Wednesday, February 23, 2011

Mourning On My Mind

The last several days have been...trying.

I thought that I'd escaped the Night of the Living Promotion Folder by successfully promoting to full professorship last year, but no, I got appointed to that very committee. My mentee is on her up-and-out, the life-or-death jump in academe. We are on the final push this week, concluding with a full-day of sequestering on Friday for critique and voting on all of the candidates.

Yesterday was the fifteenth anniversary of Stacy's death. I went off to my cousin's funeral on the other side of the state wearing a memento mori made at my request by a jewelry-crafter that commemorates the event. It was the second trip to a funeral home inside seven days. A friend's father, who was the same age as my mother, passed away suddenly on Valentine's Day, so I had to run home to Smalltownland one evening for the viewing. That Saturday, my mother's first cousin, passed away.

It points up something that I am loath to admit: I only see my family and childhood friends at the funeral home these days. Time was, it was weddings and funerals, but now...

It's a little depressing.

Anyway, I'm exhausted, behind on everything, and in need of a) a bag of dog food and b) some rest. Onward to the store...and hopefully, a little sleep at some point. I'll catch y'all in a few days, okay?

Wednesday, February 16, 2011

Distress Signals

When I was two, my parents began construction on a house about two blocks from the local hospital. My father's logic was that in really bad weather, he could walk up there to make his daily rounds...something that proved on the prophetic side about four years later during some of the only true blizzard conditions Kentucky has ever experienced.

I'm old enough to remember the very first flight ambulances: Huey Medevacs from Ireland Army Hospital in Fort Knox. If you are unfamiliar with a Huey configured for this purpose, you must never have seen any movies about the Vietnam War...especially not "Apocalypse Now", famous for the cluster of Hueys emerging at the horizon to 'Ride of the Valkyries'. They really were military green, and Medevacs really had the big white box on the bottom with an enormous red cross inscribed in it. Like Radar O'Reilly, I can hear a helicopter coming in from miles away, before anyone else notices. My family is still spooked by that.

Sunday night, as I was taking leave of my parents, I suddenly froze and said to my mother, "The helicopter's coming." She looked puzzled, and about a minute later, she heard the blades beating against the air. It's a distinctive sound; in Smalltownland, it's a bad omen.

Our tiny hospital is unequipped to handle major trauma. The Hueys used to take trauma victims to the base hospital at Knox, where experienced field surgeons who'd seen the battle carnage of a jungle war or two would make their valiant headlong charge against gruesome death. These days, a private commercial flight ambulance takes patients to a trauma ward at one of the city hospitals about ninety miles away. They will set down at the nearest hospital if the patient codes- my father's medical partner coded minutes after takeoff and died on the helipad of the neighboring town's hospital (he had already been resuscitated from a massive heart attack).

I made it as far as the intersection before a city police officer whipped out in front of me to block the street directly in front of the hospital. Traditionally, law enforcement and rescue blockade so that the helipad is free from interference. For some reason, I had a really bad feeling about this one- the helicopter was just touching down as I turned the car to leave by the only other means of egress.

I was right. I know the family. It ended badly.

I'm sure to most city-dwellers, a helicopter generally means some wealthy industrialist zipping around, or a news crew hovering overhead. Where I come from, it's a harbinger of death. I don't think I'll ever outgrow it; it's been difficult working next to an airport that incorporates a helipad. I also live in the flight path to the local hospital, something I didn't realize until I was out walking my dog a few weeks after I moved into my house. I thought I heard the faint beat of rotor grew clearer, and I saw the landing light illuminating the belly of the ship. Great.

The hospital here is much larger and more complex than the one back home, with a staff of several specialists and surgeons ranging from general practice to neurosurgery. There are still some things outside their purview, though. They, like the Smalltownland hospital, send the trauma patients out, in this case to the SFU hospital.

One quick aside: your health insurance and automobile insurance (if you are involved in a car accident) may not cover airlift, or a significant portion of the cost of an airlift. In the South, there are various regional subscription air ambulance services- subscription can defray a great deal of that cost. In rural areas, this was also common practice for ground ambulance services for many years; ours was self-supporting on a subscription basis before the county government picked up the bill. For both Smalltownland and Lake Redneckville, the air ambulance service is Air Evac Lifeteam.

Monday, February 14, 2011

VD: Another Year, Another Lesson

I ran into the parents of a childhood friend last night while doing my parents' grocery shopping in WalMart. They told me that both of their children, the son (who was my friend) and daughter, have disowned them. I did not have the heart to ask why- their son disavowed me about a year ago, too. I don't understand that, either, although there's a probable cause I'm not going to discuss in a public forum. Rather than speculate, I'll just say that it hurts to have that knife protruding from my back; if he'd do this to his own parents, I've escaped with lesser injury by far. His mother said that she does not even know her grandson's name, and I could feel my chest tightening.

There are some parents who have that kind of thing coming- no, I don't mean mine by any stretch of the imagination, but here again, I'm going to defer this one for future comment. These people, to my knowledge, didn't; but they raised their children to be independent thinkers and survivors. My former friend and his sister have chosen, therefore, to be independent of their parents and to survive on their own. I cannot fathom it.

The other thing that this year has brought me is that some old heartaches never quite go away, nor will they be completely silenced. We have to take responsibility when we reopen those wounds, though. Third time's the charm; I cannot measure my worth against a heart that abandoned me a lifetime ago.

Also for the first time in many years, the Nashville Lawyer did not send me flowers. I think everyone on the staff half expected it- but I knew it had to end someday. He was the first man to send flowers to me at work for Valentine's Day, so I'm grateful that he kept me from being a complete failure in the Obvious Valentine's Day Gift category. I still marvel at how effectively he stole his own thunder the year we were dating and he sent me two dozen roses; he was so quick to make sure that I didn't read anything into it that, well, the giddiness was transient. Just a hint, gentlemen: don't tell the woman you're dating and to whom you have just sent a gift of two dozen roses that you paid a similar floral tribute to your elderly great aunt and your mother. While that shows how well brought-up you are, it ruins the gesture. It also makes the lady in question feel like an absolute fool.

Over the weekend, I heard from an ex who touches base at random every once in a great while...another of my admirers who thinks I'm swell, aside from my just not being worthy enough to date. Ugh.

I guess I'm not much for this holiday. It's never been particularly kind to me, so I suppose it's too late for me to revel in all the hearts and flowers that go with it. I'm kind of the Grinch in the pink sweater and heart-shaped pin, trying to force myself through the day. On that note, I have homework to finish for my online class, and then I have to decide whether or not I want to order a pizza. How's that for romanticism?

Friday, February 11, 2011

The Bitter With the Sweet

This time last year, my colleague and supervisee, Patricia, took medical leave to have a debilitating tiredness and shortness of breath checked out by a pulmonary specialist her nephew, a respiratory therapist, had found for her in a larger town about forty miles away. The doctor ran some preliminary tests and put her in the hospital immediately.

She'd been ill for almost a year, and we'd nagged her constantly to get it checked out. Her cardiologist ran batteries of tests and found nothing- it wasn't her heart. Her family physician ordered additional tests, and found nothing. Her local pulmonalogist ran a few respiratory tests and thought it wasn't anything serious. The problem was, though, and I found this out from talking with her myself, that none of those three physicians consulted the others about any of this. I'm going to use the dirtiest word a doctor's child knows here: malpractice.

If they'd talked to each other, she might not have died, or died as quickly. From the Friday before Valentine's Day until a month later- from the first good diagnosis, to her untimely death. She was in her fifties. She had a new grandchild. She suffered horribly that last year, but she put her faith in three doctors who were too vain, lazy, or careless to talk to each other about what was happening to their mutual patient.

When we learned what was happening, I did what I usually do in such cases: I called my father and presented the pathology as I knew it, and waited for him to tell me what was wrong. Never discount an old G.P. just because they're old: the guys in my dad's generation of doctors had a damn good education, and my father pursued his interests in cardiovascular and pulmonary medicine as much as he could while practicing general medicine as half of a very busy joint practice. The Old Man was in Georgia, in the session, on the day that the French decrypted their AIDS research...and he knows more about HIV/AIDS than most younger doctors have forgotten.

He listened carefully and said, quietly, "Your friend most likely has pulmonary emboli. There are a lot of things that could've caused it. It sounds like she's past treatment. You should prepare yourselves."

She was moved to Vanderbilt Medical Center in Nashville, Tennessee, where she was sitting up in bed one day, talking to her husband and flipping through magazines, and then suddenly...she was gone. She just stopped, and it was over. In a single month, she went from feeling miserably sick to being dead.

Medicine is a crapshoot. That's not to say that had her local doctors communicated with one another that her death could've been, with any certainty, prevented, but early treatment might have mitigated things significantly, both the suffering and the swiftness with which death came. I say this because I've been in respiratory failure myself, at the ripe old age of thirty-five (it was corrected a couple of years out with surgery). My mother now has emphysema, COPD, a partially collapsed lung, and congestive heart failure. I know how it feels to slowly suffocate because you can't will your own lungs to work correctly anymore. I know how it looks, because I have to see it every time I go home.

There will be times that you've got to get up on your hind legs and make your doctors pay attention. Don't fail to do it. Don't let them drop the ball, because that ball is your life. Cling to it with every fiber of your being. Fight like hell.

Happy Valentine's Day, Patricia. I'm sorry it went down this way. Wherever you are, I hope that you know somebody misses you.

Monday, February 7, 2011

The Moving Hand Having Writ...

My parents both have quick tempers, although my mother is slightly better at governing hers. I inherited it from both sides, and when I hit puberty, it was Katy-bar-the-door on my verbosity. I was, in a word, volatile, and it took me a while to get it under control. The one thing that I didn't want to hear coming out of my mother's mouth was:

"Madam, I will thank you to moderate your tone."

I was about to get it if that popped out. She recorded some of my better tantrums, and when I was in my late teens, played them back for me. Mortified much? Oh, if there'd been a big hole in the yard, I'd have gotten in it, covered myself with dirt, and stayed there.

Tone is important. What differentiates a great writer from a mediocre one is the ability to effectively evoke tone from the written word. I think we often lose that, especially in the current overload of non-verbal communication, i.e., the Internet. The word "civility" is much bandied-about these days due to the rising tide of vitriol in political discourse, but it's something we need to carefully observe in our casual online conversations. I am, by nature and as a means of controlling my temper, quite sarcastic. It doesn't translate well into writing unless you know me personally...and has resulted in bruised feelings and punctured acquaintance from time to time.

Hopkins, for example, is quite literally-minded. I hope that he remembers me well enough to read the feeling behind the words, because I am frequently sarcastic about any number of things in my e-mail exchanges with him. I am far more circumspect in what and how I write to others, largely because very few people know me quite as well as he does. It pays to be a bit guarded. You can't really tell how people will take things in the absence of the accompanying vocal modulation and facial expressions.

Much as you can't un-say things, you can't un-write them, either. Thinking before you speak or before committing word to paper (or screen) is probably still an excellent idea. Civility also never goes out of style.

Saturday, February 5, 2011

Wait Five Minutes and It Will Change

I have desk duty this weekend in the Learning Commons. We have a typically schizophrenic Kentucky weather prediction: it might rain, or it might snow, or both...or possibly neither. At any rate, I opened up a half hour ago and there are exactly two students here.

Weather in my home state is unpredictable. We had mild, springlike weather one day last week, followed immediately by sub-freezing temperatures with lacerating winds the next. It's snowed on prom night several times (you folks up North are thinking, "So what?"), but prom at my high school is in April. Trust me, one of the times this happened was the night of my senior prom- I lost one of the ornamental clips off of my shoe while running to get inside; cold wind whipping up under a hooped skirt is pretty unpleasant. Since it falls around Easter, yes, it's snowed on Easter a few times, too.

My sophomore year of college, my roommate decided to attend the Derby with some of her sorority sisters. Her folks came down from Ohio to move her things back home, and she sent all of her long-sleeved clothing, sweaters, and sweatshirts back with them. She wore shorts and a t-shirt to the race, which is on the first Saturday in May, and was forced to purchase an expensive commemorative sweatshirt when it began to snow.

We are ready for the winter weather to be over around here. The college has had several snow days since the semester started, and everybody's a bit tired of rushing to the store for the Holy Trinity of snowbound necessities in the South: milk, bread, and toilet paper. I'm old enough, however, to remember the two consecutive winters during my childhood when we had true blizzard conditions resulting in a solid month of school closures. We went on Saturdays and well into June to make up the required days, which was pretty bad considering that my elementary school was built in the 1940s and had no air conditioning.

I'm sitting here eyeing the grey clouds moving toward campus. They're too dark for snow, so I guess we're going to start with rain, and we'll see where the day takes us. Whoo. Hoo. I'm telling you, Phil, you'd better not have lied to us about that shadow, because we have only one use for your ilk around here...and it's not meteorology.

Tuesday, February 1, 2011

The Joys of (Dog) Parenthood

Saturday morning, just before noon, I had to call my vet's office and explain that one of the dogs, not sure which, had consumed about eight lotion-impregnated tissues straight from the box. I strongly suspected Sister, my female Airedale, since she's the most aggressive trashcan forager, retriever of dirty Kleenex, and consumer of used dryer sheets. When she was a puppy, she had an unnatural taste for socks, clean or otherwise, which I surreptitiously retrieved from the yard upon their return and piled in an area just under the edge of the porch. My landlord was going to clean them up when he mowed one day, until I ran toward him, yelling, "Oh, Reverend Weddle, you don't want to do that!"

I'm Southern; you just don't let a minister get dog poop on his hands. It's un-Christian and profoundly ill-bred, to say the very least. I had to tapdance around it for a few minutes, then gave up and explained that those socks had been fully digested and expelled via the Airedale Alimentary Express. He took my point and left the pile of socks alone. I went out with a plastic grocery sack every so often and collected those up for the trash. Luckily, Sister outgrew her taste in hosiery.

While I waited for Dr. Hall, my long-suffering vet and fellow Airedale owner, to call back, I sat at my kitchen table carefully reviewing the ingredients in Puffs-plus-Lotion. There was nothing toxic, and I hoped that the shea butter and aloe might encourage the paper products toward a swift exit. Dr. Hall did eventually call, and as usual, was generally amused by my dogs' proclivity for eating weird things. He also said that the tissues didn't sound toxic and not to induce vomiting or anything...that they'd likely pass on their own.

I was taking this all in stride until the cats lobbed the new, full box of tissues off into the floor...and Sister ate four or five more. I'd been told to watch and see if she went off her feed, because Dr. Hall was counting on the bulk of the food to push the tissues on through the digestive tract. Lo and behold, on Sunday evening, the first tissue came out in the yard. On Monday morning, another tissue came through, but Sister was panting uncomfortably; after work, I bought a package of Fig Newtons and fed her four of them. That provoked the desired response, with one slight problem: one of the tissues got stuck coming out. Picture my poor, distressed Airedale, freaking out over this flag hanging out of her behind...

I am woman; we are conditioned from an early age to deal with unpleasantness, i.e., vomit, dirty diapers, spoiled food- you get the general idea. I keep a box of vinyl medical gloves for just such emergencies, but Sister had other ideas. It was like an Airedale rodeo at my house, with me astride the offending party, trying to becalm her long enough to extract the remains of the tissue. I finally got a grip and removed it, much to Sister's consternation. She glared at me for five solid minutes and cut me a wide swath for the rest of the night. I guess I offended her delicate, ladylike sensibilities.

Oh, the joys of pet ownership. Ugh. I think I'll be fine if this doesn't happen again for quite some time.