Wednesday, January 23, 2008


When work is going well, I can mostly think about other things as I type operative reports, cardiac catheterizations, consults, Emergency Department cases, etc. Between my work software crammed with shorthand terminology and medications I use constantly (loaded in by me over time) and my natural spelling ability, I almost never have to look anything up.

I am brought back to current reality, though, by statements at the beginning of a new dictation like I heard tonight:

First was "Chief Complaint: Skillsaw mishap involving loss of digits." Holy fuck, my fingers curled on themselves in sympathy. Love that "mishap" tossed in there after Skillsaw, a colorful turn of phrase.

Then came "Preoperative Diagnosis: A 40 -year-old female with 36 week pregnancy, perforation of colon and rock-hard stool throughout entirety of colon, with purulent ascites." Just to let you know, the baby got delivered and he was okay. Not so sure about mom, though. They cut out 68 cm of colon and gave her a colostomy. Since it was an op report, there was no explanation of how she got in these dire straits.

When you hear what can possibly go wrong with the human body over the course of 30 years, it makes you grateful for all the ways things go right day after day -- enzymes process dinner without your oversight, ligaments flex (mostly), taste buds send off feedback, gas makes it way out of you, and that big complicated muscle in your chest keeps squeezing to its electrofunk beat. Miracle after miracle.

(Yep, from little gator.)

One of my big accomplishments this week, leading to enhanced quality of life, was assembling a new office chair. The joints in my hands don't cooperate as they once did, but I finally got it done and am, as I type this, enjoying the new comfort of it all. Dinah likewise had a spike in her entertainment level because the long plastic strap around the carton that the chair came in is wonderfully snaky and rattly. If I go too long without lashing it around provocatively, I hear her coming my way with it gripped between her teeth, her paws stepping over it sideways, until she can drop it within reach and look at me pointedly. At the moment, it holds the status of Best Toy Ever.

("Holding Onto Myself" by Peter Callesen)

Here's a little reality check: When you get scared, you don't think well. You're undergoing a physiological response which may be slowed down but is still releasing chemicals into your bloodstream as if you had just looked up and saw a sabertooth tiger about to leap on your head. Your brain shunts processes over to reactive mode, and, well, unless you really are facing down a Smilodon, it would be better if you stopped making decisions (or trying to) and instead lay down for a long nap.


I know things look bad out there. Perhaps they really are that bad, in which case, flecks of feces will soon be splattering through the blades of the Kenmore fan and we'll be reaching for a wet-wipe. Until that happens, though, trying to "get ready" for something which has not yet occurred means you'll be operating on incomplete information. Using old scripts, and the legacy your parents handed you.

There is wisdom and hope to be had without turning to Revelations or reality TV. You know what these rejuvenating wellsprings are: Hanging out with kids. Going out in nature. Cooking something from scratch. The books and poetry you never get tired of (Annie Dillard, here I come). Watercolors. Meditation/prayer/davening. Singing out loud (Beatles are good for this, all you need is love, love, love...)

Texas has more natural springs than any other state in the country (we have a LOT of water here, folks, forget about "Comanche Moon" and all the ways we're portrayed on TV). We talk and think often about recharge zones, how to keep springs alive by not building on top of the labyrinth underground feeding their essence. Pay attention to your recharge zones, my friends. Balance.

There's a Quaker saying, "Proceed as the way opens." Imbedded in that logic is that you DON'T try to move forward until the way opens. Fits and starts is a perfectly okay way to live.

And if you really can't turn off the electronic media immediately, go read about the Overton Window by Sara Robinson at Orcinus. Things are changing for the better. Take a load off, teach a toddler the joy of knock-knock jokes, and eat some veggies. Catch you when you've rested up a bit.


little gator said...

Mr Gator's medical transcription story:

We had a mature dog and had just adopted a 55 lb, mostly black, 5 month old,very stupid but loveable puppy.

One night we heard a fight start up(they were still figuring out which of them was in charge). Mr Gator ran yelling into a dark room and tripped over the black dog. The dog, hearing a yelling human approach, fled and got under Mr. Gator's feet. Poor guy was the dumbest dog I've ever had. Mr Gator landed hard on one hand and we eventually learned he'd chipped a tiny bit off a bone in his thumb. And it healed just fine.

They asked him to fill out a report and where it asked how the accident happened he wrote:

"I was breaking up a dog fight and tripped over a fleeing dog." Bet you never had to transcribe that one!

At one point a nurse entered the exam room and said "um, your report didn't say what type of injury you had." They hadn't exactly asked for it, and he had given them what they asked for.

So he added to the sentence the phrase, "injuring my thumb."

letsdance said...

Maggie, I love you. It never fails that reading your posts opens my eyes and my mind to other possibilities.

I'm also crazy in love with the Stairway to Heaven.jpg. I love stained glass!

shadocat said...

Maggie, is that last picture the RLDS(aka Community of Christ)Temple in Independence, Mo.? Jesus is supposed to make his comeback right across the street from there, ya know...

Maggie Jochild said...

Re the stained glass image: I don't know where it's from, though from what I researched just now on the web, I don't think it's the temple you mentioned, Shado -- the glass in that dome does not appear to be stained. I pulled it from watching Play Blogger, a stream of endless images pouring in from around the world, spellbinding and occasionally something so unusual I pause and steal.

I had an ex who did stained glass, sold it at Michigan. When I hear the term, I have a sensory memory of the smell of burning flux.

Nope, little gator, I can't remember a story resembling that one. I used to type for a doctor who earned most of his income disputing Workers' Comp claims in California, a neurologist who had no ethics whatsoever. One time, a railroad worker was closing the sliding metal door on a boxcar (weighs several hundred pounds) when it broke from the side and fell on top of him, pinning him and crushing him for a couple of hours. Broke almost every bone in his body, including his skull, leaving him with TBI, etc. This doc declared "If the man wanted to find meaningful work, such as working as a greeter at a restaurant, he could do so" and said the guy was not disabled. That one really took the cake.

The most memorable reports have involved sexual experiments gone wrong (one doctor called what he extracted from a woman's colon a "tubular electrosexual device", a phrase we used around the office for months) and work injuries using mechanical equipment. One story actually made it's way into Reader's Digest, one of those "Most Memorable" articles -- a guy working alone in a room with a conveyor line assembly of various horrific equipment, getting snagged and his arm sucked into the gears, with a metal rod going all the way through his wrist. He screamed for help for an hour, then began pulling himself loose by actually sacrificing bits of his arm to the machine. When he realized if he got the bolt all the way out, the gears would start back up and suck the rest of him in, he pushed the bolt back through his wrist and waited.

What wasn't in the Reader's Digest version is that the reason why the guy was alone in that room was because a new supervisor had instituted cutbacks in personnel, against union regulations, and the emergency cut-off switch was out of the reach of the single worker he allowed for that section. This particular patient lost his arm, then had a heart attack when he went back to work to pick up his severance package and had to meet with this supervisor. The cardiologist who saw him (and for whom I type the report) said the patient became homicidally angry when the supervisor's name was mentioned and his blood pressure would go off the charts. They got him counseling. And yeah, he got disability.