the ER staff for causing Little Johnny's behavior because we "made him wait so long". Awesome. Now it's our fault for him being out of control. The ER doctor finally made the decision to sew him up herself on two conditons: grandma left the room and dad allowed us to hold Little Johnny still. About 10 minutes later, using three staff members to subdue Little Johnny while ER MD sewed, we finished the job. Little Johnny, with five stitches in his head, bragged to us how brave he was and high-fived all of us that he had kicked and threatened to bite.

Little old lady across the hall, meanwhile, finally had her finger reattached successfully! Yeah!

About an hour later, a two year old came in who had fallen and had a deep laceration inside her lip. You know the piece of skin attaching your upper gums to your upper lip? Yeah, needed stitches. She sat quietly, while her parents sang to her, and the ER MD held her lip up and put in four stitches. Wow! I don't know many adults who would do that.

Later on, a 3 1/2 year old presented with a cut on his eyebrow. His name was Charles and his mom told us we could call him Charlie Tuna. We needed to stitch him but Charlie Tuna wasn't having it. He fought, he kicked, he screamed. That's okay. We put him in a papoose and started our work. He called us "jerks" and "fat assess". His parents giggled nervously and told us they let him watch Family Guy. "I thought it was just a cartoon!", mom explains. Charlie Tuna continued to launch his verbal abuse throughout the procedure. Again, totally okay with me. The little guy is scared. But just as the doc is about to finish, Charlie Tuna starts yelling "No more! No more!" and mom says to us: "The doctor needs to stop now because Charlie Tuna says no". I almost blew snot out of my nose trying to hold in my laughter. Not to sound harsh but I don't give a f*ck what Charlie Tuna does or doesn't want to do. He's three!!! Keep in mind that these are the same parents that seem shocked when we tell them that, yes, there will be a scar. That's what happens when flesh is torn apart. It's never quite the same.

I hope I didn't sound too cynical. I get that way on my hard days...

Birthday weekend!

2008-08-18T21:42:00.000-07:00

Took a last minute flight to Portland to surprise our nieces for their birthday party. Portland is soo cool and we were sad to only have a short visit. But boy, was it worth while!

At the start of the egg race! Kaden was not tricked by his pinecone "egg". Look at his skeptical face!

Clever girl! She knows exactly how to run with an egg in a spoon and not let it fall!

How adorable are the hand knit kitten ears?! Leah's friends give the best thoughtful gifts. No bullshit Barbie's from Wal-mart for this group of friends...

Ham and eggin' it up for Uncle Noah and the camera!

The start of the potato sack race! Some kids fit better than others... Sometimes you forget how enjoyable the simple games are. No cheesy "bouncy rooms" for this group!

Come on! You can do it!

This is probably one of the cutest, most iconic child photograph we have taken.

Wheeeeee!!!!! It has been so much fun to watch my nieces grow up, make friendships, and learn. It is the first time in my life that I think back to my own childhood and realize that my parents and their friends were enjoying the same things I am now when I watch them.

Wow!!!

2008-08-03T20:38:00.000-07:00

Congratulations Noah on receiving Angeleno magazine's Best New Restaurant of 2008! Check it out at:

Angeleno Magazine.com

I am so proud!

Food porn

2008-08-01T01:14:00.000-07:00

We were stoked to have the owner of Summerland Winery outside of Santa Barbara offer us use of his condo the other weekend. Santa Barbara is a mere 1 hour 15 minute drive away from LA and truly, seems worlds away. The condo was at the Santa Barbara Polo Club. Check out our view on Sunday from the patio...

I've always loved to take photos of Noah preparing food. He is such a perfectionist. Dicing shallots becomes a sensual moment...

Noah was so excited to find a Viking range in the condo. He couldn't wait to start cooking...
Noah bought some beautiful scallops from Santa Monica Seafoods. We brought them with us.
His parsley chopping skills are truly an art form...
This is what I consider food porn.. Look at those insane scallops cooked perfectly. You want to suck the juice right off of them..

The next day we celebrated my nieces birthday on the Santa Barbara shoreline..
Happy 6th birthday Mayan!

Earthquake!!!!

2008-07-30T23:56:00.000-07:00

Felt my second earthquake since I've lived in SoCal. If you have never felt one, it is something unique, scary, and unforgettable. First of all, earthquakes don't give a f*ck. They don't care if you have a home in the Hollywood hills or a cardboard box under the Santa Monica Pier. No consideration is given to us puny mankind parasiting (word?) on the face of the earth. Second of all, an earthquake sounds weird. There is really no other sound quite like your house groaning and shifting under your feet.

So here is what happened to me at 11:42am. I was lounging in bed, dozing on and off, in my pajamas. I wasn't quite sure if my husband was home or not. He tends to stay really quiet if I'm in bed. At precisely 11:42 I had pulled back the covers to get out of bed when the house started shaking. In one instant I thought a big truck must be going by and in the next instant I knew it was an earthquake. I called out to Noah and the bedroom door opened. Noah walked in with a really worried look on his face and I jumped up and we stood in the hallway together. The house was still moving. It lasted about 10 seconds which doesn't really seem that long but when you have no idea if it is going to stop or get stronger... 10 seconds is a long time. As we were standing in the doorway I kept thinking, 'I'm in my underwear. I need to put on some pants.' That was my deep thought as I faced what could have possibly been a horrible disaster. Then it just stopped. We put on the news, heard it was a 5.4 with the epicenter in Chino Hills. Then of course it was hype, hype, hype all day long on the news.

At least no one was hurt. It could have been ugly. They keep saying this was an "advertisement" for the big one. Great...

2008-07-20T00:00:00.000-07:00

Oh, some crazy days at work! Drunks, schizos, and attention seekers try my patience while really cool, normal, beautiful people remind me that we are all just humanity trying to enjoy life.

One of the challenges of my job is trying to be patient with people if I am stressed out. I believe everyone has a "cup" that can fill up with stress and once that cup bubbles over... Beware! We have a certain amount of energy to spend and once it is spent we have no more energy to give out. Like a checking account. Luckily we have days off and nights of sleep to replenish our account. I feel bad when I have "spent" everything I have, yet still have 4 more hours of work left.

The other day we were short a nurse (typical) and had an extremely busy day (Murphy's Law). The patient's were piling up in the waiting room while we were trying to treat the ones we already had in the exam rooms. One of the rules we have in the Fast Track is that we do not take psychiatric patients. I can understand not taking them if they are suicidal but if someone is schizophrenic but just happens to twist their ankle, I didn't see any reason why we couldn't see them. Now I know why. We were sent three psych patient's, one after the other. One was having trouble breathing (history of asthma), so we put him in a room right away. Unfortunately, I was working with a nurse who didn't have much experience in our department and she put him in the room directly behind the nurses station, room number 2. Room 2 has such a bad history that we often refer to it as "haunted" because it seems that everyone we put in there starts to flip out somehow. And because it is right behind us, we have little protection from the inevitable "flip out". Right away this homeless asthmatic starts accusing all of us of stealing his cigarettes. He's standing in the nurses station in sagging, dingy long johns, stinking to high heaven, pointing a cigarette stained finger at all us doc's and nurses. About this time, psych patient #2 comes up to the nurses station and asks me, "Do you have an internist I can see?" I explain to her, patiently, that she is in an Emergency Room, that the only doctors available are emergency room doctors. "Oh, I see", she says but her face says she is clearly confused. "It is Saturday", I continue. "The only doctors available today are ER doctors."

"Oh, okay." She walks back to the waiting room just as Psych #3 walks up to the desk. "Is a doctor going to look at my foot?" she asks. She's got a decidedly Haldol or Thorazine induced look to her.

"As soon as we can get a room for you, someone will look at your foot," I reply.

"Then I'm going to go. My foot feels fine." She says this with conviction.

"Okay, just sign this Against Medical Advice form and you can go." I hand her a pen and push a form toward her. I am impatient because Mr. Saggy Long Johns is getting louder with his accusations. She hesitates, then signs the form and walks away. Thank God! One less freak to worry about! Meanwhile, someone has pushed the "duress" button, designed to get security in our department in a hurry when we are fearing for our lives. So far, no one has showed up from security.

I start to prepare some antibiotics for a patient with pneumonia, when psych #2 approaches me. "Is there an internist here?" she asks. "No, only ER doctors, remember? I told you that two minutes ago." I continue preparing my medications.

"Oh." She looks defeated. Then she brightens up again. "Do you think I can see an internist?"

What am I to do? I have 7 other patient's in exam rooms, family members peering out the doors, looking at me like, "Are you coming back?" and meanwhile I have six patient's waiting in the waiting room, peering out at me, "Are you going to see us now?". I understand that when people are not feeling well that they become egocentric. They feel like hell, so the only world that exists is their own. Get over yourself people! Go visit a third world country or back woods America and see what suffering really is... Anyway...

I'm in a room taking care of someone and then walk out to the nurses station. Psych #3 is standing there. "I think I'll spend the night", she says. "You can"t", I reply. "You signed out AMA (Against Medical Advice)."

"I signed out what?" She obviously does not understand. Security has finally made it over and is haggling with Mr. Saggy Long Johns. I am at my breaking point. I call the main ER and ask to speak to the Charge Nurse. "Tell security to bring psych #2 and #3 to our waiting room," she says. Thank God! I don't have time for this! Security escorts out Mr. Saggy Long Johns, Psych #2 and 3. I feel a lot better.

One of the patient's (patience) waiting in the waiting room is a 15 month old girl who has a smashed toe. I mean bloody, smashed, open fracture, toe. We are supposed to take patients first come, first serve. But sometimes I don't think that is right. This poor baby is about six down on the line up. I call the ER and ask them how they are doing. The charge nurse says she has two open beds. Wow! We are drowning and they have open beds! So I explain the situation and ask her to take the baby with the smashed toe. She says no. Flat out. The two open beds are monitored and she doesn't want to risk giving up a bed to a "Fast Track" patient if a stroke or heart attack comes in. I understand but am still frustrated. I have a bed open up and instead of giving it to the next patient in line, I gesture to the parents of the 15 month old to come back to the open exam room. I know I am taking a risk because people are told that the Fast Track is first come, first serve. I brace myself for trouble in the waiting room.

30 seconds later, I face what I have feared. A 28 year old kid with a twisted ankle saw us take the baby before him and he decides to throw himself onto the waiting room floor and "hyperventilate" in supposed pain. His mother runs up to us and screams, "He's going into shock!"

I am already aware of all the malady's of the patient's waiting and am pretty sure that none of the injuries would make someone go "into shock". My patience has run it's course. "He is not going into shock", I tell the mother with a unimpressed tone. I reluctantly walk into the waiting room where a man is laid out onto the floor, breathing heavily. I pull a gurney into the waiting room and kneel down next to him. In an even tone I say to him, "You need to slow down your breathing". He is able (miraculously!) to catch his breath long enough to say, sarcastically, "Yeah, thanks!". Then he resumes his heavy breathing. Lordy! I scoop him up onto the gurney and all of a sudden he is calm. I walk back to the nurses station and tell the doc the situation. She tells me to give him 1mg Dilaudid IM. No way. The doc looks at me as I defy her. "The last thing we need is this stupid kid all fucked up and can't leave our department because his is overmedicated." The physician's assistant backs me up: "Why don't we give him two Vicodin?" The doctor agrees and that's what I give him. I wheel the gurney into an exam room as his mom and grandma follow. After the xray? He's got a sprained ankle. That's it. A sprained ankle. Hardly an emergency. The clincher is that two people waiting to be seen, that technically should have been seen before him, had broken ankles. Broken!!!! And they had waited patiently during his temper tantrum.

Guess what happened to the 15 month old with the smashed toe? She ultimately got sent back to the ER so she could go under conscious sedation to get her toe fixed by a plastic surgeon. Turns out she needed the "monitored" bed after all...

I work in a hospital in Santa Monica, California. The clientele include movie stars all the way down to the homeless. I'm told by other nurses that the patient's in other Los Angeles hospitals never complain about waiting 6 to 12 hours (!!) to be seen. I guess I just live in an area of "entitled" people that don't know what real suffering is. Maybe I don't know what real suffering is. I get worked up about twisted ankles...

268th reason my job can be annoying...

2008-06-21T02:26:00.000-07:00

Another annoying thing about nursing... Picture this: Busy Friday night on a hot, sweltering June night in Santa Monica. I actually told someone that the only people coming into the ER are the very sick or the very stupid. Boy, was I right. In one room I have a elderly woman with severe dementia who had her leg ripped open while seated in some sort of chair that is supposed to keep her stayed put. In the next room, a girl who (we piece together) is telling her friends and family that she has a brain tumor. We do all sorts of tests and find out there is absolutely nothing wrong with her. A CAT scan of her head shows a perfectly normal 23 year old brain. Kinda what we thought in the first place. She specifically asked us not to reveal her test results to her friends. This STUPID girl is faking an illness while the woman in the next room needs our full attention. I'm more than pissed. I just wasted time on a silly game while I could have been assisting the actual sick person right next door.

I'm driven nuts by the "trolls", "malingerers", and hypochondriacs that waste all the staff's time when we could be focused on the actual sick people. Wonder why medical care and insurance is expensive? Blame these assholes...

A warning...

2008-06-06T00:45:00.000-07:00

Just a little note tonight to plead to dog owners/lovers: Never, ever try to break up a fight between two dogs. You will lose, every time. As much as you may love them and want to protect them, let them injure each other. They have thicker skin. You do not. I saw a patient today who practically had her thumb ripped off while trying to break up a fight. She had numerous lacerations and puncture wounds. We had to call in a hand specialist and the chance of getting an infection is astronomical. Her medical expenses will well surpass any she would have had to pay at the vet if she would have just let them do their thing...

ER stories (long time coming)

2008-06-01T21:45:00.000-07:00

My sister recently sent me a shout out and reminded me that I need to write some ER stories!

I work in an area of the ER that is more like an urgent care. No gun shot wounds or traumas, just the usual bumps and bruises that can't wait to see someone's regular doc. For example, a man visiting from ******. (I won't say where to protect his identity and his pride.) He decided, while at the beach, to "pet" a sting ray. Not very bright. He walked away with a 2 inch laceration to the back of his hand. (By the way, if you are ever punctured by a stingray stinger, soak your affected appendage in hot water for about an hour. The hot water denaturizes the proteins in the poison.) Anyway, the doc sewed up his laceration and I was called upon to clean him up and bandage him. I cleaned up his bloody hand with normal saline and spread a nice layer of antibiotic ointment before bandaging his hand. This guy complained about my clean up job, was demanding ointment before I was even done cleaning, then complained about the amount of tape I used to secure his bandage. That's okay, I'm used to people being bossy because usually it is a cover up for how stupid they feel for being there in the first place. Fast forward two days. He comes in for a wound check and my intuition is screaming at me not to deal with him. But, I decide, why subject another nurse to his pickiness. I already know him. I walk in to his exam room and am immediately barraged by insults. He tells me what a "crappy" job I did washing his hand, my "terrible" bandage job, and if I'm having a bad day I shouldn't take it out on him, so on and so forth. "Remember the tape?!" he proclaims, like he is putting me in my place. So I tell him this: "I'm sorry that you are upset.". Not really an apology, because I have nothing to apologize for. As far as my "crappy" wash job, I invite him to wash his own hands in the sink. Well, that didn't go over so well. Apparently I should've soaked my hair in oil and washed his hands that way. He continued to insult me. I calmly set down my bandages and told him I would be right back. Now here is the part where I feel bad. I had to ask another nurse to go in and take over for me. Maybe he just hated me and treated her nicely. But I felt bad putting another nurse in the crossfire. And I refuse to apologize to someone who is asking too much. I did my best job like I would have done for any other patient. I really had to bite my tongue as he left. I wanted to say, "Feel better! Don't pet sting rays!!" It is so hard to give, give, give to people and then have someone treat you as if you are a servant.

A very sweet woman came in after taking a big fall on her skateboard. She was visiting from Seattle. She was sobbing as I brought her into the exam room. This normally doesn't mean anything to me (don't think me callous but some people sob because they stubbed their toe). She told me what happened and I carefully took off her shoe and sock. It was apparent to me that she had a severe fracture, possible needing surgery, at the very least a reduction (re-set). She told me where it had happened and it turns out it was one block away from my house! As she continued to cry she said, "People told me that nobody is nice in LA but people came out to help me!" This statement made me think. Before I moved to LA, I thought the same. The first week I was here I was visually assaulted by someone as I was walking down the street. Some douchebag decided it would be a turn on to jack off in his car and watch me catch a glimpse as I walked by. At the time I was very upset but never called the cops because I thought nobody would care. After living here for over 4 years I know better. Los Angeles is a city made of many small communities. Yes, there are a bunch of idiots, but there are also lots of very nice, loving people who make this city their home, as well. I learn that every day at my job. Lots of idiots, lots of cool people. What can you expect in a city of 10 million people? By the way, we re-set her ankle and as far as I know, is enjoying LA from her moms couch with her foot elevated...

Long time coming...

2008-05-25T20:29:00.000-07:00

Spent a fabulous week in Bend and Portland. Got to see all the family, including new inductee George! The girls are super cute and we had a great time playing "school" and learning about the body and first aid.
I spent some quality time in Bend...
The drive over the mountains was insane...
I even saw snow.. (in May!)...
I got to see my bro play drums again...

His band was great!

I got to celebrate my friend Melanie's 35th birthday...

I even saw my very first boyfriend! (With his beautiful girlfriend)...

New baby George is sooo cute!!!

Spending time with the family was so much fun!

small photo post... more to come...

2008-05-18T02:07:00.000-07:00

What a beautiful family! More to come...

Mind boggling...

2008-05-02T21:02:00.000-07:00

I'm speechless.

Meet George Ephraim Blake Perlingieri. My nephew. 7lbs 9ozs. Born at home. No drugs. My sister is a titan!!!

My tired, working chef...

2008-04-19T02:03:00.000-07:00

My poor, overworked, abused chef comes home around midnight or one looking like this:

We are so happy to see each other! We talk about our days and sip wine or beer. He showers and about 30 minutes later, starts looking like this:

Soon, after fervent denials that he is "not tired" and "wants to hang out with my super" (that what we call each other) he looks like this: (his pajama top says "I'm with Super")

I miss him. But on lovely (rare) days off he makes me something like this:

I am one of the luckiest girls in the world!

Chef Widow perks...

2008-04-03T00:22:00.000-07:00

One of the benefits of having a chef husband is that occasionally people give him things. Fun things. Last year a purveyor gave us tickets to a Los Angeles Angels game. The seats were so great we could hear the players swearing and I could make out all the sweet buns. This last Monday we got VIP tix to the Los Angeles Clippers. I was super excited until I did some research and realized they were the worst team of the league. But that didn't faze us, the tickets were a gift after all, and we had never seen a pro basketball game. We started our night at Osteria Mozza. (check out mozza-la.com since they won't allow a link.) We sat at the bar for a couple of hours feasting on ravioli's topped with egg, grilled octopus, homeade orrichette, sweetbreads, and seasonal cocktails. Thank you Matt for treating us so good!

Thoroughly stuffed, we drove downtown to the Staples Center. We took a wrong turn off the freeway and got to see what downtown LA looks like at 8pm on a Monday night. Sketchy. We were running low on gas and I had time to ponder if I would be able to run fast in the shoes I wore. Luckily, we made it to the parking garage. Free, thanks to our tickets. We entered the stadium from the VIP entrance and got to walk by all the cars of the "playas". Bentleys, Rolls, Range Rovers, and Ferraris. I ask this: If you have enough money to buy a Ferrari, why choose orange?? Anyway, we bought some big ass beers and found our seats. The view of the not-so-great game was fabulous. The biggest entertainment was during half time when they brought out the "junior" cheerleaders. It was really weird. One moment we were looking (ogling) at the regular cheerleaders in skimpy outfits and then they bring out little girls in skimpy outfits to do the same routine. Eeeww. We ended up leaving early when a Spurs fan in our section and a Lakers fan in the section behind us started screaming obscenities at each other. The final straw was when the Spurs fan yelled, "I'll pimp your ass right now!". What?! What does that mean? You got a 9mm underneath your oversized jersey? Why are sports fans such psychos? As we left, security stopped us and asked us not to leave. "We are kicking out those troublemakers", they assured us. Umm, I'm not waiting around for that. For future reference, the stadium has these private rooms that are basically like a hotel room with large glass windows facing onto the action. No sitting around stupid people. That is VIP. Next time...

Still, it's always fun to get free stuff. Especially for things I wouldn't normally choose to spend money on. Thanks to Rhonda from LA Specialty for hookin' us up!

Chefs' Widow. Again...

2008-03-24T22:21:00.000-07:00

I am once again a chefs' widow. I pretend I look like this: but this is probably more reality..
I suppose I had forgotten, after 8 months of having my husband home and at my beck and call, what it truly was like to be married to a chef. His last day off was, ummm, 3 weeks ago. I think. I can't remember. I do remember that he got about a thousand phone calls, from work. He leaves the house before I get up and comes home pretty much right around the time I decide I'm done waiting up for him to come home. When he does come home he is his usual loving self, but then falls asleep in his chair while I'm midsentence. I find his clothes all over the house. Dirty aprons by the door, pants by the closet, and his undies on the bathroom floor in front of the shower. I can piece together his time at home by following the clues of his clothing. I've taken out the garbage several times. The fridge is bare. My cooking is WAY out of practice. We "share" a car, which means I haven't been in it in several weeks and I know my bus routes by heart.

He finally has a day off tomorrow. You know what he wants to do? Visit his grandmother! I hate to be selfish but, what?!? So I will be the dutiful wife and visit gramma Lea on our one day off together. One cool thing is that we can hit the Chino Farm stand and get all sorts of goodies and cook a fabulous lunch for her. My husband loves to cook even on his days off. (or maybe he would rather cook than have me cook, out of practice and all..)

So, I'm back in the club all you chef wives! My fave chef wife is funny, smart, and cute. Check her out at www.desperatechefswives.com

The Top Ten Reasons you are lucky...

2008-03-24T01:35:00.000-07:00

#1: You either haven't gotten or are (finally) over influenza this season.

#2: You haven't bitten into a prickly pear cactus and filled your mouth full of thorns because you "heard they are edible" and took a bite.

#3: You didn't dip your finger into the sauce you were making, not thinking that you also had a hand held blender at full speed in the same bowl.

#4: You didn't amputate the tip of your finger and then the leave the ER (with your finger dangling) because you are an illegal alien.

#5: You didn't get bacterial pneumonia and just happen to be allergic to almost every antibiotic known to man.

#6: Your rectum didn't prolapse as you were having a particularly trying bowel movement.

#7: You're not homeless and the best prospect to having sex is in an ER exam room after your peritonsillar abscess is drained of pus. (See last blog.)

#8: You didn't break your collarbone jogging because you stared so hard at another jogger of the opposite sex running by that you ran into a stop sign.

#9: You didn't slice your hand open from "cutting cheese".

#10: You didn't give a guy a blow job who happened to have an outbreak of herpes and now you have genital herpes covering the whole inside of your mouth.

For God's Sake!

2008-03-16T21:34:00.001-07:00

As you know, Santa Monica is the "home of the homeless". Out of a population of 85,000, there are approximately 1,000 homeless people. The craziness of Santa Monica is that there are insanely wealthy people here and the dirt,dirt poor. Working in an ER setting, I can take care of a urine-stinking homeless person and then (after its cleaned) put the CEO of some gigantic corporation in the same gurney. The population in Santa Monica runs the whole gamut of every conceivable class of society. It's a little disturbing when I stop to think about it...

We see a large population of homeless people in the ER. Some are nice, some are horrible. Some reek to high heaven, some manage to keep themselves clean. Some abuse the system, some avoid us unless they are really ill. I could use these same examples for every social class. (i.e., the wealthy patients who come in; some are nice, some are horrible. Some reek (of perfume or BO), some are clean, etc.) We are all the same when it comes down to it. Everyone, no matter who you are, has to come to an ER sometime.

A homeless guy came in complaining of severe throat pain. He was with his (homeless) girlfriend. They were nice enough. But what I couldn't stop thinking about was that they were not mentally ill, nor did they come across as junkies. I couldn't quite figure out why they were homeless at their age. He was early 40's, she looked to be late 20's. It got me thinking that homelessness is a hard cycle. I think once you become homeless, you can't break it. How do you get a job, to pay rent, if you cant' shower on a regular basis? And even if you got a job (minimum wage), there is no way you would actually want to pay taxes, or an electric bill or all the other responsibilities that come with renting. I think it must be easier for these people to "live off the grid" and not have to deal with the day to day bill-paying, rent-owing, mail-getting, dog-feeding life that we all see as totally normal. Put yourself in a homeless persons position for a moment. Where do you take a shit? Where do you shower? Where do you put your "things"? What about your period? How do you get food? And even if you get food, it has to be ready to eat. You can't cook anywhere. Yeah, there are homeless shelters but the rules are strict and the scabies runs rampant. It's a shitty life.

Anyway, back to my homeless guy with the sore throat. He could barely swallow and had a fever. The PA seeing him diagnosed a peritonsillar abscess. Nasty shit. It means an infection has started in the tonsils but never could make it's way out so it just festers in the back of the throat. I started an IV (possible track marks but I wasn't sure), and gave him some antibiotics and morphine. He was obviously ill and we did our best to keep him comfortable while we waited for the ENT (ear,nose, throat) doctor to come in. The great thing about a catholic hospital is that if someone is truly in need, we will take care of them. So, the ENT doc came in and did what he had to do. Which means numbing up the back of the throat with shots of lidocaine, then using a scalpel to slice into the back of throat and let the pus drain out. Totally barbaric but the only way to do it. If that isn't gross enough, the doc made the patient spit the pus that was draining out of his mouth into a basin instead of using suction to whisk it away. So this guy had been struggling the whole time. How many of us would voluntarily open our mouths knowing that this horribleness was about to happen? The doc successfully drained the abscess and decided the patient could leave the hospital, aka "go home". When we know a patient cannot pay for a prescription we fill it for them through our "indigent fund". We told "throat abscess guy" that we were waiting for the pharmacy to fill the prescriptions for him. Our nurse, Holly, had taken the long trek to the hospital pharmacy to pick up the medications. When she got back, she opened the door to the exam room and found homeless guy and girlfriend in a "compromising" position. They were doing it on the gurney! She had her pants down and her leg up, he was pumping away like there was no tomorrow. Wow, draining that abscess obviously made him feel a lot better! Holly, the nurse, yelled, "For God's Sake! This is a hospital, not a brothel!" We kicked them out after they had pulled up their pants. Another question, where do you have sex if you are homeless? I had to excuse this couple for doing what they did. It's probably been a while since they had the opportunity to have sex on an actual bed...

Feel lucky you can have sex on a comfortable bed, or couch, or kitchen table...

Late night reflections...

2008-03-06T01:47:00.000-08:00

Had a patient who came in after hot roof tar in a bucket overturned and splashed all over his hands, neck, ears, and face. We called a burn center and they told us mineral oil would take it off. Believe it or not, we did not have access to a vat of mineral oil. The work crew that came in with the patient brought in a large amount of alkali "degreaser". We tested it on his hand and it took the tar off without doing any more skin damage. We went to work to remove all the tar. Of course, under the tar was a second degree blister. Everywhere the tar splashed was a painful blister. The patient was amazingly cool about the whole situation. He smiled, he joked, he helped remove the tar along with his buddies. We took over the ER bathroom with sponges, towels, degreaser and fumes. What I learned: Cool the tar as fast as can using cold water. Use a alkaline degreaser or mineral oil to remove the tar as fast as you can. Take antibiotics to ward off infection and apply silvadene or neosporin to help heal the burns. This guy was lucky, he was wearing a hard hat and goggles that protected his head and eyes. His safety goggles were covered in tar...

Had another patient who came in complaining of "the worst headache" of her life. This is a key phrasing that many health care professionals interpret as either a brain bleed or meningitis. Either way, a life threatening illness. The patient was in her early twenties and, in my opinion, was so focused on herself that she didn't pay any attention to anyone else. When she was brought to our waiting room we had four other patients waiting to be seen. So basically she walked into a "full" waiting room. She proceeded to walk straight up to the nurses station and ask, "Am I supposed to wait? Can't you put me a room right now?". So basically she is saying, 'I am more important than everyone else.". That pisses me off. I told her she needs to wait, just like everyone else. Not that we down played her complaint. But the possible appendicitis and the severely broken ankle was just as important. We got her into a room and did our usual, blood draws, IVs, meds, ordered a head CT. The PA (physicians assistant) had told the patient the possibility of meningitis (which any good practitioner would because of the original complaint) and the tests we would be doing. What bothered me about this patient (besides the fact that she thought she was the only person in the department) was that she was not acting like a typical meningitis case. I know, because I had meningitis three years ago. She claimed to have the worst headache of her life, but she was laughing and joking with the twenty family members coming in and out of the room. I couldn't tolerate light, voices, and sent everyone out of my room. She claimed to have neck pain but easily moved and adjusted herself to a position "to get comfortable". I hate to be cynical but when I had meningitis I was unable to move, open my eyes, and was vomiting (dry heaving) about every minute. I just wasn't buying it but I have been wrong before. I kept my opinions to myself this time. Well, every test turned out negative and she went home with a diagnosis of sinusitis. (Infection of the sinuses which causes a bad headache but far from life threatening.) An ER nurse has to be very careful of peoples complaints because some people way over exaggerate and some people are so stoic you have no idea how sick they are until they "crash".

True story..

2008-03-02T03:22:00.000-08:00

So, you all know it is flu season. I've waxed poetic about the flu shot and the flu itself. How we (as an ER) can't really help, you just have to sweat it out, etc, etc. A patient came in today complaining of cough and fever. (Classic signs!) We encourage all our patients who have these symptoms to wear a face mask and we, as health care providers, also wear masks to keep from spreading the flu and starting an epidemic (or pandemic, god forbid). I was helping this particular patient, all the while wearing my mask. She refused to wear a mask, even after I asked her to. She asked me, "Is there something going on in the hospital that 'you all' don't want to get coughed on?" I replied, as pleasantly as I could, "Yes, influenza. It's contagious. And no-one likes to get 'coughed on', regardless." After I discharged her, her husband came to the nurses station and asked, "Are you the nurse that took care of my wife?" I answered yes. He asked for my first name and wanted to know if my supervisor would know who they were talking about when they filed their complaint. I answered yes. Are you kidding me? You want to complain because I am trying to protect myself and other patients? It pains me that we actually have a staff member that deals with complaints and this is what she has to deal with.

Zoom to zoom..

2008-02-27T00:33:00.000-08:00

Now, I know, that everyone thinks their own kid/blood relative is "the cutest thing ever". But you have got to check out my five year old niece's blog. She just started it and likes to talk about her dreams and various daily activities. Sometimes she dictates to my sister who types it for her and sometimes she types it herself. (Mrs. G, she's only five. Please excuse the spelling. She's hooked on phonics.) I would love to start reading more blogs from all those bloggy mommas' kids out there!

www.mayanszoomtozoom.blogspot.com

Needle in a... banana?

2008-02-24T14:05:00.000-08:00

A man came into the ER reporting he had bitten into a banana and found a hypodermic needle in it. We thought at first, "Yeah, right. Who is this kook?" But he turned out to be a normal, white collar guy and his story was legitimate. He had brought in the banana and the needle. (20g for all you medical folk). He said he had bought 4 bananas at a large supermarket outlet on Sunday. He had one on Monday, one on Tuesday, and when he bit into his "Wednesday" banana he felt something hard and spit out a large bore needle minus the plastic part. On closer inspection of the banana skin he found a puncture mark. Understandably, he was upset. We did all the medical things necessary for him and notified the police. The poor guy had been watching too much CSI because he asked me to "dust the needle for prints" and to "test the needle for all toxic substances including cyanide and arsenic." I had to explain to him that the hospital does not have a crime lab and that the police were going to have to take care of any "testing". We also notified LA County Health Department and asked them to send someone to the grocery store to notify them and possibly pull the bananas from the shelf. How typical of Los Angeles to actually have this happen and also typical for the police department to not be very impressed. Imagine what LAPD sees every day. I'm sure a needle in a banana was not high on their list of priorities. I know that sounds crass but it is reality.

Now before you throw away all the bananas in your house and boycott Chiquita, I googled "hypodermic needle in banana" and found an article from the Oxford Journal of Experimental Botany (you don't subscribe to this?) that reported hypodermic needles are used to test "the gaseous atmosphere in the intercellular spaces of bananas". So, you see, there could be a perfectly acceptable explanation. I'm really trying to convince myself of this because the alternate explanation is too horrid to comprehend.

Epic birthday dinner!

2008-02-23T14:43:00.000-08:00

Noah surprised me for my birthday last night and took me to Bastide, a french restaurant on Melrose Place. He kept the secret well but of course I had an inkling. :) We had reservations at 9pm and showed up a little early. The maitre'd put chairs in front of the fireplace and served us champagne while we waited for our table. He sat us at a table in a private room with only one other table in it besides ours. Another couple was dining at the same time. The menu had only two choices: a four course meal or a seven course. The courses had no descriptions, just what the main ingredient was: fish, duck, suckling pig, etc. We ordered the seven course with wine pairings. I can't even begin to explain how amazing each dish was. Perfect flavors combining, nothing too big, just beautiful tastes paired with some great wines. The sommelier just kept pouring the wines. We must have had over 10 different wines. He seemed excited about his job and would pour two different wines for us to try with courses. He even poured a sake with a beautiful abalone and noodle soup with uni (sea urchin) flan and dashi broth. We continued to be blown away by the food and flavor combinations. The chef came out and introduced himself and gave Noah a tour of his kitchen.

We struck up a conversation with the couple across from us and it turns out the guy is a chef at one of our favorite spots in LA, Pizzeria Mozza. He and Noah knew a lot of the same people. He asked me if I was "in the industry" and I replied, "The nursing industry." His wife said "Me too!" She is a nurse at Cedars Sinai. How bizzare that we were sitting right across from a chef and nurse couple. We got a big laugh out of that. Then the server brought them a dessert with a candle in it. It was his birthday! More laughs!

The evening wrapped up and we got the bill. What was supposed to have been a 400 dollar bill was only 200. Bastide had only charged us for the wine, not the food. We left a huge tip. It was worth every penny and more for such a special evening with amazing food and great conversation and company. We left high from the whole experience and keep talking and reminiscing about it today. Fabulous birthday!

My birfday!

2008-02-22T10:34:00.000-08:00

I'm twenty thirteen today, haha! And besides my poor eyesight, my chronic back ache, my inability to wear heels for more than an hour, and my annoyance at anyone in their early twenties, I feel pretty good. I was trying to recall what I had done for my birthdays since I had moved to LA and the only way I could refresh my memory was by looking at past photos. But, oh, what good times I have had!
Last year we were on a cruise. Playing bingo and drinking obnoxious drinks. What, did I turn 72??

The year before we went to Napa for olive oil and wine tasting. We ate at a friends restaurant in Yountville.

Aahh, this is more like it!

The year before was San Francisco. We had oysters at the wharf and went into Berkeley to visit friends Chris and Mona. Chris cooked up 10 million courses for me right out of his kitchen. Fabulous wine was poured of course.

This year? I went out with friends last night to a wine bar in Culver City and then to a bar called Saints and Sinners. I actually did a shot! Got all sorts of pamperey (word?) gifts from the ladies. Soaps and lotions and bubble bath and wine and candles. As far as tonight goes, I have no idea what we are doing. Noah has something up his sleeve and I have instructions to buy a dress... Sounds fun!

The flu!

2008-02-09T17:37:00.000-08:00

I made a vow to myself this year to protect myself and all the people I come into contact with during the flu season and get a flu shot. So in October I did my nurse duty and subjected my left deltoid muscle to be injected with a small amount of the CDC's "guess" of what the flu virus should be this year.

I GOT THE FLU! Just spent three horrific, feverish, achy and exhausting days battling it out. Couldn't go anywhere, made a nest on the couch and popped massive amounts of advil while watching horrible TV in between my fever induced nightmares. Slept probably 16 hours a day. Now I'm on the up and up, thank advil, and actually ventured outside yesterday for some fresh air. I think the only good thing the flu shot did for me was keep the illness shorter than it would have been.

Keep well, people. It's out there and its not fun.

3 in a row, again...

2008-02-01T01:03:00.000-08:00

I'm working three shifts in a row, again. And I know that a lot of you nine to fivers do five in a row every week, for some reason three 12 hour shifts back-to-back is really hard. My husband will scoff, he being a chef and does five to six 12 hour shifts every week. But it is a tiny bit different owing to the fact that he is cooking food and I am saving lives (ha ha). A small sampling:

A patient came in complaining of a swollen, painful calf. This is usually indicative of a DVT (blood clot in the leg). He looks ill, he's red in the face, he's kinda huffin and puffin, although his vitals are good and he doesn't complain of SOB (shortness of breath). I ask him about recent travel. "I just got back from Wisconsin to see Green Bay play (lose)." This guy not only had a ginormous blood clot in his leg but several in each lung. Staying idle during a long flight will do this to you so flex your calves, get up and walk around a bit. Life threatening condition, all for the love of a football team. I tell ya...

The triage nurse calls us and says she has a 77 year old with a simple laceration of the leg. "Send him on over!" I tell her enthusiastically. Here he comes, bleeding like a stuck pig from practically every orifice. What the hell? Oh, he's on Coumadin, a potent blood thinner that in too high of doses can completely block the body's ability to clot. His nostrils are filled with blood, every time we stick him to get a blood sample he develops a huge hematoma at the site. This guy has the pharmaceutical equivalent to the Ebola virus. He bruises just breathing on him. His INR is over 10! (for all you medical folk) Not good. We sent him back to the main ER for closer monitoring. We got too busy and I could never follow up to see what happened. The weird thing though is that the man used to be an attorney and he had a very loving and attentive family at his bedside. He also was suffering from multiple sclerosis and being treated for lung cancer. According to his MD's office, his blood clotting time was perfectly therapeutic 5 days ago. Was it the chemo or was it an accidental overdose of Coumadin? As sick as he was, and has been for the past few years, I just hope he lives out the rest of his years in peace...

During all this time that we are dealing with very sick patients, we have to deal with several of these scenarios:

Patient (with a swollen ankle): We've been waiting for 45 minutes for an xray.

Me: I know and I understand, we are very busy.

Patient: I'm just going to leave. I have somewhere to be, this is ridiculous.

Me: If you have something more important to do then leave. But we would like to treat you.

And another (common):

Patient: I have a fever and body aches.

Me: Did Tylenol reduce your fever?

Patient: Um. Tylenol?

Me: Yes, Tylenol. Here, let me give you a (50 dollar) dose of Tylenol.

Ladies and gentlemen...

2008-01-25T23:38:00.001-08:00

Meet the new executive chef at BLT Steak, Los Angeles!

(BLT is not Bacon, lettuce, and tomato.. it's Bistro Laurent Tournadel) ;)

Noah News!

2008-01-23T00:56:00.000-08:00

Very exciting time for Noah who is being flown to NYC to do a tasting/interview for a big chef who is opening a restaurant in Los Angeles. He has to prepare four courses for the chef this Friday. I'm sure he'll do great and this would be a really great opportunity for him! I'll keep you posted!

Bad hairstyles..

2008-01-20T01:05:00.000-08:00

Inspired by Mrs. G at derfwadmanor.blogspot.com I decided to post my half Rick Springfield, half Joan Jett (I wish) haircut from back in the day. I have no shame!

Happy Pickling!

2008-01-17T18:41:00.001-08:00

That's what my mom said to me when I got off the phone with her after asking her advice on pickling. I decided it would be fun to make my own pickles. As everyone in my family knows, I had quite an obsession with pickles for awhile. One morning, when we lived in Alaska, my dad was in charge of getting us off to school. He had made our lunches (mine included two plastic wrapped dill pickles) but when the bus pulled up in front of our house he realized he hadn't fed us breakfast. "The bus is here, Dad!", I yelled. His answer? He handed me a pickle. So I ate a pickle on the bus, then ate two pickles for lunch. At recess, it was raining lightly, (as it does in Alaska, everyday pretty much) and I realized my hands were swelling up so much I couldn't bend my fingers! I went to the school nurse and she told me to cut down on my pickle consumption. Wow, digital edema secondary to sodium consumption!

So I pickled today and had lots of fun! I promised my mom I would post the photos: I did pickled beets, one with blood orange slices and one plain, pickled green beans with garlic, and two types of pickles, sliced and quartered. They should be ready for cold storage in three days and to eat in a week! I can't wait! I'll try to ration my pickled meals to avoid any unwanted bodily effects...

My Super!

2008-01-13T11:35:00.000-08:00

Happy 35th birthday to you, Noah!

Incredible chef...

Sexy surfer...

Wonderful uncle...

and loving husband! Here's to the next 35 years!

ER Schmee-are...

2008-01-12T02:19:00.000-08:00

Another busy day today... Had a poor 4 1/2 year old come in after falling off a top bunk of a bunk bed. (I understand the space needs of homes but this is my second horribly broken arm on a young tot from a bunk bed in two days..). Such an incredibly nice family. His arm was visibly deformed above the elbow. We knew he was a surgery candidate right away. The orthopedic surgeon who specializes in pediatrics was called and came in right away. Our only problem: our hospital does not operate or admit pediatrics! How was this poor family supposed to know this as they rushed to the nearest hospital in distress. Our options were to transfer him to another nearby hospital or have them sign out AMA (against medical advice) and drive 8 blocks to UCLA. I was a fan of the latter. Let them know the legistics and allow their son to be treated in a hospital that specializes in pediatric surgery. Our wonderful doc who was in charge got on the phone and started making phone calls. I called our house supervisor and told her the situation. It turns out we can operate on pediatric patients but they cannot be "admitted" to the hospital. The doc felt this was the best option for the kid. He's already here, lets fix his arm, and send him home after the surgery. Okay, great, but the kid had eaten dinner at 6pm and you have to wait at least 6 hours to do the surgery after a meal. The operating room is open only to dire emergencies at midnight. So this wonderful family had to wait until 7am for the surgery. I give props to the orthopedic surgeon for bullying the OR staff into pushing all their other scheduled surgeries back so this kid could get in first. Meanwhile, we were managing his pain and fear, and the fear and worry of the parents. I continually try to imagine that it is my nieces in these predicaments and give the optimum care that I would want for them. I also give props to the ER doc that kept every option open (even the "controversial" one of letting them go AMA so they could take him to a pediatric hospital) if that would give him the fastest and best care. I am amazed at times of the caring and "fuck the system" attitude of ER doctors to try to get the best care for patients within the constraints of the health care system. I did not notice what kind of insurance this family had. I don't think I'm going to last long in health care if I dwell on it.. I know there are problems but I don't know what I can do except keep patients informed of their choices...

I also learned a lesson in humility (and not overstepping my scope of practice) the other night. A patient came in who I recognized. She was making a big scene in the waiting room, moaning and yelling. I got her into an exam room and I realized I recognized her from several previous visits. I immediately labeled her as a "drug seeker". Her behavior was typical for drug seeking and her visit history was at least 15 visits in the past 3 months for various pain complaints: headaches, back pain,etc. Her behavior was always over the top and she always demanded strong pain medications by name. This visit she was complaining of abdominal pain. We started an IV and gave her a small amount of morphine. She insisted on more and could never exactly tell where the pain was located. She would say "All over" when asked where her abdominal pain was. I doubted her and told the doctor "If she has an acute appy (appendicitis) I will run the halls naked!" Luckily, the doctor believed her and not me. The CAT scan report revealed and inflamed appendix that needed to come out that night. The doctor is still asking me to pay up on my bet... (Yeah, right!) It is sad for me to realize that I have become so cynical towards patients that I don't recognize a real emergency. At least the doc backed me up by saying "She still is a drug seeker. She is displaying the over-the-top behavior. She just actually has a medical condition".

It is hard when so many people come into the ER "crying wolf" or over-exaggerating their problems. It's easy to become cynical. I'll try not to. But it's hard..

Other fun things in the ER..

2008-01-10T00:58:00.000-08:00

So please read my last blog to appreciate this one: I was dealing with a patient with a finger amputation. It doesn't matter how busy you are, the patients keep rolling in.. A twenty something girl came in a few minutes after our poor guy who was losing his finger. Of course, she didn't know this. Her complaint was " a big, deep cut". She had a TINY cut on her wrist that you and I would not walk into an ER for. I wanted to walk her into the amputee room and tell her, "THIS is a big, deep cut!!!"

Tell me, would a nurse hotline be helpful to people? A way to avoid the ER $$$ for possible practical advice? Let me know..

Got good insurance?

2008-01-09T23:09:00.000-08:00

I was actually going to post a more graphic photo and then decided this would be more appropriate...
I walked into work the other day at 11am, my scheduled time. It is when our department opens although an LVN (licensed vocational nurse) comes in a half hour before to do all the opening bullsh*t. As I walk in, the charge nurse from the main ER strides in with a syringe in one hand and a man following her who has his left hand elevated above his head and wrapped in bloody gauze. Right away I know this is not an ordinary patient. Rarely does the charge nurse from the ER get upset or excited about anything. "Bring him into room 4", I tell her, not even knowing what to expect. The story is this: a spanish speaking only construction worker (I'll call him Jose) was working with a skillsaw and "got" his fingers on his left hand. I knew right away, without even looking at his hand, that he was going to be prepared for surgery just by the presence and attentiveness of the charge nurse. I called the physician's assistant in as I started an IV and drew blood. The poor guy was pale and scared. Luckily he had his brother with him who spoke fluent english (I think!) and translated for us. The hand surgeon was called and showed up in 5 minutes. He took one look and told the patient his options. This is where it gets tricky.. Insurance. Wow, you would think that someone who's middle finger is hanging on by a piece of skin would get the best treatment available. But no. There are two hospitals in LA that specialize in "replantation". Our hand surgeon called them and they both denied him. I don't know the details on why but the bottom line is that they refused to accept him as a replantation candidate. Our hand surgeon, (who wonderfully had been making all the phone calls himself), had to break the news to the patient that no experts in finger replantation would accept him as a patient. By this time, his amputated finger was no longer viable and his only option was to go to surgery at our facility, for an amputation. Very sad. This man is a construction worker. He needs all his fingers. We all need all our fingers. Any normal person would think that if they cut off their finger and went to a hospital, that they would get all possible help. Nope. A finger that could have been saved was lost because of insurance. I find no fault with the hand surgeon that came in because he did everything he could to save the finger. The patient insisted to be transferred to a transplantation hospital (like we all would). The poor patient just didn't know that he would be rejected based on insurance. What can we do about this? This is not right! What next? We can't save your eye or your ear or your leg because you don't have the right insurance??? I'm very upset...

2007-12-31T21:57:00.000-08:00

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!

Check out my buns!

2007-12-20T00:48:00.000-08:00

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!

LA living...

2007-12-19T00:17:00.000-08:00

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...

Where are your kids right now??

2007-12-14T19:59:00.000-08:00

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.

Took some time off..

2007-12-09T20:22:00.000-08:00

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...is my Monday.

2007-11-30T23:40:00.000-08:00

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...

2007-11-29T21:48:00.000-08:00

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!

Spoiled rotten...

2007-11-28T20:27:00.000-08:00

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...

YAWN...

2007-11-27T10:44:00.000-08:00

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...

Dinner party success...

2007-11-26T02:50:00.000-08:00

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!

Work Schmork!

2007-11-24T21:44:00.000-08:00

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!

Store bought pie..

2007-11-22T19:56:00.000-08:00

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...

T-Day preparedness

2007-11-21T21:29:00.000-08:00

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!

To Lou!

2007-11-20T11:04:00.001-08:00

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!

Nancy Silverton rules!

2007-11-19T19:49:00.000-08:00

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!

Cool weather food..

2007-11-18T20:12:00.001-08:00

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..

2007-11-18T17:40:00.000-08:00

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.

Soo..

2007-11-17T21:03:00.000-08:00

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??

Ggrrrrr...(part 2)

2007-11-16T10:35:00.000-08:00

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!

Ggrrrrr...

2007-11-15T10:49:00.000-08:00

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!