I Don’t Want to Complain, But…

Just in cases you were wondering, I’m totally loving being a retired guy. I find it almost impossible to find anything about my life that isn’t great. My lovely supermodel wife and I have been trying to avoid using the P word.

Perfect.

It’s been our experience that saying stuff like that will inevitably incur the wrath of the gods, and then things won’t be perfect anymore.

I’ve been staying busy doing anything but writing for awhile. I built a golldarn thing that ended up being more of a really stout shelf than a golldarn thing. I still have the materials for a golldarn thing, and I may build one someday, but I have to replace my drill/power screwdriver first.

I’ve been doing a lots of small maintenance jobs around the house. I lavish attention on my plants on the patio. They’re looking good, and most of the plants we inherited from Planet Janet are looking better. The jade plants are even starting to look better, and they were in terrible shape when we moved in.

I bought a hammock for the frame that looks like unto a Viking longship, and I’ve been practicing getting in and out of it so I don’t look like a complete idiot on the offhand chance someone comes down to visit us.

And we bought a very darlingpreshadorbs table and chairs for the patio for the same reason. It’s a work of art. Seriously. The chairs are all signed by  the artist that painted them. I wonder if he’s a famous guy, like Van Gogh…  If we keep this up, we’re going to need a much bigger patio…

I’ve been practicing my golf swing. I’m going golfing for the first time in eight or nine years next Friday with Phyllis, Tom and Cheryl. I’ve never been a great golfer, so I don’t have to worry too much about sucking. That’s pretty much a given, and if I needed something to complain about, I’ll probably have it after about ten minutes of golf…

And even though I don’t have an actual story in mind, I decided it was time to write something, lest I forget how to do it altogether, and I end up with a permanent case of writer’s block.

I have no Muse for this story. It’s more of a status update on our lives than an actual story.

* * * *

In the interest of fair and balanced reporting, we have had a few bumps in the road since we’ve moved to Mexico. Literally, and figuratively. Literally, the roads are nothing but bumps. The roads here were probably built during the time of the Roman Empire, using the same materials the Romans would’ve used.

The village of Ajijic has been here for about six hundred years. It has more history than any other place we’ve ever lived. There’s only one paved road in the Lakeside area, the carretera. It’s the major thoroughfare in the area. It’s a two lane highway that quickly becomes clogged with traffic during the weekend and any major holiday.

Take, for example, Easter. The village of Ajijic hosts a live Passion Play each year. Thousands of people come to see it. If you have no desire to fight the crowds, your best bet is to stay at home, which is what we did. Last week was pretty damn crazy/crowded here. It was worse than Snowbird season, and most of those people had just departed, returning to the Great White North for the summer.

If anything like unto a serious natural or unnatural disaster happens here, you’d better be the first person out of town, otherwise, you may as well stay home. You won’t be going anywhere…

Everyone complains about traffic, it’s an universal complaint, no matter where you live. So even if you don’t have anything else to complain about, you’ll always have that. Or the weather. Although the weather here is extremely hard to complain about. It’s, well, pretty much per–

It’s okay.

But some people have a deep and abiding love of complaining. Back when I was a nurse, I knew a lots of people that loved to bitch and moan, and not all of them were patients. Some of the nurses I knew seemingly thought it was part of their job description.

Even here, in Heaven on Earth, there are people who look for things to complain about. I think they go through withdrawal, and they’ll jump on the most insignificant thing they can find, simply because they don’t have anything else to complain about. Lea and I got to meet a couple of these types of people a few weeks ago, and the issue at hand was the placement of our satellite dish.

We subscribed to Shaw Direct when we moved here. There are no cable companies in the Lakeside area. I don’t know if there are any cable companies in all of Mexico. Shaw is a Canadian television company, so we get a lots of Canadian shows, plus a few American networks. I’ve learned a lots about Canadia in the last several months, eh.

Beauty.

And like unto everyone else that lives in our development, we had our satellite dish placed on our roof. I mean, it seemed like the best place to put it…

The guy that lives two houses west of us on the other side of the street filed a complaint with the owner of the house we’re renting about our dish, but he didn’t say anything about it until six months after we had it installed. Six fucking months! This guy told Planet Janet that our dish was obstructing his scenic view, and he wanted our dish moved.

There’s a backstory to this. Planet Janet and her husband, Don Padrino del Basura, used to live in Casa del Selva. (That’s the really cool name of our house. It means House of the Forest, or something like unto that.) About fifteen years ago, the guy that complained about our dish got into some sort of an argument with Don and Janet, and he hadn’t spoken to either of them since. Until we moved in and had a satellite dish placed on our roof.

I contacted the guy who installed our dish, Michael E. Merryman. He’s a darling man, and sur’n he’s Irish. He came over, and we went up on the roof to survey the scene, and scouted out possible placement options, and he said wherever we moved it on the roof, someone would be able to see it, and they might object to its new position.

Our satellite dish is about four feet in diameter. It’s a good sized dish, no doubt. However, I’m not sure how much of an obstruction it would’ve posed to the guy living two houses west of us. It would certainly impact the view of the people living directly behind us, but they didn’t have any complaints that I’m aware of.

Michael couldn’t believe this had actually become an issue, and why did it take six months for someone to complain about?!?

Yeah, that was a good question.

Michael asked me to call him once we figured out where we wanted to put it, and he’d send his crew out to move it. And he added that we should make the guy who complained pay for having it moved. See? I told you he was a darling man. And although I liked the idea of making the guy two doors down pay for moving our dish, we decided not to do that.

Planet Janet came over, and Lea and I went up on the roof with her to survey the scene.  We looked everything over, and started brainstorming possible options for a new place for our satellite dish.

Yes, it would be visible no matter where it was on the roof. Lea and Planet Janet thought a good place would be on the western wall of our house, or possibly the southwestern part of the wall, right above my bathroom window.

I made this observation: the only place we could put our dish that it wouldn’t obstruct anyone’s view was way down by the bodega on the western side of our backyard, just off of our terraced patio.

“Then it’ll obstruct our view.” Lea replied.

The guy who registered the complaint happened to be outside, so we invited him to come up on the roof and give us his opinion. He told me he wasn’t trying to create any problems. I told him it was a little late for that. From my point of view, if he really didn’t want to create any problems, all he had to do was keep his mouth shut. And just for the record, the complaining guy has two satellite dishes on the roof of his house.

Be that as it may, he was reasonably pleased with our possible solutions and said any of them would be fine with him.

When we finished our negotiations on the roof, I decided I better check with the guy who lives next to us to make sure he didn’t have any objections to our possible placement solutions. Having a satellite dish on our roof didn’t impact his view of the world in the least. However, if we moved it to the wall next to his house, it might, and I didn’t want to have to move it a third time.

It’s probably a good thing I decided to talk to my neighbor because he turned out to be an asshole, and he didn’t want our dish on a wall that faced his house, whether he could see it or not.

“It wasn’t here when we left for the summer, and no one told me it was going to be there when we got back.”

He actually said that. Like we were supposed to contact him in Canadia to get his permission to install our satellite dish. For a moment, I thought about killing him…

To wrap this story up, our neighbor was okay with placing our dish down by the bodega, and that’s where it sits now, hidden from the view of all of our neighbors. And there is peace in our development once more.

* * * *

There was one other less than perfect event, and concerned our kit-ten, Samantha. About nine days ago, Lea and Sam went outside in the early morning hours. It was still dark. Sam, being a cat, decided to go look for things to chase in the bushes. She used to be really good at chasing things, but it’s something she rarely does anymore now that she’s old. She’s something like unto eighty years old in human years.

On this morning, Sam encountered what Lea thinks was another cat, and there was muchos hissing and howling in the bushes. Whatever it was that Sam had encountered had fled by the time Lea ran down into the yard, and it took another forty minutes for Sam to calm down enough to let Lea examine her.

Sam was clearly in pain. She limped when she walked, and every movement she made was done at great cost. We decided to take our kit-ten to see the vet.

Good news, no major injuries were discovered, but Sam was clearly in a lots of pain. The vet gave Sam an injection of a low dose of morphine, and Sam looked a whole lots better by the time we got her home.

Bad news, morphine is a narcotic, and one of the side effects of morphine can be constipation. After three days of no cat poop in the litter box, we decided to take our kit-ten back to the vet.

It turns out that feline constipation is more prevalent of a problem than one might think. The vet gave Sam an enema. I didn’t even know there was such a thing. About an hour later, Sam pooped, and we took her home. She’s pretty much back to her old self again, and I doubt Lea will ever let her kit-ten explore the yard in the dark again.

* * * *

You may not know this about me, but I love music. I have a few hundred CD’s, and I downloaded a ton of songs onto our PC. And the only reason I ever got a smartphone was because you can download music onto it.

And it was easy to do. Just plug your phone into your computer, pick the songs you want to load and Click! It was so simple, even I could do it!

And then we moved to Mexico, and I had to buy a Mexican cellphone. My Mexican cellphone and my American computer wouldn’t interface, and I couldn’t directly download any of my music onto my new mobile device.

I had to set up a Music Manager application on my computer through my Google Play® account, and download every single song, all seven thousand of them. It took eight days.

As the songs downloaded to Google Play®, they were then wirelessly transferred to my Mexican cellphone. I’ve spent the last eight days going through the seemingly endless list of songs, deleting the songs I didn’t want on my phone, and keeping the roughly one thousand songs I wanted to keep on my playlist.

My lovely supermodel wife thinks I am totally insane.

She may be right about that.

However, I have a playlist that is pretty much perfect for my life, and I don’t care who knows it. If you ever have about eighty hours that aren’t scheduled with other things to do, you could come down and listen to it. But you’d probably hate it here.

You could lay in the hammock, in the equatorial sunshine, and try to not look like an idiot getting out of it. The weather is…okay…at best. There are only a few thousand amazing places to eat, and you wouldn’t believe the prices. You do have to pay cash for almost everything, so you’ll  have to adjust to carrying a lots of  Monopoly® money. The Mexican people are incredibly friendly and polite, and they don’t care how badly you butcher their language. They simply appreciate that you make the attempt to learn Espanish.

It’s a lots to get used to, and not everyone is up to the task.  But the roads and the traffic, that’ll be the last straw.

From the Odds and Ends Department

Have you ever watched something on TV, or read something, and thought, Man, I could do so much better than that! You might even be thinking that right now…  Especially if you’ve read more than one of my blog posts.

I mean, all this guy writes about is getting wasted, his slutty girlfriends, and how all of his relationships fell apart! There was that story about his nympho Russian girlfriend, Ivana Sukyurkokov. And his heartbroken Chinese girlfriend, Wat Wen Wong. Jeez, his blog is dumber than putting wheels on a ball! I liked him more when he wrote about crazy people!

And I hear you. Before I started writing my blog, I thought bloggers were people who needed to get a fucking life, man. They were probably people who thought Paris Hilton and Kim Kardashian were the epitome of American society and they all wanted to be Paris-ites, or biffles, or twat waffles with them or something.

I’ve started reading some of the blogs that are out there on the Interweb, and I was wrong about bloggers. Most of them appear to have lives.

Except me.

I’m retired. If I were to write about my day-to-day life now, my blog would consist of restaurant reviews in the Lakeside area, and stories about how much I love my Sleep Number bed®.

And to be honest, I probably liked me more when I was writing about crazy people, too. But those stories are relatively easy to write, and like everything else in life, it’s only when you step outside of your comfort zone that anything meaningful happens. It’s the stories I didn’t want to write that taught me the most about myself. It was the stories that hurt like hell that showed me how far I’ve come.

And how far I still have to go.

And the other thing about writing about my nursing career is not every person I cared for resulted in a story worth telling.  Knife wielding homicidal maniacs were the exception, not the rule, thank God. Most of my patients were never a problem, unlike medical dramas on TV. I’d probably hate being a TV nurse, unless my work partner was the hot nurse with the big tits…

The majority of my nursing career was pretty ho-hum. Mischief was managed. Shit got done. No one died. And that was that. But there were a lots of snippets and moments and oneliners, and if I could patchwork a lots of them together, I might be able to spin a tale or two…

* * * *

I’ve discovered that time management is still necessary once you retire. I certainly have more time to do things I enjoy now, like reading. And because other bloggers sometimes read my posts, I feel a certain obligation to read some of their posts, too. My favorite blogger is a young woman in New York who writes about her struggle to overcome her eating disorder. Her blog is called Beauty Beyond Bones. And while I love her now, I probably would’ve hated her as a patient.

Back when I was a psych nurse in Arizona, there were a couple of eating disorder treatment facilities in the little town of Wickenburg, about thirty miles northwest of Surprise. Remuda Ranch and Rosewood Ranch. She’s never come out and said if she was a patient at either of them, but I’m going to guess she was at Remuda. I hope she doesn’t mind me saying that. I interviewed at both facilities, but decided not to take a position at either one of them. I absolutely sucked at working with eating disorder patients.

Remuda is a Christian based treatment facility. One of the questions they asked me in the interview was did I think the Bible was the sole source of truth. I said no, it wasn’t, and I wasn’t even sure all of the things written in the Bible were true. After my interview, they told me I wasn’t Christian enough to meet their criteria. I told them that was okay. They weren’t the first Christians to tell me that.

A few weeks later they called me back and told me that they had changed their mind about me, and asked if I was still interested in working there. I wanted to say something like, God, you guys must be fucking desperate! But instead I thanked them for thinking of me, and told them I had found another position and I wasn’t available anymore.

Well, it was the truth…

Like most every psychological/psychiatric disorder, eating disorders are caused by a multitude of complex factors, and as with every psychological/psychiatric disorder–except dementia–the successful treatment of anorexia or bulimia depends completely on the patient. If they don’t want to change their behavior, there ain’t nothin’ anyone can do for them once they’re discharged from the hospital.

It’s like alcoholism or drug addiction, only worse. Just as the drinking and chemical use are usually a symptom of a deeper, darker pathology, eating disorders are about far more than food.

Eating disorders are incredibly difficult to treat, mostly because eating disorder patients are the spawn of Satan. I mean that in a Christian way. They are sneakier than a ninja. They can vomit silently so they can purge without anyone knowing. They stockpile food so they can binge feed when no one is looking. And if their lips are moving, they’re probably lying.

The other thing I remember most clearly about most of these women, and they were all females, is the majority of them were gorgeous. And that is truly one of the great mysteries that used to keep me awake at night when I was learning how to be a psych nurse. How could someone so beautiful be so fucking miserable?

One of my first posts was about one of my patients at the MVAMC. I called him the Piano Man because he liked to play the piano. About the time he walked onto the unit for one of his many admissions, we had just discharged a gal with anorexia. She had been on our unit for a couple of weeks, and none of the staff were sad to see her go.

After we got the Piano Man admitted, he sat down at the piano and started playing, and the piano sounded like a wounded moose. We opened the top to find the eating disorder girl had hid enough food inside of the piano to feed Hannibal’s entire army when he crossed the Alps to attack Rome. Including the elephants.

For someone who has never worked in a psychiatric setting, it would be easy to say that we, as staff members, totally sucked at our job, and I really don’t have much of anything to say in our defense. We were hardly specialists at treating eating disorders, and the fact we were so happy to see that particular patient leave speaks volumes to the level of struggle we all had with her.

* * * *

To be sure, it’s very easy to be an armchair quarterback or a wheelchair general, and criticize someone doing a job you’ve never attempted. And when you’re in a service oriented occupation like Nursing, you are never going to be able to make everybody happy. No one is that good, and people can be incredibly demanding/entitled. And it is generally the people who were making the least positive contribution to anything who were the most demanding and entitled.

You guys have to be the worst fucking nurses I’ve ever seen! I couldn’t tell you how many times I’ve heard that one. And it was usually a guy that you and your team had spent a month busting your asses trying to arrange housing and follow up for, who had been discharged from your unit forty-eight hours earlier, and was already back because he chose to drink as much alcohol and smoke as much meth as he possibly could before he came crawling back to the hospital.

Most of the time it’s better to just agree with someone like that, and walk away. But there were times when I couldn’t.

“Maybe you should get out more…  That means a lots coming from you…”

I said something like unto that to one of my unhappy frequent flyer guys at the MVAMC who probably spent as much time in the hospital as I did. His name was Ray. I’m going to guess that the total bill for the many, many times we detoxed him off of alcohol, sobered him up and set him up to succeed was in excess of one million dollars, and he had this response, “You used to be a good guy, but you need a new job. You’ve been inpatient too long.”

“So have you.” I replied.

He froze to death one cold December night in Minneapolis. He had gotten drunk and was walking to the hospital so he could be admitted again. His body was found propped up against a tree across the street from the hospital in the morning. He had stopped to rest before making his final stumbling trek to the ED, and had fallen asleep.

You meet a lots of guys like unto that when you’re a psych nurse. There was Charles. He was another MVAMC guy who spent an inordinate amount of time getting drunker than fifty guys combined, and the rest of his time detoxing on my unit.

We had safely detoxed Charles for the umpteenth time, and discharged him at 9:00 AM on a Friday morning. At 2:30 PM that same day, I answered the phone. It was Charles.

“Hey, I don’t think this discharge thing is going to work, man. I’ve been out of the hospital for about six hours, and I’m pretty fuckin’ wasted, man.” he slurred.

“Hey, Charles. Has it ever occurred to you that you need to quit drinking?” I decided to ask. There was a long silence, and then Charles said this,

“Is there anyone else there I can talk to?”

For one of the few times in my life, I had no response. I handed the phone to one of my co-workers. Charles would also die to death as a result of his alcohol abuse.

Sometimes the disease wins.

* * * *

You never know what you’ll see or hear as a psych nurse, and there’s a reason for that. People are capable of an infinite amount of kooky stuff, not that you have to be a psych nurse to experience the full spectrum of kookiness available out there.

All you really need to see that is a family.

But one thing you may not experience unless you’re a psych nurse is the dreaded Dissociative Identity Disorder, or more commonly, Multiple Personality Disorder. In my thirty year career, I met a lots of people who claimed to have multiple personalities, but none of them ever seemed to be legitimate to me, or anyone else I worked with.

Multiple Personality Disorder was virtually unheard of until the 1970’s. That’s when the book Sybil was published, 1973 to be exact. Three years later, the TV movie of the same name was broadcast on NBC, starring Sally Field and Joanne Woodward, and like magic, suddenly everyone had multiple personalities.

For my money, all of the people I met who claimed to have multiple personalities were just assholes looking for an easy excuse for their behavior.

* * * *

I was working nights at the MVAMC fairly early in my career. I was the Med nurse that night, so anyone needing any medications had to see me. Enter Sam. It was around 2:00 AM. We had detoxed Sam off of alcohol with a Valium protocol. Once someone had been safely detoxed, the protocol was discontinued.

Sam had been off the protocol for a day or two, but he wanted more Valium. I explained to him how the protocol worked, and Sam had a five star meltdown. He screamed at me, waking up everyone on the unit. One of the other nurses called the POD and got a one time order of Valium for Sam, and he went back to bed.

At 6:00 AM, Sam came up to the nursing station to get his morning meds. He was quite pleasant, and I remarked that he was much nicer than he had been at 2:00 AM.

“Oh, that. That wasn’t me. That was Samuel.”

“No kidding. He looks just like you.” I said.

Sam gave me, and anyone else willing to listen, a detailed description of his three personalities: Sam, Samuel and Sheryl. A line of patients had formed behind Sam. They were waiting to get their meds so they could go smoke. According to Sam, Samuel was the troublemaker. Sheryl was the lover, and Sam was the drunk. I listened to Sam, and gave him his meds.

“Well, the next time you talk to Samuel, give him a message.” I said. “If he ever talks to me like that again, I’m gonna punch you in the fuckin’ mouth.”

Sam’s jaw dropped. He turned to the guys standing behind him, “Did you hear that! He threatened me!”

“Hey! Take your goddamn meds and get the hell out of the way! And if you ever pull that shit again, if he doesn’t punch you in the fuckin’ mouth, I will.” one of the Nam vets growled.

Yeah, not one of my better moments, but Samuel never made another appearance.

* * * *

I think the last time I met anyone who claimed to have multiple personalities was at Aurora. I walked onto the Canyon Unit, and Nikki was on a 1:1. She was a frequent flyer, and I was usually her nurse.

A 1:1 is a special precaution, usually reserved for patients that are acutely suicidal. In essence, one staff person is assigned to one patient, and that patient is never more than an arm’s length away from the person assigned to watch over them.

Well, that’s how it’s supposed to work, but it’s rarely played out that way.

I went over to talk to Nikki. She had scratched her wrist with a plastic spoon on the evening shift. She didn’t even break the integrity of her skin, and her nurse had placed her on the 1:1.

I’m shaking my head while I write this. I don’t usually like to criticize the actions of other nurses, but that was a lazy-ass intervention. If the evening nurse had taken even five minutes to talk to Nikki, that ridiculous waste of manpower and resources wouldn’t have been needed. We barely had enough staff to cover the units, let alone have one staff assigned to watch someone for no good reason.

I asked Nikki to tell me what happened.

“I didn’t do anything! It was Alexandra!”

“And whom might that be?”

“She’s one of my three personalities! She–”

“Stop. Cut the crap, Nikki. You’re on a 1:1. You can’t smoke if you’re on a 1:1.” I said.

“But they let me smoke last night, and this morning!”

“I don’t care what they did last night. This is my unit, my rules. If I can’t trust you to be safe on the unit, I’m sure as hell not going to trust you to be safe off the unit, with a lit cigarette in your hand. What if you decide to burn yourself?”

“It wasn’t me! It was Alexandra!”

“I don’t care who did it. None of you get to smoke.”

“I’ll be safe, I promise! Please!!”

Less than five minutes. Mischief managed. And I never heard another word about Alexandra again. Ever.

* * * *

There was a fairly consistent response whenever I told someone that I had just met that I was a psychiatric nurse. Their eyes would widen, and they would say something like unto, “I bet you’ve seen it all, huh.”

I would reply, “No. I’ve seen a lots of strange stuff, but the kookiness of humans is infinite.”

And that is the fucking truth.

Every time I thought I had seen it all, something I didn’t think was humanly possible walked through the door. I eventually made peace with the fact that I would never see it all, and I was okay with that. My two other personalities are still sulking about that a bit, but they’ll get over it.

Or I’ll punch them in the mouth.

The Doctors

You get to work with a lots of different disciplines as a nurse. Social Work. Adjunctive Therapy. Physical Therapy. Laboratory. Dietary. Even Housekeeping.

But the most challenging discipline you’ll likely encounter is the doctor. Well, Dietary can be a real pain sometimes. You know who the sweetest people are? The housekeepers. I loved them, especially the housekeepers at Aurora.

Doctor shows are incredibly popular on TV. I have no idea why. I’ve spent years hanging around doctors, and I never found most of them to be that interesting.

TV doctors have changed a lots over the years. They used to be older, wise, fatherly figures that made house calls and took care of you and your family from birth to death and everything in between. Nowadays they’re young, pill-popping, supersexy smartass mannequins who perform some obscure lifesaving surgery, then go get drunk and have sex with another supersexy doctor or the nurse with the big tits.

From a nurse’s point of view, doctors can either make or break your day, depending on a wide variety of factors and variables. Sometimes the most difficult part of being a nurse is getting what you need from your doctor.

And as a psych nurse, mostly what you need from your doctor is good coffee in the morning, and a shitload of medications to offer your patients.

* * * *

My first psych nurse position was at the Minnesota State Hospital. You had to be certified crazy to be a patient there, and some of them were downright scary.

Vincent was a certified crazy, angry young man, and he often made threats of death and other types of destruction to the staff. I never found those situations to be especially fun, so I asked his doctor to maybe increase his meds, just a little.

Vincent’s doc was a tall guy named Bruce, who spent about five minutes a month meeting with his patients. When I spoke to Doctor Bruce and informed him how his patient had decompensated of late, and was threatening death and destruction to pretty much everyone, Doctor Bruce had this classic response:

“Well, Mark, we all have to die from something.”

* * * *

The next stop in my career was at the MVAMC, and I would stay there for almost twenty years. I would meet a lots of doctors there.

Doctor Bob was an older, wise, father figure guy who had been at the VA for eons. He was an alcoholic, but had quit drinking some years before we met. But that was all he did, and he was a mixed bag of moods most of the time.

We had a guy on our unit named Duane. Duane was a was what we called a non-compliant patient. He refused to take any medications. He refused to take part in any programming. Duane just wanted to eat and sleep and he was rather rude in his interactions with the staff.

Doctor Bob walked onto the unit one morning, and walked into Duane’s room. They had a brief, loud interaction, then Duane started screaming. Two seconds later, Doctor Bob emerged from Duane’s room with Duane in tow. He had grabbed Duane by the ankle, pulled him out of bed, dragged him down the hallway to the nearest dayroom, and told him to stay there.

Doctor Bob was investigated by the hospital for alleged patient abuse, and ended up getting a three day suspension. Anyone other than Doctor Bob would’ve been terminated immediately and most likely would’ve lost any professional licensing they had.

* * * *

Lori Suvalsky was my favorite doctor at the MVAMC, and my personal favorite doctor of all time. She knew her stuff, and was a very good doc, and she was hotter than July in Phoenix.

I’m very serious about that.

We took care of a lots of crazy people together, and she was the first doc I worked with that seriously listened not just to me, but all the nurses. As hard to believe as that might seem, a lots of doctors weren’t all that interested in what the nurses had to say. Doctor Lori absolutely loved the nursing notes I wrote. It was so refreshing working with her.

Doctor Lori spent a lots of time talking to her patients, and she almost always took the nurse caring for a patient with her to get input from the patient and the nurses. She was the only doc I worked with that consistently did that.

Doctor Lori wasn’t just the first doc I formed a professional relationship with, she was the first doc that I counted as a friend. We went out for drinks and dinner after work. We talked about the problems we had in our personal lives. She threw elegant parties and invited me and my lovely supermodel wife.

She told me I needed to quit smoking. I told her she had a nice ass. She helped me survive the traumatic aftermath when one of our patients committed suicide on our unit. When the VA decided to create an assistant head nurse position, she lobbied for me to get the job, and she had my back when I quit finally drinking.

She cried when I left Minneapolis and moved to Phoenix. Of all the people I would miss when I left the MVAMC, I missed her the most.

* * * *

I worked at several psych facilities in the Phoenix area, but it wasn’t until my third job that I found a doc I really liked. I worked with some decent doctors at the County and Del Webb, but there were some real losers, too. Especially at the County.

Hey, Dr Loser. We have a guy starting to escalate here. He’s hyperventilating and pacing. He just punched a hole in the solid concrete wall, and he’s threatening to kill everyone. What kind of injections would you like us to give him. Immediately!

No injections. Offer him Haldol 2 mg by mouth, and a half a milligram of Ativan.

Seriously? This guy is six foot five, and weighs about four bills. With all due respect, we’ve had four Code Blacks with this guy in the last three days. Yesterday we gave him ten of Haldol, two of Ativan and a hundred of Benadryl. And it finally caught up with him after we gave him a repeat dose!

Are you a doctor? Do you think you know more about this than I do? You don’t give me orders, I give orders to you! Do what I say!!

That might be an extreme illustration, but shit like that happened occasionally. The big badass guy would inevitably go off. Fifty staff members would come running, and there would be an huge wrestling match. We’d shoot the guy up with what we knew would work, and then get orders. If Dr Loser still refused to give us orders for what we needed, we’d call the Medical Director, and he’d sign off on them, then he’d call Dr Loser and chew him a new asshole.

* * * *

My favorite doctor at St Luke’s was Naveen Cherukuri. My favoritest thing about Naveen was listening to him tell a funny story. He would start laughing so hard I couldn’t understand a thing he said, but was still thoroughly entertained listening to it.

Naveen was also a really good doc, and he took care of the nurses. St Luke’s could be a really scary place to work at times, and Naveen wasn’t afraid to lock and load. I really liked working with him.

He married one of my favorite St Luke’s nurses, Stacey Supermodel. They have a couple kids now. Hopefully, they look like their mom…  Just kidding, Naveen. I don’t know if I’ll ever see him again, but I hope I do.

* * * *

I ended my semi-legendary psych nursing career at Aurora Behavioral Health, and I would work with several doctors there that I would come to view as not just colleagues, but good friends.

Bill Sbiliris was the primary doc on the Canyon Unit, my home at Aurora. We didn’t get along all that great at first. We probably had a similar opinion about each other: That arrogant sonuvabitch thinks he knows everything!

And then we discovered between the two of us we really did know everything, and we were both Minnesota Vikings fans, which was rare in Arizona. After that, we made a great team. Too bad our football team didn’t achieve similar greatness…

Doctor Bill also wasn’t afraid to lock and load medications. He was pretty easy to work with in that regard, and that made it easy for the nurses to drop the Canyon Hammer if we ever needed to.

Doctor Bill wasn’t so great at spending a lots of time with his patients. They called him Dr Drive-by. Be that as it may, Doctor Bill was a good guy to work with, and we stabilized a lots of crazy people together.

Doctor Bill also took very good care of the nurses. He usually stopped at Starbucks on his way to work and brought in a wide variety of caffeinated beverages for the nurses. He bought lunch for the nurses more consistently than any other doc I worked with, and he also threw great parties.

* * * *

Michael Fermo was another Aurora doc. He was also a very good doc, and another wizard of psychopharmacological management, and he spent a reasonable amount of time meeting with his patients.

Doctor Mike used to transfer a lots of patients to my unit. Fiona, the Queen of the World, was one of his patients. The nurses on his unit used to say their patients needed to spend some quality time in the Canyon. Doctor Mike used to say this: “I think they need some quality Mark time.”

That was a pretty high compliment.

For his especially difficult patients on my unit, we would do a Good Cop, Bad Cop routine. Doctor Mike always played the Bad Cop, and would rip his patient a new asshole, and then I’d put a band-aid on it and make it all better. And then we would laugh our asses off. We were incredibly successful, and there was mostly peace on the Canyon.

“How’s my boy doing today? Do I need to get all medieval on his ass again?” he’d ask.

“Nope. He’s got his damn mind right now.” I’d reply.

“Good. I love it when a plan comes together.”

And when it came to throwing epic parties, none of the docs I worked with could hold a candle to Doctor Mike. The only thing he didn’t have at his parties was strippers, even though I lobbied hard for them the next time.

* * * *

But my favorite Aurora doc was Reyes Topete. He was the staff addictionologist, and he was a freaking dream to work with. Whatever I needed for my detox patients, El Topete delivered.

“Give him Ativan 2 mg now, and set up a taper, 2 mg QID. I’ll see him when I come in and take care of the rest.” Or “Give her Subutex 8 mg now, and set up a four day taper. You need anything else?”

If I wanted a Subutex taper extended, no problem. If I wanted one stopped, it was done. If I thought we should add something, like phenobarbital, sure, why not. It was the same if I thought we should remove something from a patient’s med profile.

“You’re my eyes and ears on the unit.” he told me one day. “And if you tell me one of my patients needs something, or doesn’t need something, I trust you.”

As far as compliments from doctors go, it doesn’t get any better than that.

I told him about my drug use history, and he had trouble believing parts of it. Mostly the quitting part.

“And you just stopped? Cold turkey? Man, don’t tell my patients that! I have kids in college!!”

El Topete is from Guadalajara, Jalisco, Mexico–the Big City about forty miles away from where we’re currently living. He was thrilled when I told him we were going on vacation here the year before we retired.

“Really? I’m grew up in Guadalajara. You’re gonna love it! You have to go here, and there…” He was so excited he started speaking a combination of English and Spanish and probably a couple of languages no one has ever heard before, outside of a Star Wars® movie.

And when I told him we were retiring down here, he was jealous. At my retirement party, he cried. To this day, that touches me more than I can say.

* * * *

I’ve said before that I don’t miss working for a living, and that’s true. I’ve also said that I miss some of the people I used to work with. That is also true. I’ll probably travel back up to the States again from time to time, but I have no intention of staying there, and I sure as hell don’t plan on rejoining the workforce.

I’ll try to see as many of my friends as I can cram into any of our Stateside visits. But we do have a guest room here…

Why Management Tends to Suck and the General Relativity Theory of Guys

Back when I was contemplating getting my Master’s degree, I was going to do my thesis on Guys.

That’s so much crap even I can’t believe I wrote that.

I have never contemplated getting my Master’s. I’m pretty sure I’d rather got dead than go back to school. Hell, I’d probably rather write another book than go back to school. School was one of the reasons I decided to flee BannerHealth. One of the requirements of being a manager was having a degree, and I didn’t have any. Zero. Zip. Nada. None.

I graduated from a Diploma Nursing Program. I don’t even have an Associate’s degree.

And after my darling boss, Jane Stevenson, was eviscerated and terminated, I was pretty sure I was next in line, so that was a strong motivating factor as well. I think one of the reasons BannerHealth wanted me to disappear as a manager was because I was a guy.

Disclaimer: I am not a classic, stereotypical guy. I’m an atypical guy. I might be the only complex guy on the planet. My lovely supermodel wife says I’m way more complicated than she is, and I’m not sure that’s even remotely possible. However, neither am I sure a complex guy can exist outside of an Hollywood movie. For example, probably any movie starring Nicolas Cage.

Guys generally make lousy managers, in my opinion. Men, on the other hand, make much better managers. Believe it or not, there’s a big difference between Guys and Men.

The latest election is a perfect example. Donald Trump is a Guy. Barack Obama, and probably Hillary Clinton, are Men.

Guys tend to be the opposite of circumspect. When it comes to sharing their point of view, guys tend to shoot first and make friends later. Tact isn’t a tool most guys use a lots, if ever. Guys tend to react to any given situation, not respond. And there’s a huge difference between those two actions.

Shortly after I accepted the clinical manager position at Del E Webb, I told Jane that I was a lousy manager. I actually told her that more than once. I clarified my statements by adding I was an effective leader, but that didn’t make me a good manager.

This is how I believe leadership works: Good leaders lead by example, and I spent a lots of time modelling the behavior I wanted my staff to emulate. They knew all the medical stuff far better than I ever would. They didn’t need me to manage those situations, but they weren’t psych nurses. They had no idea how to manage crazy people.

I did.

Another thing a good leader does is support his/her people. Never make them work short, if you can avoid it. Help out where help is needed. I passed meds. I helped old ladies to the bathroom and back to bed. Serve and support, that was my focus. As a very last resort, I told them what to do.

I was a good leader.

Management is all about meetings and reports and paperwork, and I hated each of those things. In my humble opinion, they were an immense waste of time. As near as I could tell, if you ever wanted to make sure nothing ever got done, all you had to do was schedule a committee meeting to discuss changing something.

I was probably the worst manager in the hospital.

Case in point, the Falls Committee. As a manager, I was required to attend these things at least once a month. I had to explain to the Big Administration Bosses and Directors why any of the patients on the SAGE Units fell, and what I was going to do to prevent future falls. It was a torturous experience.

One disastrous month, we had twelve falls. Even I had to admit that was a lots of falls for one month. However…

“That’s an anomaly. We’ll go three or four months now without a fall and it’ll all balance out by the end of the year.” I said. Hard to believe as that might be, that’s a true statement.

“How do you account for this anomaly?”

“All of our patients are elderly. They’re sometimes confused. They think they can make it to the bathroom by themselves, and they slip on the floor and fall.”

“Your staff needs to be more attentive to the the needs of their patients.”

“My staff is incredibly attentive to the needs of our patients. That’s not the problem.”

“Then what is the problem?”

“The problem? My staff hasn’t figured out how to be in three places at once. Look, these are old people, with small bladders. If one of them says they have to go to the bathroom, all of them magically have to go to the bathroom at the same time.”

Seriously. When an old person tells you they have to pee, urine is already running down their legs. They’re like toddlers, only worse. A toddler doesn’t know any better.

“Maybe they could wait and take turns.”

“Yeah, that’d be nice, but it doesn’t work that way in reality. When they want to do something, they want to do it now. They’re old, and depressed, and cranky. And when they have to go to the bathroom, it’s a damn emergency. That’s another part of the problem, they all think they’re going to pee their pants, so they move too fast on those slippery floors. And they don’t want anyone telling them what to do. They’re seventy, going on three. And if you try to do that, they’ll barbecue you on the Satisfaction Survey. Look, SAGE was one of the pilot units for the latest fall prevention protocols. We’re already following the most current interventions in the hospital! My staff is doing everything they possibly can to keep all of our patients safe. This stuff just happens from time to time, trust me, it’ll all balance out.”

“Well, what would you suggest to ensure these falls don’t continue?”

“Beyond what we’re already doing?”

“Yes.”

“You could give me more CNA’s, and we could put everyone on 1:1 observation.”

Are you… serious?”

“Do you see me laughing?”

“Do you have any other ideas?”

“I suppose we could close the unit down for a couple months. We wouldn’t have any falls then…”

“Do you have anything…else…you’d like to add?”

Did I ever, but I doubted telling them what a bunch of stupid bitches I thought they were would accomplish anything.

“No. I think that’s sufficient.”

“Well, I think you’re being rude and sarcastic.”

* * * *

My first ex-work wife, Deb Goral, would’ve appreciated my candor, and she would’ve understood my rationale. That’s why she was such a great supervisor to work for. She looked out for her people.

Now that I ponder this deeper, Deb would’ve made a great guy.

As sad a truth as this is going to sound, Big Administrative Bosses and Directors in healthcare could care less about the well-being of their employees most of the time. They don’t exist to make anyone’s life easier. They’re far more interested in their next promotion and making money for themselves and their facilities.

It was after that committee meeting that I finally realized I needed to find another job.

* * * *

Back to my theory…  Bikers are guys. Mechanics are guys. The more blue collar the job, the greater likelihood of it being filled by a guy. Your plumber, the guy that exposes the crack of his ass every time he squats or bends over, is definitely a guy.

Guys are good with their hands. They’re not really deep thinkers, in fact, most guy brains aren’t properly wired for deep thought. There are always exceptions to this rule. I’m a guy, and I have gone deeper into the abyss of thought than I should have. I should’ve remembered my own rule about diving too deep.

After all, I don’t know how to swim.

Ever see a person of the masculine gender appear to be deep in thought, and then you asked what he was thinking about?

“Oh, nothing.”

That, is a guy response.

Guys, and men for that matter, have a Nothing Box inside their heads, and can spend seemingly vast amounts of time thinking about absolutely nothing.

And to clarify that a bit. We’re not thinking about nothing, exactly. Just nothing important.

Man, those ribs I ate last night were really good! I wish I had a truck like that…  Am I going bald? Whoa! Nice tits. Yep, I am totally going bald…

Seriously. We can think about tits for hours on end and nothing else. Unless those ribs were really, really good.

Guys are simple creatures; amoebas are probably more complex than the average guy. For example, most guys can’t correctly spell amoeba.

Men are a bit more complex than guys, if there’s such a thing as a complex man. I’m still not sure about this. I think men are far more confused than complex, but they say they’re complex because they think it makes them appear mysterious.

Men tend to become professors, doctors, layers and politicians. You know what? Men appear to be the root of all evil…  Bastards!

Men have aspirations, and plans, and they don’t let much of anything stand in their way. Guys have dreams, and they’re by and large content to dream. However, do not, under any circumstances try to destroy a guy’s dream. He will fuckin’ kill you.

That’s pretty much it. If you made it this far, I commend you. Thanks for hanging in there.

Okay, Mr Noble. I’m ready for my prize.

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.

The Jawbone of an Ass

My jaw has been bothering me quite a bit lately. It’s been a little over eight months since I was assaulted, resulting in the nondisplaced mandibular fracture that certainly doesn’t feel all that nondisplaced to me.

My dentist at Surprise Smiles 😆 told me it could take up to a year for my jaw muscles to realign to the new profile of my bite. This wasn’t what I wanted to hear back then, but if it will truly take that long, the good news is I have a mere four months to go.

I have sustained several physical injuries during my career as a psychiatric nurse. I also sustained several more injuries during my career as a drunken moron. These two careers overlapped each other for at least ten years, so it’s hard for me to separate them sometimes. The net result is pain, and for anyone that lives with daily chronic pain, it really doesn’t matter where or how it originated. You simply have to learn to live with it.

I was physically assaulted on three separate occasions during my nursing career. That averages out to one assault roughly every ten years. Somewhat oddly, I was struck in the face each time.

The first time, I never saw the punch coming. I was working at the MVAMC. My back was turned to the guy that hit me. Merrill came up behind me and suckerpunched the right side of my face because he wanted to go smoke, but I had taken away his smoking privileges because he was being an asshole.

It took me a moment to figure out what the hell got happened, and then it hit me, so to speak. That sonuvabitch punched me! My first response was to immediately punch him back. Yeah, guy logic, if there is such a thing.

My co-workers intervened. Merrill was quickly whisked into a seclusion room. I was sent to Employee Health be evaluated. I sustained no serious injury, but the doctor gave me the rest of the day off, just because.

The second assault occurred at Aurora. It was my second year there. I remember it as The Year of the Borderlines. My unit was generally designated as the  Marginally Functional Psychotic Unit, but that year we got hit with a tsunami of patients with Borderline Personality Disorder.

One Borderline can be enough to stand your unit on its head. A gaggle of Borderlines (?) A gossip of Borderlines…  I like that! A lots of Borderlines gathered together is rarely a good thing, particularly if you’re a psych nurse. And especially if the gossip is gaggling on your unit.

It takes an awesome skill set to effectively manage that.

The patient in question was Melissa, maybe. I used to remember everything about every one of my patients, but they eventually melded into one multi-headed mutant patient. Mel was having a difficult day obtaining the level of attention she desired, so she decided to go full on Drama Llama and had a VPM–Very Public Meltdown. Mel was good for usually one of these a day. She would set off a chain reaction with the rest of her Borderline buddies, and chaos would ensue.

On this particular day, I didn’t respond the way she wanted me to (I didn’t call the doctor to get injectable meds), so she stormed off to her room to slam the door and scream.

Karen Rae Goff, social worker extraordinaire, happened to be on the unit at the time. Karen also happened to be Melissa’s social worker, so we went to her room to see what Mel had planned for her next move.

“Get out of here!” Mel screamed at us as I opened the door.

“I need to know that you’re going to be safe.” I said, from the doorway.

“Leave me alone, or I’ll kick your fucking ass!” she screamed. And then I did something stupid:

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Melissa launched herself at me and started swinging. I blocked her first punch or two, but then she caught me with a left jab that knocked my glasses askew on my face.

That stirred something inside Karen, and she let loose on Melissa with her Mom Voice, and Mel was so stunned she stopped acting like a temper tantrum toddler.

“I can’t fucking believe you did that.” I said, and calmly readjusted my glasses.

“You asked for it.” Melissa replied.

“Are you going to press charges?” Karen asked me. It’s a felony to physically assault a healthcare worker in Arizona. Melissa let a momentary look of panic escape, and that’s when I fell in love with Karen. We never had another problem with Melissa. She was a little angel for the remainder of her stay.

And that brings us to Assault #3, which also happened at Aurora.

That day started out like any other day. Dr Sbiliris, the psychiatrist assigned to the Canyon Unit, came onto the unit to meet with his patients. One of them, a young kid named Desean asked to be discharged. Dr Sbiliris kind of laughed and said, “No, probably Friday. Maybe Wednesday.”

Desean seemed to accept that, even if it wasn’t the answer he wanted to hear.

And then something happened that should’ve sent my Spidey senses tingling. A patient on the Canyon Unit started loudly acting out, and when the staff from other units rushed over to aid and assist, Desean bolted out the unit doors and made a break for freedom.

We took care of the Yelling Guy. Desean fell short in his sprint to escape. He returned to the unit with an escort, and went to his room. And there was peace in the Canyon once more. Until 2:00 PM.

That’s when Desean entered the dayroom and started yelling and throwing stuff.

My boss of bosses, Lori Milus, must’ve been having a rare quiet day because she had come down to chat. I went into the day room. One of the BHT’s was trying to verbally redirect Desean, and I provided back up. But Desean wasn’t having any of that shit.

“Come on, man.” I said. “You know how this works. Sbiliris says that to everyone. He wants to see how you’ll respond. You know acting like this isn’t going to get you out of here. If anything, it’ll extend your stay, and you clearly don’t want that. Use your head, think about this!”

Desean and I were standing in the doorway of the dayroom. The nursing station and the unit doors were behind me. The hallway leading to the patient rooms was behind Desean.

He didn’t say anything, as if he were contemplating the veracity of my words. He appeared to me to start turning to his right, and I thought he would keep on going and go back to his room. I also started turning to my right, thinking my work was done. But Desean was merely loading up. He stopped turning to his right and reversed direction. His right fist came flying at me at about the speed of light, catching me squarely on the jaw.

unnamed-1

I was launched into space, much like that. I landed by the unit doors, seven or eight feet away. Desean may have howled in triumph. He ripped off his shirt, daring me to get up and fight him.

Like that was going to happen.

I didn’t lose consciousness. I even kept my head elevated so it wouldn’t hit the floor. But I don’t think I could’ve gotten off the floor just then if my life had depended on it.

One of the darling nurses I worked with, Lindsey Stirling, picked up my glasses and protectively leaned over me as I lay on the floor, trying to out figure out what I should do next. Another nurse, Brea Bils, one of my darlingpreshadorbs work daughters, tried to check my blood pressure. She later told me she no idea what she was doing. She thought I had gotten dead.

I knew I didn’t got dead, so I think I even said that.

“I’m not dead. I didn’t lose consciousness. My jaw…is really sore, but other than that, I’m okay.”

A group of BHT’s had escorted Desean into one of the Overflow rooms. Aurora was the only psychiatric facility I worked at that didn’t allow the use of seclusion and/or restraints to manage a behavioral crisis. Desean got several injections. And he was kept under close observation by several large men.

Once Desean was medicated and no longer actively assaultive, my boss asked me if I wanted to press charges. I did.

If Desean had been psychotic and responding to internal stimuli, that might’ve changed my decision. But Desean wasn’t psychotic. He didn’t get what he wanted, and he decided to act like a thug. That definitely was a factor in determining my decision.

The police took my statement. They took Desean into custody. Thankfully, Frankie Baby wasn’t there, or the police would’ve had to arrest him for murder. And there was peace in the Canyon once more.

I didn’t find out my jaw was broken until the following day when I had a CT scan. Because my fracture was nondisplaced, there wasn’t much of a treatment. I was on a soft diet for six to eight weeks; nothing but soups, smoothies and ice cream.

I bought the world’s most expensive smoothie. I lost ten pounds. I gained all of them back once I could eat real food again. And now I’m learning to live with my new occlusion pattern. It’s a process. Some days are better than others. Today, it hasn’t been too bad. Yesterday fucking sucked.

And as Forrest Gump said, That’s all I have to say about that.

Get out and vote.

Fabulous Roya

One of the most pleasant surprises I would experience working at Aurora was Roya, or as I came to think of her, Fabulous Roya. The photo above was taken at Christmas. Roya might be Iran’s Christmas present to America.

Roya was an RN. She worked full time at an Eye Surgery Clinic in Scottsdale when I first met her. She picked up extra shifts at Aurora on the weekends because, well, you never know what’s going to happen, and you shouldn’t put all your camels in the barn before the peacocks have their pajamas on.

I’ll tell you what. I used to spend a lots of time in Texas, and when it comes to turning a phrase, can’t nobody beat a Texan. They have a way with words, Texans do.

Now I’m gonna tell you damn what–Texans got nothing on Persians when it comes to turning a phrase. And not even a Texan can hold a candle to a Persian when they start waxing philosophic about life, or love, or food, or anything. And maybe it’s not all Persians. Maybe it was Roya. After all, she is fabulous.

I will never forget my first time working with Roya. My wife took one look at me when I got home and started dialing 911. I had to convince her I hadn’t been assaulted and ended up with a traumatic brain injury. I had a dazed look in my eyes.

“I’m fine. I just worked with Roya today.”

“What does that mean? What’s a ‘roya’?”

Roya’s family fled Iran after Mohammad Reza Shah Pahlavi was ousted from the Peacock Throne in 1979. She was the youngest of something like fifty children; the Prophet David would’ve been proud. This was perhaps the only subject Roya wouldn’t expansively talk about, but I think Roya was an honest to Allah, 100% genuinely real princess in Iran.

She came to this country, learned to speak English and got her nursing license. She got a job, divorced her husband, bought a house, and renovated everything inside and outside of it. (Spoiler alert! It was fabulous!) She built a life of her choosing, and continued her education, getting her Master’s degree in Nursing and she’ll be nurse practitioner by the end of the year.

Roya told me she became a nurse because the nurses in Iran wore the cutest outfits back before the overthrow of the Shah. I did a Google search. Iranian fashion was very Western before the Ayatollah took charge and burned all the miniskirts and go-go boots, and I think that’s what Iranian nurses once wore. I encouraged Roya to dress like her nursing idols, but she declined. That doesn’t mean she donned a chador–I didn’t call her Fabulous Roya for nothing.

Roya was one of the best nurses I’ve ever worked with. If there was a code of any color, Roya was always one of the first responders. There was one time I know of that she was the only responder. I used to be a first responder. The longer I worked in Psych, the less likely I was to actually respond to a code, unless it was on my unit. Also, the longer I worked in Psych, the less likely it was that there would be a behavioral code on my unit.

On the second day I worked with Roya, one of her patients started escalating. He probably wanted more meds, or different meds. And by different I mean Ativan, or maybe Subutex. Roya told the guy what she was willing to do for him, and she also told him what she wouldn’t do. She’d check his MAR, talk to his doctor; he was going to have to be patient and wait, but she was going to take care of him. And she called him Sweetheart. I can’t recall if the guy got what he wanted or if he was so stunned he simply walked away, but Roya was impressive.

“When I first saw you, I figured you were just another pretty face, but you’re a damn good nurse.”

“Seriously, you think I am just pretty, and nothing else? Markie! I can’t believe you would think that about me!” See? Fabulous.

Part of Roya’s charm was her voice and her accent. Replicating the sound of someone’s voice isn’t easy to do in a narrative. And in terms of Persians, what do most Americans think of when they hear that term? The Shahs of Sunset? I Dream of Jeannie?

Roya’s voice is what Jeannie’s voice should’ve sounded like. It was lilting, it was lyrical and musical. And it was non-stop.

In an earlier essay, I talked about my friend and mentor, Sondra, and I mentioned that she liked to talk. Sondra was a catatonic mute compared to Roya. Sondra was talkative. Roya was hyperverbal, on steroids. Seriously, I have never met anyone that wasn’t hypermanic, or on methamphetamine that talked as much as Roya. I doubt Roya had much self awareness about this aspect of her personality, and I know she had even less awareness about her volume. She even processed her thoughts out loud.

That part wasn’t so charming. In fact, for myself and almost everyone that ever worked with her, it was exhausting. I have described certain people I know as a force of nature, like, for instance, my wife. After working with Roya, I think Forces of Nature need to be measured on something like unto the Fujita scale for tornadoes. And based on that scale, Roya was an F-5. Maybe an F-6.

We all have our issues, right? Well, you do. As I sometimes tell my daughters, can’t everyone be perfect like me and you. And when it comes to fabulous, well, there’s only one Roya. The rest of us look like the Three Stooges trying to get a cat out of a tree compared to Roya.

I’ve been retired for a little over a month. Do I miss working for a living? I might, if I weren’t living in heaven on earth. Do I miss the people I worked with? Yes. And some of them I miss a lots.

Dooset daram, Fabulous Roya. I miss your koon.

The Muppet Woman

Sue Severson gave Ailene her nickname. Ailene was one of our patients at the Minneapolis VAMC. I had been working there a little over a year, I think. I had been an RN for about three years or so. Sue was one of the nurses I worked with. She was younger than me, taller, attractive, long blonde hair. She had been at the VA longer than I had, so she was teaching me how to be a psych nurse.

“Doesn’t she look like a muppet? I mean, it looks like someone has their hand inside her head, making her jaw move, doesn’t it?” Sue said. She was getting kind of obsessed with the whole muppet theory thing.

Well, yeah, I suppose. I thought. Ailene did kind of look like a muppet. She was an older African American woman that stood about four and a half feet tall. I think she was around fifty years old when I first met her, but she looked to be closer to seventy. Her eyes were overly wide, so she had the appearance that her eyeballs were trying to jump out of their sockets. And she had one of the weirdest voices of any of my patients ever, like Elmo on helium, maybe. Ailene became the Muppet Woman that night.

The Muppet Woman was a relatively benign crazy woman most of the time. Sometimes she’d get all worked up about something, but she was easily redirected, and rarely a problem. She had never been violent or assaultive before, and therefore not a serious problem.

I was working the night shift. It had a been an uneventful night. Sue and I had been talking at the nursing station. There was one more nurse working the unit with us, a hulking taciturn woman who rarely spoke to anyone.

Sue had been telling me she had to pee for the last hour. I got up to do rounds on the unit, and had just checked on Ailene. She was in bed and appeared to be asleep. I filled in the blanks on the Rounds sheet. I was standing in the hallway facing Ailene’s room, which was about halfway down the hallway from the nursing station, when I heard the sound of a Helium Elmo being possessed by the devil. I looked up to see the Muppet Woman charging me like a fullback headed for the end zone, screaming as she ran.

I dropped the clipboard I was holding to the floor, and caught one of the Muppet Woman’s arms before she hit me. Her free hand grabbed my shirt and pulled. Hard.

Pop pop pop pop pop went the buttons, flying off my shirt and bouncing off down the hallway.

“Hey!” the other nurse we were working with said. I remember being more surprised by that nurse speaking than I was by being charged by a possessed muppet.

“Help! We need help over here!” the nurse called out toward the nursing station, then proceeded to envelope the Muppet Woman in the steam shovel maneuver. She essentially scooped the Muppet Woman into her arms and carried her down the hallway.

The only thing not perfect about her intervention was the Muppet Woman was still firmly gripping my shirt, and I was being forcefully pulled down the hallway by a possessed muppet in the arms of a big nurse moving like a bulldozer.

“We need help over here!” I said loudly, looking back over my shoulder. I saw Sue Severson fly around the corner, then fall to floor laughing when she saw me being dragged down the hall by the Muppet Woman and the Bulldozer Nurse.

Bulldozer carried the Muppet Woman, and dragged me, into a seclusion room, where we waited for a moment until back up arrived in the form of Sue, who was laughing so hard she almost peed her pants.

Bulldozer saw help arrive, and dropped her load. The Muppet Woman fell to the mattress on the bedframe, and because she still had a death grip on the front of my shirt, I fell on top of her. Sue gave out a little scream because this time she did pee her pants, a little, but that didn’t stop her from laughing.

I don’t know who Bulldozer was more irritated with by this time, the Muppet Woman, me or Sue.

“Oh! That’s enough of this nonsense!” Bulldozer snapped, and pulled me off of the Muppet Woman, who apparently had no intention of ever letting go of my shirt. And it was right about then I started wondering what I had done that had enraged the Muppet Woman in the first place. “I said enough!” Bulldozer snapped at the Muppet Woman. “Let go of him!!” she ordered, and grabbed the Muppet Woman’s arm.

“Get your fat hands off me, you gray haired old whore!” demon-possessed Helium Elmo Muppet Woman shrieked back at the Bulldozer nurse. Her crazy eyes were popping in and out of her head simultaneously.

“My hair isn’t gray,” Bulldozer replied meekly.

Sue let out a higher pitched scream, because she peed her pants again. This time, a lot.

I never did find out what I did to the Muppet Woman that made her react the way she did that night. She died not long after getting out of the hospital.

Bulldozer retired and moved to Arkansas a couple years after that incident. I loved to tell that story to my co-workers. Bulldozer never thought it was as funny as I did. And she never forgave Sue for acting so unprofessionally, and for pissing all over the floor.

Sue Severson transferred to the Outpatient Department. She was only nurse I ever worked with that laughed herself incontinent while responding to a behavioral management situation. She would eventually marry my boss and make at least one baby with him before I left the VA. She forgave herself for pissing all over the floor. So did I.

“It’s not like the Muppet Woman was actually hurting you, and you should’ve seen how funny you three looked…”

All true. I was probably in more danger when I was being dragged down the hall by Bulldozer.

But I learned some important things that night. Never, ever, let your guard down at work. Always know your crew. And take bathroom breaks. You just never know…