Saving Captain Covington

One of the perks of working for the Federal Government is the amount of time you get off. For starters, you get all of the holidays. When was the last time you got Columbus Day off?

And, you get five weeks of paid vacation a year.

In April of 1995, I did something I had never done since I had started working at the MVAMC. I took two consecutive weeks off, but I did it for a good reason. My father-in-law had called, and said he needed help cleaning out his house after his wife had died.

Wanda had died the previous October after traveling all the way from the bottom of Texas to Minnesota to see her baby girl before her fourth abdominal surgery in three years. Wanda had had an heart attack after arriving in Minnesota, and needed another coronary bypass surgery before she could safely travel back to the bottom of Texas. She would die on the table in the OR, leaving a tidal wave of shock and grief in her wake.

My lovely supermodel wife called her sister, and plans were made. The three of us would drive down to the bottom of Texas and clean out Dave’s house. We would rent a truck, load that sucker up, then drive back home. I would drive the truck. Leslie would drive our car. Lea would ride with me or Leslie. Done deal.

Early Saturday morning on April 8th, Lea and I drove from our house in Minneapolis to just outside of Ettrick, WI where Bill and Leslie lived on their hobby farm, Pfaff’s Happy Acres.

I loved their farm. Bill had planted a bunch of apple trees, and collected himself an herd of miniature goats. He named all his goats after Biblical prophets. Amos. Isaiah. I think he even named one Elijah. And he had a girl goat named Ruth, of course.

Leslie had a kind of a miniature horse named Andy. Miniature horses are supposed to be, you know, small. But in the Spring of 1995, Andy went through a growth spurt, and had turned into a mutant, semi-large horse.

I was much taller than Andy the first time I met him. Andy was a few inches taller than me the second time we met. And he had developed a bad attitude.

As I was packing Leslie’s luggage in the trunk of our car, Andy grabbed one of the goats by the scruff of the neck and started shaking it around like a ragdoll. I raced into the house to tell Bill.

Bill was working as a consultant back then, and he traveled a lots. Bill had just returned from a trip to Philadelphia, where he had contracted a particularly virulent, though short-lived stomach virus, and he still looked a little green around the gills.

Despite his weakened state, Bill and I ran out to the barn to do try to save one of the prophetic goats from the psychotic horse. We were able to get the goat away from Andy, but we were too late to save it. Then Bill moved Andy into a different pen before he decided to kill any more goats, but Andy wasn’t exactly cooperative with the move, and Bill was shaking with anger and exhaustion by the time he was finished.

“I have a really bad feeling about this…” I whispered to Lea, as the goat we tried to save took one last gasping breath, and died. We said our good-byes to Bill, and climbed into the car, and headed off to San Benito, TX.

* * * *

It’s a little over 1500 miles from Ettrick to San Benito, and none of us felt like spending twenty-two consecutive hours in the car. Dusk was approaching when we reached Oklahoma City. We found an hotel in Purcell, OK, and checked in. We would resume our journey in the morning.

Lea and I were ready to roll early Sunday morning, but Leslie was not. She was pale and clammy looking. She just needed a few more minutes to compose herself. Before we hit the road, we stopped at a nearby Burger King for breakfast. Leslie took one bite of her breakfast sandwich, and turned a stunning color of green. She ran to the Ladies Room, and she stayed there.

“Maybe you should go check on your sister, and make sure she’s still alive.” I suggested to my wife.

“She’s laying on the floor.” Lea announced when she returned, and sat down to finish her coffee.

“What does that mean? Should we call 911?”

“No. She’s just being dramatic. She’ll be okay.”

This was my first exposure to the odd dynamics of my wife’s family. There would be more.

There was an Urgent Care office next door to the Burger King. I thought about dragging Leslie across the parking lot to be evaluated. She’s a much larger woman than her sister, but when Leslie finally emerged from the Ladies Room, she declined all offers of medical treatment, and crawled into the backseat of the car.

“Drive!” she ordered. I drove.

The next 700 miles were perhaps the longest miles of all our lives. Leslie was utterly miserable. She moaned and groaned and prayed for death.

“If she doesn’t shut up, I’ll fucking kill her myself!” Lea told me during one of our stops for gas.

As night started to fall, we pulled into Dave’s driveway. The first stage of our rescue mission was over. We had arrived safely, and more or less alive.

* * * *

Leslie looked a whole lots better on Monday morning. The Philadelphia flu had wreaked its’ havoc upon her, and then it was gone.

Lea and I slept in the guest room. Dave moved into his motorhome, so Leslie could sleep in the master suite. We usually went out to eat while we down in the bottom of Texas, except when Leslie or Lea felt like cooking. But I think those occasions were rare. The reason for our visit took an emotional toll on everyone.

Dave’s daughters surveyed the house like generals planning an invasion. They started sorting stuff into three piles: Leslie’s Stuff. Lea’s Stuff. Stuff No One Wants. The stuff no one wanted, like all of Wanda’s clothes, would be sold at a local consignment shop, or given away.

Leslie and Lea shed a lots of tears in the process. They understood the necessity of what they were doing, but it was tough duty.

Dave and I tried to stay out of their way as much as possible. He showed me his medals from the Army, two Purple Hearts and a Bronze Star, and casually told me how he got them. Dave had received a battlefield commission to captain during the Battle of the Chosin Reservoir in Korea after all the officers in his unit had been killed to death. He had only been almost killed, and as the highest ranking surviving NCO, he instantly became the commanding officer of what remained of his unit.

Dave had to have been the luckiest unlucky bastard I ever met. He was at Anzio in WW II, which was one of the worst places you could be at that time. And he was at the Chosin Reservoir, which was one of the worst places to be, ever. For all time. He was lucky because he wasn’t killed or captured, but he was wounded twice. And he was an emotional basketcase for the rest of his life.

He showed me his pistol, a .45 automatic, and offered to let me handle it because I had been in the Army, and I could appreciate it. But I had seen one too many handguns up close and personal, the last one during my vacation in Dallas with my buddy, Shorty.

I declined.

Leslie and Lea would occasionally question Dave about what to do with a particular item. He almost always opted to get rid of it. The sorting continued daily, the three piles of stuff grew progressively larger. No one else started exhibiting the symptoms of the Philadelphia flu, and I thought the rest of us were going to dodge a bullet.

Leslie felt like cooking on Wednesday. She made beef stroganoff, and she made a lots of it. We had a meal that couldn’t be beat, then retired to the living room to relax. After watching TV for awhile, we all headed for bed. And I started feeling not so good.

I can’t remember how many times I vomited, but by the time I finished, I knew one thing for sure. I would never eat beef stroganoff again.

Being sick is one thing, but being puking sick is the worst. Ever. I’ve rarely been puking sick in my life, even when I drank to excess, and I did that a lots. If I had been prone to vomiting, I might have been inspired to quit drinking sooner because I fucking hate puking.

I eventually crawled into bed, and started praying for death, much like Leslie had a few days earlier. I tried not to moan or whine too much because I knew what my wife had endured when she had been trying to survive her battles with Crohn’s disease.

But I was miserable. I eventually said this to my wife, “Honey, I hope you don’t think I’m a sissy or anything, but I’m sicker than a dog, and… I… want… my…mom!”

* * * *

By the next morning, I was pretty sure I was going to live, though I was feeling very shaky. And then Dave came into the house from his motorhome. We took one look at each other, and knew we had both fought the same battle.

Dave thought we all needed a break, so we got into his car and drove the short distance to the Mexican border to do some shopping and stuff.

Leslie and Lea walked around some of the streets of Reynosa while Dave and I parked ourselves in a little cantina and tried to drink a beer. It was perhaps the least amount of fun I’ve ever had with a beer in my hand.

We ate dinner at a Mexican restaurant in Reynosa, and I actually started feeling better. I was ready to back to the cantina, but everyone else wanted to go home. Lea said she wasn’t feeling too good. By the time we got back to Dave’s house, the Philadelphia flu was beginning its first assault on my wife’s already compromised body.

Lea’s health, or the lack thereof, had been the intense focus of our lives for the three previous years. She’d had four major abdominal surgeries, and had almost died at least three times. She had had about one third of her intestines removed, and had ended up with an ileostomy and an external pouch.

I wasn’t a medical nurse, but I knew enough about my wife and her medical issues to know she wouldn’t be able to survive the ravages of the Philadelphia flu without professional help. At the very least, she’d need IV fluids and electrolyte replacement therapy, or the consequences could be dire.

Lea ran into the house and down the hallway to the bathroom as soon as we got back to Dave’s house, and as the rest of us walked into the house, the phone rang. Bill was calling, from wherever he was in the world on business, and he needed to talk to Leslie. It was an emergency!

I had an emergency of my own to take care of. I tossed the phone to Leslie, got directions to the nearest hospital from Dave–fortunately, there was a little forty bed facility just a few miles from Dave’s–and helped Lea into the car, hoping she could get the medical attention she needed before she started having seizures. She said her muscles were starting to spasm, and I didn’t think a full blown grand mal seizure was far behind.

The local hospital had an emergency room. I got Lea checked in, and started explaining her complicated medical history to the admissions clerk while the staff started taking care of Lea. The ER staff all knew Dave and Wanda, and they assured me they wouldn’t let anything happen to Wanda’s baby girl.

But I knew this was going to be kind of an ordeal, no matter what anyone said. When I told the clerk at the desk my wife had an ileostomy, this was her response.

Illy-what? Can y’all spell that for me?

Like most ER’s, this one was busy. I gave the clerk a list of all the medications Lea was taking and the dosages of all of them. It was a very long list. I made her make a bunch of copies, and I would hand a copy to anyone that had anything to do with Lea’s care while we were in the ER. I stopped every staff person I saw, and told them I was a nurse, and what my wife needed. STAT!

The nurses in the ER were actually very helpful, and Lea had an IV running with a potassium piggyback running in no time. She didn’t have the same issue with vomiting that I had had, but her external pouch needed to be emptied constantly.

Lea’s nurse was a tall Texas blonde. Besides my wife, she was busy taking care of at least three other people, one of whom was a big hairy guy that had been brought in by a couple of Texas Department of Corrections Officers.

I don’t know what this guy had done, but I’m guessing jail isn’t anywhere near as much fun as they make it look on TV. This guy presented with chest pain, but didn’t appear to be in any apparent distress as he strolled into the ER. He had a big smile on his face, and he waved at everyone, making sure they saw the handcuffs on his wrists.

Per hospital policy, the big hairy guy was restrained to a litter because he came in under police escort. He totally cooperated with that, but he had stopped smiling. Once he was restrained, the tall Texas blonde nurse explained what was going to happen in no uncertain terms.

A nasal cannula was placed in his nose holes, and he was started on O2. An IV was started, and labs were drawn, using the biggest needle the nurse could find. And she made sure she missed his vein with her first attempt. Then she informed the big hairy guy she needed an urine sample.

“I can pee in a cup. I do it all the time for my PO.”

“Nope, y’all can just lay back and relax. I’m going to cath you.” And she did, using a catheter about the diameter of a small garden hose.

The big hairy convict guy probably wasn’t in any pain in any part of his body when he walked into the ER, but after roughly thirty minutes of tender loving care from the ER staff, he was hurting in at least two places.

“Hey! Take me back to jail! I’m good! Get me the fuck outta here!!” And once his lab results came back normal, back to jail he went.

* * * *

Just between you and me, that was the most beautiful intervention I’d ever seen on a malingering patient, ever.

A malingering patient endorses a plethora of symptoms to lengthen their stay in the hospital. We saw this all the time in Psychiatry. Some of our patients wanted to stay in the hospital as long as they could, for a multitude of reasons.

Some of them were homeless, and if you’ve never tried living on the streets, it totally sucks. Some of them were trying to avoid going to jail, and I’m going to guess that probably sucks, too.

It might have been legal to restrain a guy and stab him in the arm with a really big needle a couple of times, then shove a garden hose down his dick in Texas, but it wasn’t in Minnesota. If we had been allowed to use those interventions, we could have easily cut our recidivism rate in half, if not more. We couldn’t even carry tasers, which I thought every psych nurse should be issued, no matter which state they worked in.

Seeing how Lea’s nurse was busy taking care of a guy that didn’t need any care, I decided to take care of my wife because she did, and I was a nurse, too. I grabbed a box of gloves and a basin, and I informed her nurse each time I emptied Lea’s pouch, or she vomited, and the volume of fluids she expelled each time. Her nurse was grateful for the help, and offered me a job.

One of the other ER nurses heard I worked in Psych. She came over to quiz me about her ten year old son, who had recently been diagnosed as Bipolar. I can’t remember her name, but she was probably a couple of years younger than I was. She was kind of attractive, and clearly overwhelmed by the situation with her son, and practically started crying on my shoulder.

That seemed like a weird diagnosis for a ten year old to me, and to her, for that matter. I suggested she get a second opinion from a real doctor next time, and spent close to half an hour listening to her. I wished her luck, then we both went back to work.

Bipolar Disorder is a terrible disease.

Lea’s condition had stabilized somewhat. Her nausea had passed. She was no longer vomiting. In fact, I thought she looked good enough to go home, and even Lea thought she was going to be okay.

But given the fact she’d had multiple surgeries and she had an ileostomy, and then there was her family history of heart disease…  The ER doctor didn’t feel comfortable discharging my lovely supermodel wife, no matter what we said. He wanted to keep her overnight for observation, just in cases.

And that’s where the ordeal started. Given Lea’s cardiac history, the ER doctor wanted her to be admitted to a monitored bed. The only problem was there weren’t any open monitored beds in the hospital.

Now, you might be thinking, it’s an hospital! Aren’t all of the beds monitored? A monitored bed is hooked up via EKG leads and highly sophisticated circuitry to an alarm system behind the nursing station. If something goes awry in a monitored bed, alarms go off and every nurse on the floor goes running to that room with crash carts and oxygen and a shitload of medications to save a life.

I used to work in Cardiac Care, and I understood the rationale behind the ER doctor’s decision. So we waited for a bed. And we waited. And we waited.

The first symptoms of the Philadelphia flu hit Lea about 6:00 PM. I had called Dave’s house a couple of times with updates. My last call was probably around 10:00 PM. Lea was doing better, but the doctor wanted to keep her overnight. Dave said he and Leslie were going to bed, but they’d leave the door unlocked so I could get in the house when I got home. They’d see me in the morning.

When midnight arrived, Lea was still waiting for a bed. She was getting a little upset with the wait. I was way past that.

I’m an incredibly patient man. You can ask around if you like. But this situation was beyond ridiculous. I asked to see the Administrator on Duty, every hospital has one, and I wanted some answers. I was informed she was busy, of course, but she’d be down to see me in a few minutes

When 1:00 AM rolled around, I demanded to see the AOD. Now.

She actually came running into the ER. She was a very sweet woman who apologized profusely in her darling Texas accent. She offered her condolences to us. Wanda had been a friend of hers, then explained the difficulties she was facing.

There were a limited number of monitored beds in her hospital, and they were all currently occupied. She had called in the maintenance team, and they were moving heaven and earth to hook up a monitoring system in one of the rooms to the nursing station so Lea could be admitted.

In the meantime, was there anything she could do for us?

Well, yeah, there was. It was incredibly noisy in the ER. It was filled with a lots of unhappy people. Was there any place to put my lovely supermodel wife that wasn’t as loud and busy while we waited for the monitored bed was being set up?

Yes! Lea could be moved into a room in the ER, and a real bed could be put inside the room. Lea would be more comfortable, and the room would be much quieter…

Lea said that would be fine. And the very sweet woman left to see that this was taken care of immediately. And it was. As to how long it would take for Lea’s monitored bed to be ready, well, that was a mystery.

When 2:00 AM rolled around, I was falling asleep standing up. I told Lea I was going to go back to Dave’s house. I hoped her bed would be ready soon, but she was at least in a quieter place, and maybe she could even get some sleep, but I had run out of gas. I had to go.

I think I finally got back to Dave’s around 3:00 AM. I would find out later that Lea would wait in that room for at least another three hours before she was admitted to her hastily assembled monitored bed.

* * * *

I woke up the next morning around 9:30 AM because Dave knocked on the door and told me Lea was on the phone. My head was foggy, and full of cobwebs.

“Come and get me!” Lea’s voice said. She sounded terrible.

“Are you being discharged?” I asked. I was a nurse. I kind of understood how hospitals worked.

“No! The fucking doctor here doesn’t think I have Crohn’s disease! He wants to run a bunch of stupid tests on me! I told him to go to hell!”

“How did he take that?” I decided to ask.

“He’s not very happy with me right now.”

“How’s everything else going? Are you getting your meds?”

I knew getting her meds right would be complicated. That’s why I handed out a list of them to everyone, hoping the floor nurses would get a copy and get them ordered.

“No! I haven’t gotten anything! Not even morphine!”

“I’ll be there in ten minutes.”

I was so pissed I was shaking. I almost asked Dave for his gun.

* * * *

Lea wasn’t in the best of shape when I had taken her to the ER, but she looked even worse when I arrived at the hospital the next day. She was drenched with sweat, and writhing on her bed. I was a nurse, and I was a very good nurse. I knew what what was happening to her the moment I laid eyes on her. My wife, was going through serious opiate withdrawal.

I went to the nursing station, then tracked down her nurse in the hallway, and I tried to be polite, at first.

“Excuse me. I know you’re incredibly busy, but my wife is in that room down there at the end of the hallway, and you need to come see her now, please.”

Lea’s nurse was a young-ish slob wearing light blue scrub bottoms and a multicolored top about the size of a pup tent. She kind of shuffled when she walked, and her hair looked like it hadn’t been combed since March.

“Yeah, I’ll be down there just as soon as I can. I’m doing something right now.”

“I’m sure you are, but have you seen my wife lately? She hasn’t gotten any of her meds yet, not even her pain meds, and she’s going through withdrawal.”

“I haven’t had time to go over her meds yet. Like I said, I’m doing something right now.” she replied, not even bothering to look at me when she talked. And that was the last straw for me.

“You listen to me, and you better hear every word I say.” I said softly, but loud enough for her to hear me clearly. “I’m a nurse, too. So when I tell you you need to come to my wife’s room now, I mean right fucking now. And if you don’t do as I ask, I’ll have your ass in front of the Board of Nursing before your shift ends. Now, move!”

I appeared to have gotten her attention. She stopped doing whatever it was she’d been doing and turned to look at me for the first time. I nodded in the direction of Lea’s room, barely controlling the urge to push her down the hallway.

“Oh my word!” she said when she entered Lea’s room and saw my wife.”She didn’t look like this the last time I was here! Let me go check her meds. I’ll be right back, I promise!”

“That’s bullshit.” Lea said, as her slob of a nurse shuffled out of her room. “I’ve been like this for at least an hour!”

“Well, let’s give her a minute to fix this. Then I’ll kill her.” I said. I was only partially joking. It’s probably a good thing I didn’t ask Dave for his gun. Unlike Hillary, I probably would’ve used it.

In a very short amount of time, Lea’s nurse returned with a syringe filled with Demerol. She injected the drug into a port in Lea’s IV tubing, and by the time she shuffled out the door, Lea looked a whole lots better. My wife exhaled a huge sigh of relief, and smiled.

“That’s better!” she said.

“Can you walk?” I asked. I was making an assessment. Lea was wearing a hospital gown and a pair of panties. The only clothes she had with her were a pair of denim cutoffs, which I pulled out of the closet and handed to her. She didn’t even have a pair of shoes. I had taken her purse and the rest of her clothes home with me when I left the ER.

“Yes. I’m fine now. Why? What are you thinking?”

“I’m thinking if I don’t get you out of here, you’re going to die.”

“Then get me out of here!” she said, and pulled on her shorts.

I disconnected Lea’s IV, and covered her IV site with gauze and tape. Then I started disconnecting the leads of the monitor. This was the tricky part. Lea was in a monitored bed, and the moment I started messing with her leads, all kinds of alarms would go off. A veritable army of nurses would descend upon us, and even her slob of a nurse would eventually shuffle back to her room to check on her.

But a funny thing happened when I disconnected the first lead.

Nothing.

No alarms went off. No one came running. And I got even more pissed off, if that were possible. When Lea was disconnected from all her equipment, we walked out of her room, down the hallway past her slob of a nurse, who was so busy doing something she didn’t notice us walk by her, and got on the elevator.

We walked out the front door of the hospital, my barefoot, hospital gown wearing lovely supermodel wife and I, across the parking lot, and I drove us back to Dave’s house. I think we laughed the entire way.

* * * *

Dave was waiting for us at the front door when we pulled into the driveway. He had a puzzled look on his face.

“Mark! The hospital is on the phone!” he said. His expression was also one of concern. “They said you took Lea out of the hospital without permission! They want you to bring her back, right away!” Lea was his daughter. And he had just lost his wife a few months earlier. I don’t know if he ever understood how many times his daughter had almost died in the last few years, but he clearly thought I had done something to endanger her life now.

“This is Mark.” I said into the receiver. Lea was explaining what had happened while she was in the hospital to her her father and her sister, and that way her family would know I wasn’t trying to kill her to death.

“Mr Rowen, this is the hospital administrator.” a male voice said into my ear. “I understand you and your wife have had a bit of a bumpy ride while you were here, but we would certainly like the opportunity to fix that. You’re a nurse, right? You have to know your wife is very sick!”

“Yes, I know.” I replied. “And I’d like to keep her that way if you don’t mind.”

“I…I don’t understand, Mr Rowen.”

“Yes. My wife was very sick, but your hospital did a great job and she’s doing much better now.”

“But your wife is still very sick.”

“And, she’s still alive, and I’d really like to keep her that way. However, if she had much more care at your facility, I don’t think she would be.”

“Now, Mr Rowen, that’s–”

“I agree. That’s more than quite enough.” I interrupted, and hung up the phone.

We had driven from the top of the country to the bottom of the country to help Dave do something he didn’t have the heart to do himself. And it was a task that nearly broke the hearts of my wife and her sister. They were clearing their father’s home of most of the items that reminded him of his dead wife, and collecting the items that reminded them the most of their mother.

We had all come down with the Philadelphia flu, and we had all survived. Even Lea. There had been one casualty, an innocent goat had been murdered by a homicidal horse, but that had been way back in Wisconsin, before we had actually set off for the bottom of Texas.

Thank you, God, I thought. And I also thought at least nothing else could go wrong on this trip, and that the worst was over.

But life is a funny thing sometimes. And while there might be times when things can’t get any better, things can always get worse.

Sometimes, they can get a lots worse.

Horrible Bosses, Part II

I’m struggling to figure out how to start this installment of my blog. Maybe if I acknowledge that, I can get started.

My lovely supermodel wife was in the hospital recovering from her fourth, and most devastating surgery of the five surgeries she would have in that time period.

My mother-in-law had died on the table in the Operating Room. Lea’s dad and her sister, Leslie, were using my house as their headquarters to contact their family to inform everyone about Wanda’s passing, and plan her funeral.

I can’t remember exactly how I ended up being chosen to write her eulogy…  It might have been because of all the things I said about her when we went to see her body the night she died. Dave was touched, and may have asked me to say something at her memorial service. I would spend a few days camped in front of my computer monitor, writing and editing and rewriting what I wanted to say.

My boss and her boss, Marj and Mary, had done the unthinkable. They had questioned whether I really needed to take a week off after the sudden death of my mother-in-law.

And that’s how this story gets started.

* * * *

I wasn’t particularly close to anyone in Lea’s family at that time. Her parents lived almost two thousand miles away. I hadn’t actually seen them in person more than a handful of times. I liked Wanda, she was a sweet gal. Dave was a difficult guy to like. Even the people that knew him best agreed on that.

This was my first time meeting Lea’s sister and her husband. She didn’t come to our wedding, she didn’t approve of Lea marrying a man she had known less than six months. Leslie and Lea were as different as two sisters could be. I didn’t quite know what to think of her the first time we met. But I really liked her husband. Bill was a really sweet guy, and he had a great sense of humor. We became friends almost immediately.

The relatives started arriving. They dropped by the house to see Dave and Leslie and Bill.

Shirley, Dave’s sister. Pat, Wanda’s sister. Gene, Dave’s brother. And Joan, Gene’s wife. I met them all and listened to their stories about Wanda. And that’s how I learned about her life and what kind of woman she was. And those stories would become the eulogy I wrote.

I focused on that, but in the back of my mind I started writing another paper. One that would take my horrible boss and her even more horrible boss out at the knees.

I split time that week between my house and Fairview Medical Center. Lea’s fourth surgery had resulted in the removal of all of her colon, and about ten feet of her small bowel as well. And there was one more thing. She had an ileostomy with an external pouch.

My lovely supermodel wife was devastated.

It was a difficult time for us. Lea was reluctant to tell me the result of her surgery. She was distant and distracted. I attributed her response to the death of her mother. I knew I would’ve been distraught if my mother had died. Her surgeon had informed me about the results of Surgery #4, so I wasn’t completely in the dark about what had got happened.

I spent hours at the hospital, saying nothing, watching my wife sleep. She slept more after that surgery than any of the others. I had many whispered conversations with her nurses and the visitors that dropped in to see her.

It was maybe toward the middle of the week that she told me she had an ileostomy. Tears rolled down her face like rain. I think I asked her what took her so long to tell me.

“I was afraid you wouldn’t think of me as a whole person anymore.”

“Honey, if wanted someone who was all there, I never would’ve married you.”

Sometimes, a guy just has to reassure his wife.

* * * *

Lea’s doctor had to write an order for a pass so Lea could go to her mother’s funeral service on Friday. I brought an outfit she requested to the hospital. It was probably the first time she’d worn something besides an hospital gown in a month.

Wanda’s service was held at a funeral home. Dave wasn’t a big believer in God. He never went to church, and he wasn’t about to start now.

Bill had also been selected to say a few words at Wanda’s service. The gist of his words was knowing when you’ve had enough and when to say when. And that was one of Wanda’s graces. She knew when she’d had enough.

And then I took the podium.

I first met David and Wanda the day before Lea and I got married in 1988. I got the impression on our wedding day that Wanda was quite a character, but it wasn’t until the first Saturday after we were married that I truly realized how much of a character Wanda was. And that was when the telephone rang at 6:00 AM.

Lea says she has been trying unsuccessfully for 22 years to get her mother to call her at a later hour. Lea’s sister, Leslie, had been lobbying for 30 years. It’s a certainty that what the two of them couldn’t achieve in a combined 52 years, I wasn’t going to change in the 6 years that I knew Wanda. Dave and I were talking the other day and he said, “The girls are really going to miss their mother calling them on Saturday morning.” I think I can speak for Leslie and Lea when I say, “Dave, if you want to call us at 6:00 AM on Saturday morning, please pick up the phone and give us a call.”

Speaking only for myself, I’d like to point out that 8:00 AM is a very fine hour. 9:00 AM is a good hour, also. Seriously Dave; anytime, any day, you want to call, call us. Any time.

I remember the trip Lea and I took to Harlingen, TX a couple years ago to see her parents. You can practically spit into Mexico from their mailbox, so of course we took a trip to one of the border towns nearby. Dave and I found we aren’t very good at haggling with the street vendors in Mexico. I’d see something I like and ask how much it cost and the vendor would say, “$50.00.” And I’d say, “Okay.” Wanda came to my rescue. And she was a tough negotiator, so Dave and I did the only sensible thing we could do under the circumstances. We left the shopping to Wanda and Lea, and we went to go have a few beers.

Another story I have of Wanda is one that Dave told me recently. When Dave and Wanda lived up here in Minnesota, they had season tickets to the Vikings games. Back then, the Vikings played football outdoors at Metropolitan Stadium. It was out in the elements, and football was football. The players got their uniforms dirty and everything. Also back then, the fans would have tailgate parties out at the Met, set up their barbecues an partied in the parking lot at Met Stadium–did all that stuff that no one can do now that the Metrodome is here. After one of the games Dave and Wanda and their group had their tailgate party going, and there was another group or two not far away. Back then, some of the Viking players would stop in and have a beer and a burger with the fans, and a former Vikings wide receiver named Gene Washington was doing that with a group not far from where Dave and Wanda were at.

A crowd of young boys had gathered around Mr. Washington, hoping to get his autograph, but Mr. Washington wasn’t in an autograph signing mood. He told the kids to leave him alone. When Wanda saw that she went over to Mr. Washington and told him, “Those boys idolize you, you’re their hero. All they want from you is an autograph–You should be ashamed of yourself!” And I can just see Wanda doing that.

I won’t repeat Mr. Washington’s reply to Wanda, but needless to say he wasn’t very polite, nor did he sign any autographs for those boys.

I was probably the same age as some of those boys were when that incident happened. When I was a young boy I worshipped the Vikings, I watched all their games, I idolized the players. They were my heroes. And Gene Washington was one of my heroes. But I have a different hero now.

There’s a saying that goes, “When you’re Irish, you know that sooner or later the world’s going to break your heart.” And it is true. It is so true.

If there’s any consolation for those of us gathered here to remember Wanda, it is this: Heroes, true heroes, never die. Their actions, their deeds and their legacies live forever. 

It would be the first of the four eulogies I’ve done in my life. It was the most difficult public speech I had ever attempted. Only my dad’s eulogy would surpass it terms of personal heartache for me.

Lea returned to the hospital almost immediately after the service. I didn’t take her back–I think Gwen drove her–but I remember walking into her room when I got to the hospital after the meal. There’s always food after a funeral in Minnesota. Lea’s clothes were strewn on the floor. Lea never did that. I knew her suffering vastly surpassed mine. I was afraid this blow might be too much for her to take. She was asleep in bed, again. I folded her clothes and hung them in her closet, then sat down and watched her sleep.

But in my mind, I was writing the paper I would send to my Director of Nursing at the MVAMC. A paper that would more than even the score against the heartless bitches that were making my life miserable at work, and get them off my back.

It would be the greatest thing I ever wrote.

* * * *

There’s only problem I have with my greatest work of prose now. I can’t remember exactly what I wrote anymore, and I didn’t save a copy of it.

I know I outlined the situation regarding my wife’s lengthy illness, and the life and death situation it had become. And I was especially clear about what Marj and Mary had said after my mother-in-law died, and how she had travelled up to Minnesota from the bottom of Texas to see her daughter one last time.

I know I talked about the qualities of caring and compassion that nurses are endowed with, except when regarding our colleagues. That’s really all I wanted. I wanted to be treated with a little compassion, and I wanted my goddamn bosses to stop hitting me with a guilt trip every time I needed to take time off because my wife was in the hospital fighting for her life.

I think my write up was about five pages long. I returned to work to another stretch of nights. I put my paper into an intraoffice mailing envelope, and addressed it to the DON. I would hear from my co-workers about its effect.

The DON at the MVAMC was a gal named Betty Theis. She was a no-nonsense, tough as nails administrator. Steel wished it was made of Betty, and when she got angry, grown men had been known to start crying under her unrelenting gaze.

I really wish I could have been present when Betty summoned Marj and Mary to her office. My co-workers told me Marj looked like she had seen two ghosts when she returned to the unit, and closed the door to her office. Her eyes were red from crying when she left.

Marj called me into her office when I returned to working days.

“I know you’ve gone through a lot lately, and I haven’t been as supportive as I could.” That would be the closest thing to an apology I would receive from Marj. Mary would only speak to me one more time while she worked at the MVAMC, and it would not be an apology.

But it was what Marj said next that truly surprised me.

“I think you’re depressed and suicidal, and I’m sending you see an EAP counselor.” I think I may have started laughing at her, and at the very least, I had to have flashed her a smile of amusement. Of all the things I anticipated she might say, this was one thing I most certainly hadn’t expected.

Nurses might have a lots of duties and responsibilities, but no part of a my job description, or Marj’s for that matter, had anything to do with diagnosing anyone. I probably could have gotten her dumb ass fired for that remark, but that had never been part of my agenda.

So I went to the EAP Office to meet with my counselor. He met me at the door. He was a nice guy that had trouble believing I was the suicidal guy he was supposed to save.

“You drove here yourself? No one accompanied you? I heard you were an imminent suicide risk!”

“Yeah, that’s what I heard, too.”

I told my counselor my story. By the time I finished, I think he wanted to kill Marj.

“I don’t think you’re depressed, or suicidal. I think you’ve been through a lot of stress, for an extended period of time, and I think both you and your wife need some time to just take everything in so you can put your lives back together.”

I was hoping his recommendation would be for me to take a month off.

“Look. You won the battle. Don’t lose the war. Go back to work. Keep your head down, and I’d look for a new position if I were you. Your boss,” he said. “Is nuts!”

That guy gave me some good advice when I needed it most. The more I thought about Marj’s response, the more I started thinking maybe I should make getting her dumb ass fired part of my agenda.

But the last thing I needed at that time was to fight a war on a second front. I took his advice. I went back to work and kept my head down. I tried not to turn my back on my horrible boss, just in cases she had a knife in her hand.

And I took the first opportunity I had to apply for another pysch position at the MVAMC,. A staff nurse position opened up on the other psych unit, and I interviewed with Kevin. It would end up being the smartest career move I made at the VA, and once free of Marj, I would start to become a great psych nurse.

And more importantly, my wife would finally start getting better, and our lives together would finally begin to achieve some measure of balance.

But that would be in the future, and there would be plenty of challenges waiting for us to face. And one in particular that almost destroyed our marriage.

A Rose By Any Other Name

I first met Rose when I started working at MIHS, Maricopa Integrated Healthcare Services, otherwise known as the County. Maricopa Medical Center was the ancient hospital that was its primary treatment facility. And by ancient I mean it was built in the 1970’s. There’s not a lots of historical places in Phoenix.

MIHS also provided psychiatric care, and they had two facilities for that. The first was the Psych Annex. That’s where I worked. It was a nondescript two story building behind the medical center. The second was Desert Vista, a much newer, incredibly secure building in Mesa. It’s the place you’ll end up at if there’s ever a petition for court ordered examination/treatment filed against you.

I’m sure I’ve suppressed some of the memories I have of working there, mostly because I hated the management there so much. I really liked the people I worked with, and the patients I cared for weren’t terribly different than the patients I’d taken care of at the MVAMC.

I left the MVAMC in October of 2007, and started working for MIHS in November. And that’s when I met Rose.

What do you think of when you think of a rose? A beautiful, fragrant flower, right?

Yeah, that wasn’t Rose.

She was loud, intrusive, disruptive and did I mention loud? She was rude and undisciplined. Her hygiene was crude, her manners were random and unpredictable. And watching her eat could ruin your appetite for a few days. On top of that, she was also one of the most profoundly psychotic persons I’ve ever met. I can’t imagine what happened to her to transform her into the person she became.

Rose was possibly cute at one time, but those days were long gone by the time we crossed paths. She always looked disheveled, even after she had just showered. She had no fashion taste. Her outfits could cause seizures. Even if you were blind.

But the most distinctive thing about Rose was her voice. It was harsh, discordant and gravelly. Clint Eastwood sounded almost gay compared to Rose. And after listening to Rose for eight hours, even someone speaking into a megaphone sounded like they were whispering.

Rose could easily be described as a problem patient. She needed a lots of redirection. And there was no such thing as telling Rose something once. It was constant. And exhausting.

“Hey, Rose! Turn down the volume over there, okay!”

“YES, SIR!” I have no idea why, but Rose always called me Sir. She called other staff members by name, but not me. “I’M GONNA TURN DOWN THE VOLUME, ISN’T THAT RIGHT, JEFFREY?” Rose was constantly talking to Jeffrey MacDonald. You might remember him. He was the guy accused of murdering his pregnant wife and two daughters. He was apparently Rose’s imaginary best friend. “YOU HEARD WHAT MISTER SIR SAID! TURN DOWN THE VOLUME OVER THERE, ROSE. WHAT ABOUT YOU, JOHANNES? He was one of the BHT’s at the Psych Annex. DO YOU THINK ROSE NEEDS TO TURN THE VOLUME DOWN? I KNOW JEFFREY THINKS I NEED TO TURN IT DOWN, RIGHT JEFFREY? THATS FUCKING RIGHT!”

And she swore more better gooder than two Portuguese sailors. I purposely deleted about seventeen swear words from Rose’s dialogue. Anyone that knows me knows I don’t have any problem swearing, but even I was shocked by the amount of profanity Rose unleashed in casual conversation. And when she got upset, it was like getting hit by a fucking tsunami.

Rose was rarely violent, but she tended to provoke it in others. I think she wore on the nerves of everyone around her until they just couldn’t take it anymore. And most of the people on the same unit as Rose weren’t all that tightly wrapped either. She made more than one person lose it, and half of them were people I worked with.

I spent a lots of time with Rose. I may have even begged her to quiet down, I’m not sure anymore, but it’s not out of the question.

Rose was at the Psych Annex when I started working there. I’m pretty sure she was still there when I quit six months later. Rose was one of those people no one wanted within fifty feet of their facility, let alone inside it.

I worked Gero/Psych and did a stint in management at Banner Del E Webb for a few years, then moved on to St Luke’s Behavioral Health–straight psych–I was back in familiar territory. I hadn’t been there long, maybe a couple months, when I did something stupid. I started wondering what had happened to Rose.

There’s a rule when you work in Psychiatry: you never, ever mention the name of a discharged patient. You know, I wonder how So and so is doing? If you do, the person you invoked will invariably get admitted. The only way you’re safe doing this is if the person got dead, except if they had gotten dead, you wouldn’t have to wonder how they were doing…  For chronically frequent flying psych patients, the only way you can totally get rid of them is death. I know that sounds terribly callous, but it’s also true. You can ask around, if you so desire.

I never said Rose’s name aloud, not even to myself or any of my imaginary friends, nor to any of my co-workers–none of the people I worked with at St Luke’s knew Rose.

But they would.

Never underestimate the craftiness of a psych patient, especially the really crazy ones. They are spooky beyond belief. And like any other organism, they evolve. When I first started working as a psych nurse, a name had to be spoken out loud. By the time I was getting ready to retire, a simple thought would suffice.

I was walking into work at St Luke’s from the parking lot one day, and I ran into someone from the day shift.

“How was your day?” I asked. What happened on the day shift rarely had anything to do with how the evening shift would go, but it was always nice to ask.

“Oh. My. God. Turn around and leave now! We got a new admit today, wait until you meet Rose!”

I stopped in my tracks, and slowly turned toward my co-worker. I briefly described the Rose I knew, knowing there could be only one Rose that could effect that kind of reaction.

“Oh. I see you already know her.”

Yep. That was my Rose.

AP 5 was my home unit at St Luke’s. It was the court ordered unit. You didn’t have to be court ordered to be admitted to my unit, but if you were court ordered, it was the only unit you could be admitted to.

Rose was permanently court ordered. She was usually admitted to the Psych Annex, or Desert Vista. But the staff at those facilities were burned out by Rose. She was sent to St Luke’s purely out of desperation.

AP 5 was a chaotic place. It was two large dayrooms with the nursing station in-between. The patient rooms were dotted around the perimeter of the dayrooms. The unit was a giant echo chamber, it was concrete and linoleum. The other units had artwork. Some of them had carpeting. AP 5 was like the basement where your family locked up your crazy aunt, and no one ever talked about it. There was no no artwork, nothing for noise abatement. It was almost as loud as the artillery firing range at Fort Sill, way back when I was in the Army.

Added to the abnormally normal pandemonium, was Rose.

“WELL, HELLO, SIR! HOW ARE YOU! I HAVEN’T SEEN YOU IN THREE AND A HALF YEARS!”

I had to stop and think about it, but she was correct, almost to the day.

“Hi Rose. Say, could you do me a favor, and turn down the volume a few hundred decibels.”

“TURN DOWN THE VOLUME! YES, SIR! WHAT DID I TELL YOU, JEFFREY! MISTER SIR STILL WANTS ME TO TURN DOWN THE MOTHERFUCKIN’ VOLUME! YES, SIR! I’LL TURN THE MOTHERFUCKIN’ VOLUME DOWN!!”

I hadn’t even started my shift, and I already had a motherfuckin’ headache.

I filled my fellow evening shift staff members in on Rose. This was perhaps the best crew I would work with in my career. Deb Goral. Luis Hinojosa. Anthony Tafoya. Rachelle Carson. I loved those guys. We were a well oiled machine. And Rose had all of them pulling their hair out within the first hour.

I started herding Rose to her room to remove her from the mileau. She started peeing on the floor. I think Rachelle was ready to kill her.

I spent a lots of time talking to Rose once more. It didn’t happen right away, nor did it happen overnight. I didn’t even notice it at first, probably because it was always so noisy on AP 5, but Rose actually did turn down the motherfuckin’ volume of her voice. She didn’t swear anywhere near as much as she normally did, and she stopped peeing on the floor altogether. I think she actually became one of the better patients on the unit.

I have no reasonable explanation for it.

And then something really weird happened. Rose came up to the nursing station one evening and actually whispered something.

My name.

“Maaaaaaark!”

It was, like, the spookiest thing I’ve ever heard.

Deb could do a perfect imitation of it, and she did it often. But only because she loved me. She became my first work wife, ever. And then she became my first ex-work wife.

I’m in a lots of relationships, and they’re all complicated.

Unlike my first encounter with Rose at the County, her stay on AP 5 was relatively short. Maybe three weeks, maybe a month. She came back again almost immediately, but was discharged later that same week. We had to have set a record for her shortest hospitalization, ever.

I never saw her again, not that that’s a bad thing. There are people you meet in your life that you’ll never forget, but you don’t miss them when they’re gone.

I know a lots of people like that.

I like to think Rose was able to gain a measure of control of her insanity, and she’s doing better.

But that’s doubtful at best. More likely she’s standing on a sidewalk somewhere in Phoenix, saying, “Maaaaaaark!” Very softly.

Glenda K

Glenda was one of our patients at the Banner Del E Webb Medical Center. Prior to being acquired by BannerHealth, Del Webb and its sister facility, Boswell Hospital, were managed by SunHealth. SunHealth was a very small fish in the large healthcare pond in the Phoenix area. When Banner offered to purchase their facilities, SunHealth quickly agreed.

The employees weren’t thrilled with the acquisition. SunHealth was a very good employer. The mostly elderly population that used and staunchly supported the SunHealth facilities were extremely upset. Del Webb and Boswell hospitals were their hospitals. They didn’t want a bunch of strangers roaming the hallways of their getaway retreat hospital spas.

That’s exactly how they thought of them.

Those little old ladies even had bake sales to raise money for a new MRI machine! Do you have any idea how many cookies that is? That’s, like, a trillion fucking cookies!! Maybe they should’ve put on some cute outfits and stood on the corners in Sun City and Sun City West…

Gero/Psych nursing is a sub-specialty area of Psych nursing. Elderly psych patients generally come pre-equipped with a whole slew of medical issues, and all of those issues have to be effectively managed, as well as the psychiatric disorders they are admitted for.

Glenda was an older gal, all of our patients had to be at least fifty-fifty years old. Most of our patients were closer to one hundred seventy-fifty years old. Glenda was married, and she was a hot mess. Her husband was a sweet, supportive, long suffering man.

Glenda had asthma, emphysema and COPD. As a result of her respiratory disorders and diseases, she suffered from chronic anxiety and depression. She was a very frequent flyer on the SAGE Unit, the Gero/Psych Unit at Del Webb. I would get to know her and her husband very well in a relatively short amount of time.

In all honesty, I was extremely uncomfortable in Gero/Psych. I was not a Real Nurse. I was a psych nurse. I had worked in a strictly psychiatric setting for twenty years. When we had patients that were that physically sick at the VA, we transferred them to a Med/Surg Unit. I had to learn how to start an IV, how to draw blood all over again–even do blood transfusions. 😓 In order to transfer one of our SAGE patients to a Med/Surg Unit, they essentially had to be dead.

If you don’t use those skills, you lose those skills. I had to be retrained in almost everything. It was good to be able to master all those skills again, but I had the same underlying fear that I’d had way back in nursing school. I was sure I was going to kill one of my patients, or in a worst case scenario, all of them.

When my senior manager offered me a clinical management position, I took it out of self-preservation.

Glenda was probably what you would consider a difficult patient. We certainly did. She was anxious and depressed at home, so she desperately wanted to be hospitalized. She was depressed and anxious once she was admitted to the SAGE Unit, and she’d demand to be discharged. That’s where I came in. The staff nurses would call me and ask me to come try to reason with Glenda.

As a clinical manager, I didn’t have anything to do with her patient care, but I had a lots to do with patient and family education and satisfaction. One of my managerial duties was to round on a random sample of the patients on the SAGE Unit to assess their rating of the service being provided to them. In the world of BannerHealth, everything revolved around Patient Satisfaction Surveys. And do you know what I discovered? Old people suck!

Man, they hated everything!! That’s when I started calling them Raisins, the sunbaked asshole/bitches that they were. It was almost impossible to get them to give us high satisfaction ratings on any service we provided on those goddamn surveys, and we needed at least an eighty percent satisfaction rating or there was hell to pay! 😭😭😭

I had worked in healthcare for twenty years by this time. I knew when we were doing a great job. I knew when we were doing a bad job. The SAGE staff was extremely talented, and they did an amazing job. They should’ve gotten elevens on a scale from one to ten.

My Filipino Posse, that’s what I called them–a lots of the RN’s were from the Philippines–Al, Julius, Liligene, Wei, Jing. Julie and Ethel. I loved them all. Well, most of them. Almost all of them were great nurses. Except two. And everyone knows who they were. And they weren’t Julie and Ethel. Those two were so darlingpreshadorbs!!

I worked with another rockstar nurse there, Rhonda Dolatshahi. Rhonda told me she wanted to be listed in one of my Reflections posts someday. Well, Rhonda, today’s your lucky day.

I told she’d have to be naked in the story I wrote. So I want to thank Rhonda for coming into my office, closing the door, and taking off all her clothes and saying, “You’re a nurse. What do you think this is?”

Yeah, that never happened. Unfortunately.

Where was I? Oh, yes. Glenda.

Glenda was unhappy about everything. The nurses were rude. They weren’t doing anything to help her. They never answered her call light when she turned it on. And so on, and so forth. Blah, blah, blah.

I did a lots of redirection and refocusing with Glenda. I doubt I did much of anything to actually change Glenda’s mind, but I did spend a lots of time with her, and that’s probably all she really wanted.

But there was that one thing about Glenda. And that one thing was her tooth.

images-2

Glenda had one tooth. And it seriously looked like that picture. She had dentures, but she rarely wore them. So when I went to listen to her litany of complaints, her tooth jumped into my field of vision, and it was the only thing I could see. It was like her tooth was talking to me. It was like watching a train wreck. I wanted to look away, but I couldn’t.

I stared at her tooth as if it were the only thing that existed in the world. I knew I was staring at her tooth. And so did Glenda. She eventually started putting a finger to her mouth when she talked to me, obscuring her mutant tooth. I actually laughed the first time she did it. So did she, come to think of it.

Glenda’s respiratory problems eventually got the best of her. She died at home, thank God. You wouldn’t believe the amount of paperwork involved when someone dies on a psych unit. And there’s always a follow up investigation, even if the person dies from natural causes.

Vaya con Dios, Glenda. I have to believe you went to a better place, and you’re at peace now. And you have all your teeth once more.

Sorry about that whole staring thing.

In and Out of the Chakras We Go

Lea had survived her first near death experience at Fairview Medical Center. Her post-op recovery went well and she was discharged. I brought her home for the first time in months. I can’t remember how long she stayed home. All I can remember with certainty is she was repeatedly admitted into and discharged from Fairview Medical Center for the remainder of 1991, all of 1992 and 1993, and at least half of 1994 if not more.

Our life together back then would revolve entirely around Lea’s physical health, or the lack thereof. She would have a period of relative stability, then she would have a relapse, and back into FMC she would go. There was no pattern to this, nothing we could identify as a precursor. It wasn’t related to her diet. Stress? Maybe, but doubtful. The most stressful part of her life was being hospitalized, not being at home or work.

I came to think of this period of time as the Era of Living in Two Hospitals and Occasionally Visiting Our House. We lived in a charming arts and crafts bungalow about five miles from downtown Minneapolis. We redecorated that place several times, entirely changing its interior appearance until it eventually looked like showplace for the Pottery Barn.

I doubt that I did many, if any, of those renovations while Lea was struggling to survive her malignant flare up of Crohn’s disease. What I remember most from this time is feeling exhausted all the time. I was essentially a sleepwalker. I owe so much to my co-workers at the MVAMC–they had my back and picked up all the pieces of my job that I missed.

My mind was occupied by two things: my lovely wife, and how long she would fill that role. And how in the hell was I going to pay for this? My health insurance covered most of Lea’s medical expenses, but not all of them, and the part that wasn’t covered had quickly grown into the tens of thousands of dollars. Here’s another time when a great social worker saved the day.

I don’t remember her name, and this is so unfortunate because that woman saved our financial asses. She submitted an application for Medical Assistance on our behalf–something I didn’t think we’d even be eligible for based on our income, but lo and behold, we were, based on the extent of our medical bills. Thanks to that incredible social worker, I only had one thing to worry about.

Lea’s hospitalizations were mostly uneventful, except for the endless reconstruction that the hospital was going through. Fairview was a non-profit organization, and starting in 1992, FMC would begin reinvesting their profits by completely renovating every floor of the building. It was a noisy process, hammering, sledgehammering, jackhammering; even small doses of therapeutic dynamite.

I know, right! Freakin’ dynamite! In a hospital!! Filled with sick people!!! The nurses that took care of Lea were so great. They would move her as far from the construction noise coming from the floor above as they could so she could obtain a semblance of rest, then move her again as the process neared her room again.

The inflammatory process at work inside Lea’s body was every bit as inexorable as the construction process going on inside the hospital. It ebbed and flowed, but mostly flowed. And while Lea’s condition could be described as mostly stable, there were times of profound decompensation. I was sure I knew the answer to the one question that remained in my mind. And the answer was, not much longer.

Dr John was consulted by Dr Kromhout once more. Dr John remained conservative in his approach, but he wasn’t quite as cautious the second time around, and Lea’s condition deteriorated only to the point where she looked like she could possibly die instead of it being a foregone conclusion.

The second surgery was possibly the most unremarkable of all the surgeries Lea would have during this time period. Dr John removed another section of Lea’s large intestine, taking roughly sixty percent of that portion of her GI tract.

There were a couple of significant post op events after this surgery. The first, Lea sent me home. I could not help myself when she got out of the Recovery Room and was being transferred to her room on the Med/Surg floor. I had to touch her. I was gentle. I’m a nurse. I have a great sense of touch, and great hands. But even my careful caresses were too much for Lea.

“Don’t touch me.” she said.

“I’m sorry, honey, but I can’t not touch you!”

“Then go home.”

I’m pretty sure the nurses that were caring for Lea and were part of the transfer team actually heard the sound of my heart breaking. I stopped in my tracks in the hallway as Lea was rolled into her room, sat down with my back against the wall, and cried.

I went home and called my best friend, Gary Miklos, who was living near Dallas, TX at the time. Gary did something only a best friend will do at a time like that. He bought an airplane ticket on the next flight to Minneapolis.

I can’t remember if I tried to stumble my way through work the next day or if I called off, forcing my boss to cover one of my shifts with another nurse. I picked up Gary at the airport. I went back to the hospital to see Lea. She sent me home for a second time.

Gary took me to a billiards hall. We played pool, drank pitchers of beer and smoked packs of cigarettes. I’m pretty sure I lost every game of pool we played that day.

Gary had to work for a living, too. He flew to Minneapolis to be with me for one day, and then he had to fly back to Texas. And this wasn’t the only time Gary would travel halfway across the country to be there for me.

I went home and passed out. I know I had the following day off because I was still asleep when the phone rang.

“Hello?”

“Hi, honey!” It was Lea. “I think I’m gonna live!” Even over the phone I could see and hear the smile in her voice.

There had been a second post op event. One of the night nurses that took over Lea’s care was reviewing all the multitudinous IV bags and fluids and medications flowing into my wife’s veins, and she hung another bag of morphine solution. Not a big deal, but Lea already had a bag with morphine flowing, so she was now getting a double dose of very potent pain meds. This was a bad thing. A double dose of IV morphine will generally result in death.

“If that had been you or me, we’d be dead right now,” Dr Kromhout told me the next time we met. “But because Lea has been on high doses of morphine for awhile, and she has a strong tolerance level, all she did was get a good night’s sleep for once.”

The night nurse that accidentally overdosed my wife caught her mistake before it became a fatal med error. She called a code. Lea later said she had a vague memory of fifty people being in her room. I don’t know how many doses of Narcan she received, but it was more than one, and less than ten.

There was an investigation, of course. Lea and I met with a whole group of suits and skirts from various management and administrative departments. They wanted to know if we wanted to press charges or file a lawsuit. We declined. No harm, no foul was our take on the matter.

As a result of actually sleeping, even if it was a drug-induced coma, Lea actually felt better. She had a nursing student assigned to her when she woke up. Lea would refer to her as ‘my savior.’ That young girl helped Lea shower, got her dressed, helped with her hair and makeup, and had Lea sitting up in her room, looking like an angel when I arrived.

Despite the inflammatory process that was mindlessly trying to kill my wife, despite the construction process that prevented her from getting much rest, despite being cut open and losing another section of her GI tract, and despite almost being accidentally overdosed to death–Lea had survived by the grace of God.

God is great. God is good. God brought us together; we both believe that. It’s taken a lots of work and intentional living on both of our parts to stay together, but it’ll be twenty-eight years of staying together in one week.

I know. I can’t believe it. I’m not sure Lea can believe it either.

Sometimes you take things for granted in a relationship. I’m sure I’ve been guilty of this. But I also know my relationship with Lea has been the most life changing experience in my life. Nursing might have made me a better person, but being married to Lea has made me into a better man.

I’m Too Sexy For My Clothes

**This is the post that landed me a three day suspension from Facebook**   

It wasn’t what I wrote so much as it was the accompanying picture (See above) that FB had an issue with. And it was their decision–a process that has no appeal, you’re simply denied access to your account–to block my page that ultimately led me to create this blog. So, if you’ve enjoyed anything you read here, send Mark Zuckerberg a thank you card.

I’m not sure what it is about crazy people and clothes, or rather, the lack of them–but crazy people love to get naked.

There was Duane. He was a frequent flyer at the MVAMC. No Brain Duane would start disrobing in the parking lot. By the time he reached the front door, he was doing the Full Monty.

I called him No Brain because it rhymed, and because he just looked…gone. It was usually a time consuming process to get admitted. Duane got a police escort straight to my unit, completely bypassing the Admission Office. Now that I think about it, the guy was a frickin’ genius. When Duane could keep his clothes on for 48 consecutive hours, we knew he was ready to go home.

Old Joe didn’t come into the hospital naked, but once inside, Joe must’ve thought he was at a nudist camp. He rarely wore clothes.

I was working a double shift one evening. Old Joe had been admitted earlier that day. I was on the phone, taking report on another admission.

“Well, goodbye.” I heard Old Joe’s voice with half an ear while I took notes on the patient we were going to get. When I finished, I looked up and saw a wrinkled ass and scrotum swinging in the breeze as Old Joe walked off the unit in the general direction of the front of the hospital. Our units were ‘open’ back then. Our patients could come and go as they pleased, as long as they signed out at the nursing station and checked in with the staff when they returned.

That would change when a former patient walked onto one of the units carrying a knife.

“Hey, Joe!” I called out. He stopped and turned around. “I used to think you were crazy, but now I see your nuts. Don’t you think you should get dressed before you leave?”

Old Joe looked down, and almost seemed surprised to see his penis. He nodded, said, “Oh, that’s a good idea,” and returned to the unit. He must’ve forgotten he was leaving when he got back to his room because he didn’t try to streak to freedom again. Old Joe was another guy we knew was ready to go when he could keep his clothes on for two days straight.

There was another semi-naked guy. He was a young guy at St Luke’s, and he was actually kind of handsome. He crapped on the floor one day, then picked up his turd and ate it.

“EEWWW!” all the female staff howled in unison, then looked at me and asked what they should do, like this happened to me all the time.

“Whatever you do, don’t kiss him. His breath probably smells like shit.” was the only advice I had to offer.

Crazy guys are far more likely to strip and go naked in public than crazy girls are. Men are also far more likely to masturbate in public than women. I called it ‘playing the skin flute.’ I’ve lost track of the number of guys in the Skin Flute Band, but there were a lots of them.

If you want to play an imaginary instrument, what happened to air guitar? But it’s not as bad as playing the rusty trombone, I suppose…

I can only recall one girl that masturbated in front of me. She was a cute-ish young Korean American girl at Aurora, I called her K-Pop. She rang her joy buzzer, a lots. I went to her room to give her her meds one morning, and she was…busy.

“Just leave them on the table, I’ll take them when I’m done.” she said without missing a beat. She was laying in bed under the covers, but there was no confusion about what she was doing. She didn’t seem to be embarrassed in the least by my presence. I can’t do that, I replied. “Well, you don’t expect me to stop now, do you?” she asked. I’ll close the door on my way out.

There was another Asian girl, from China. She was acting weird in the community and running around outside naked, of course. Most Asian families will try make it through a situation like this without seeking professional help, but once the clothes come off, all bets are off.

From report, I learned she didn’t speak English. So I went to the Babblefish Translation site and printed some greetings and instructions in Chinese and English.

You’re at the County Hospital. 你在縣醫院
We will take good care of you. 我們會照顧好你
Are you hungry? 你餓了嗎?
Please keep your clothes on. 請保持你的衣服

My niece, Amber Rowen, could verify this because she knows Ung Fu Chinese.

China Doll read each page, then looked at me and smiled sweetly. She nodded her head in what I guessed was understanding. I went to the kitchen to find her something to eat. When I returned, China Doll was standing in the hallway where I’d left her, wearing nothing but a smile. She was probably the only psych patient I’ve had that I didn’t mind seeing naked. She was really quite lovely.

Rondi, on the other hand, was not. She had been my patient at the VA many times, and her main problem with all of her previous admissions was her Borderline Personality Disorder.

Da Do Ron Ron was a tough-looking, heavy set lesbian. In regards to her nudiditity, all I will say is if Samson had been female…

On her last admission as my patient, she went off the deep end and started flashing her boobs at me, then my co-workers. She eventually went full throttle stripper. All she needed was pole.
You might wonder why a lesbian would disrobe in front of a guy. I can’t explain it, but one of the ward clerks I used to work with, Justine Henley, once told me I was very ladylike, so it might be that.

I tried to talk Da Do Ron Ron back to Earth. Hell, we all did. I almost begged her to stop.

“When you come out of this and you’re on the other side,” I said. “You are going to be sooo embarrassed. Do yourself a favor and stop doing this now.”

Rondi eventually did get better, but she was mostly naked for almost a month, I think. And she was incredibly embarrassed by what she had done. She got so much better she actually got a job in the Billing Office at the VA after she cleared. I’d see her in the hallway occasionally. She couldn’t look me in the eyes. She couldn’t speak to me. I felt so bad for her.

Rondi is the only person I can think of that improved after a series of Full Frontal Nudity therapy, or I might be inclined to recommend it. Oh, and the guy at St Luke’s got better too, but he was on a specialized diet.

Send me a private message and a picture if you’re curious about this, I’ll let you know on an individual basis. If you’re a guy, let me save you some time. Keep your damn clothes on.

Creepy clowns and zombies are bad enough. We don’t need a Skin Flute Marching Band and the Joy Buzzer Corps added to the mix in our society at this point in time.

When I tell people what I did for a living, they give me a certain look most of the time. They nod knowingly, and say, “I’ll bet you’ve seen it all.”

I reply that I’ve seen a lot, but there were a couple times when I saw it all.

Horrible Bosses

When I was a manager for BannerHealth, I went to classes on how to be a good manager. Did you know seventy-five per cent of employees that leave a job do so because of poor management?

I’ve left at least three nursing positions because of my manager, including BannerHealth. As it turns out, Banner wasn’t as interested in being a good employer as they claimed to be.

My first horrible boss was Marj. She was my manager during the years Lea was so very ill, and I was working at the Minneapolis VAMC. Lea and I learned an interesting thing during that time period. During a time of crisis, you find out who your friends are. During a time of extended crisis, you find out who your real friends are.

Marj was understanding with our situation at first, and she was even very supportive. Then she became less understanding, then she became a bitch.

There were two In-patient psych units at the MVAMC. 1K &1L. Marj managed 1L. Kevin, the guy that would eventually make a baby with Sue Severson, was the manager of 1K. Marj called me into her office around the time of Lea’s fourth, and worst, major surgery to talk to me about my attendance.

“You’ve been missing a lot of work lately.”

“My wife is in the hospital fighting for her life. I think I’d almost be expected to be missing a lot of work under those circumstances.”

“Well, this has been going on for quite a while…”

“And you think I somehow missed that?” I asked.

“No, that’s not what I’m saying. I’ve had to cover for you, a lot. I’ve had to use float nurses and PRN staff when you’re not here.”

“Yeah, well, you know, that’s your job.” I replied. “Right now, my job is to be with my wife, but if it’s any consolation to you, she may not survive this time, and you won’t have to cover for me anymore.”

That’s when Marj started crying. If there’s anyone in this office that should be crying, it’s me, I thought. But I gave Marj a hug and told her to hang in there, she was doing a good job.

She had her boss, Mary Erdman, talk to me after that. I would end up writing them both up and pissing them off forever in the process. I would eventually transfer to 1K and live long and prosper under Kevin’s management. Mary Erdman was also Kevin’s boss, but he never asked her for help in managing me, so she became a non-factor in my life after that.

There’s a lot more to this story. We’ll be back.

Lea and I moved to Arizona in October of 2007. My first job in Phoenix was working for Maricopa Integrated Healthcare Services, or as it’s commonly called, the County. My boss at the County was Karen Swine, I mean Stein. She was an unpleasant woman that wore clothes about two sizes too small for her, which may have had a lot to do with her unpleasantness.

Karen and I never got along. She thought I was the Know-It-All new guy, so… Hey, we did agree on something after all! Who knew?

Karen didn’t like my methods, not that she would’ve known anything about them if it weren’t for the day shift nurses. The day shift nurses spent what seemed to me to be an inordinate amount of time tattling to Karen about me instead of actually doing their jobs.

I worked the evening shift at the County, and my crew would spend the first two hours of every shift getting the unit settled down and establishing a semblance of peace. The patients on our unit used to give the evening shift crew a standing ovation when we walked in. The day shift nurses hated us.

Karen and I had brief chats in passing, until the day she called me into her office. I had been at the County roughly six months. She asked me to explain why I did whatever it was I had done–something related to de-escalating a patient, I think. I started to explain —

“That’s not what I heard.” she interrupted.

“Yeah, well, that’s why I’m telling you what really happened.”

“That’s not what I heard.” she said once more. You know, she did kind of look like a pig that had learned to stand on its hind legs and wear makeup.

“You’re not interested in what I have to say, are you?”

“Not really,” she kind of oinked. I got up and opened the door of her pen, I mean office. “I’m not done–”

“I am.” I handed in my two week notice, and moved on. Next stop, Banner Del E Webb Medical Center.

I loved my boss at Del Webb. Jane Stevenson, you’re the sweetest boss I ever had. BannerHealth had just acquired the Boswell and Del Webb hospitals in Sun City and Sun City West. FYI: BannerHealth is the second largest employer in Arizona. Walmart is Number One.

I started out as a staff nurse at Del Webb, but Banner wanted a lot of middle management people. Jane asked me if was would be interested in one of the clinical manager positions. I pulled a quarter out of my pocket, flipped it in the air, and said, “Yep.”

All was well at Del Webb until the second year of Banner’s ownership, and then Banner showed its ugly side. In something like unto a Nazi blitzkrieg, Banner started firing all the managers that had been in place before they bought the Boswell and Del Webb hospitals.

My darling boss had lost her husband about a month before this happened. He had a heart attack and died quite suddenly and totally unexpectedly. Jane was probably still in the Denial Stage of the Grief/Loss process, when the Banner Nazis attacked.

What they did to her is a sin in every organized religion, including Atheism. All they had to do was terminate her–bullet to the head, get it over with. They didn’t need to eviscerate her and eat her liver in front of her before she bled out.

I knew I was next after Jane’s departure. My new manager was very cordial, and assured me I was welcome to stay as long as I wanted. Would I like some Kool-Aid?

I goddamn near jumped out of her window, and her office was on the fourth floor.

The rest of my Arizona bosses have been okay, though I probably would’ve left Aurora if I hadn’t retired. That place was getting kind of kooky…

Management. It can make or break a place. And even if their expressed purpose isn’t to make your work life miserable, that’s probably what they’ll end up doing anyway. It’s the people you work with on a day in, day out basis that truly make the most difference in the workplace environment. They will likely be the greatest factor in whether you stay or leave at any job you have.

Life and Death

You get to learn a lots about these subjects when you’re a nurse, but one of the fair things about life is you don’t have to be a nurse to become familiar with either of them. You simply have more exposure as a nurse.

There are two things I’ve learned about life and death in my nursing career. One, when it’s your time to go, nothing will save you. I’ve had patients come up to the nursing station to get their scheduled meds, collapse as they’re going back to their room, and were dead by the time they hit the floor. They had no complaints, no apparent concerns–and then they were DRT. Dead right there.

Conversely, when it’s not your time to go, you will live through everything. I’ve had patients that had shot themselves in the head with a .357. A .22. A .45. I’ve had patients that sliced open their bellies like a samurai committing seppuku. Patients that had deliberately collided a motor vehicle into a bridge abutment, a tree, another vehicle. Patients that had jumped into traffic, off of a building, off of a bridge. I’ve lost count of how many of them tried to overdose or hang themselves. But they had at least one thing in common: they were all walking around talking about it.

Go figure.

My wife has Crohn’s disease. It’s an autoimmune disease where the body essentially attacks itself, resulting in sometimes massive inflammation and ulcerations throughout your entire GI tract. It can result in nausea, vomiting and diarrhea, and pain something like unto that scene in ‘Alien’ where the spooky monsterbeast pops up out of that guy’s chest.

That was what Lea was experiencing when she started the first of her serial admissions to Fairview Medical Center in 1991. Over the next three years she would spend roughly half that time in the hospital connected to so many IV’s she usually needed two IV poles to hold them all, and two or three–sometimes four–IV pumps.

TPN, total parenteral nutrition. That’s two separate components right there. One is a huge bag with yellow fluid that Lea and I called her margarita bag. The other is a small glass bottle filled with creamy white lipids–her Piña Colada. The nurses that took care of Lea liked that and started calling them those names, too. A bag of normal saline with a morphine drip became her martini bag. Shaken, not stirred. No olives. Lea couldn’t eat ANYTHING during these times.

All of her nutritional needs were met by IV’s. She had to have a PICC line for that, plus one or two ancillary lines in her arms. She was on IV antibiotics; we didn’t even try to get cute with that. There were more, many more. If Lea had put a flower in her hair, she could’ve been a float in the Rose Bowl Parade.

And for the record, the real nurses that cared for my wife during that time–you all were rockstars–we loved those nurses, they were all so amazing. They. Were. Un-fucking-real.

Her GI doc, James Kromhout, had no idea what to do anymore because nothing he had tried was working, and Lea only got worse. He sent a consult to a surgeon, Dr John Something… And we waited. And waited. And waited some more.

I ended up writing him a ten page letter, explaining our situation and our frustration. Dr John actually read it. He offered this explanation: Once you open someone up and start taking things out, you can’t put them back in again.

I understood that, but I also knew if he didn’t operate on my wife, and soon, a monsterbeast was going to tear her guts apart. We waited another week. Or two. I started writing Lea’s eulogy. I would get a lots of practice with that literary piece over the next few years…

Her doctors had decided to try high doses of prednisone as a last ditch effort to stem the massive inflammation in her guts. Lea’s condition continued to deteriorate. Dr John finally decided there was no other option and scheduled her surgery.

Prednisone is a ‘dirty’ drug. It’s a very effective anti-inflammatory drug, but it has a lots of nasty side effects. Moon face, weight gain, mood swings, insomnia, mania–even psychosis–plus about a hundred other things.

Lea had all of them, and a bag of chips, on the night before her surgery. I spent that night at the hospital with her. I tucked her into bed, told her a bedtime story, sang her a lullaby–and she closed her eyes. I turned to sit in a recliner in her room, and by the time I got to the chair she was in the bathroom trying to figure out who the person in the mirror was, and how did that person get into her room? I have no idea how she managed to get her IV poles into the bathroom without knocking them over or disconnecting her tubing.

I might have gotten five minutes of sleep that night. My wife had maybe five minutes of sleep that week.

Lea was the first case on Dr John’s schedule that morning. Most abdominal surgeries run about an hour, maybe two at the most. Lea was in the Operating Room for four hours. When Dr John’s scalpel cut through her abdominal muscles and the peritoneum, Lea’s intestines flew out of her body like someone had opened a prank can of worms.

Dr John told me this after her grueling surgery. He removed about half of her large intestine. It was so swollen it looked like the Metrodome. He spent at least two hours stuffing my wife’s guts back into her body, and closing her up before anything could jump out again.

“I think you were right. About the surgery. I should’ve done it sooner.” he said. I think the only thing I could do in response was shake my head.

Whether late or early or whatever, Lea had finally had the surgery I felt she needed to have to save her life. The only question that remained was the Big One about time.

Was it her Time?