Update

Okay, I know it's been a while, and my apologies to my dedicated fans. But I know you'll be thrilled to hear my news. I have joined NaNoWriMo, which is the National Novel Writing Month click on that coloured text there to see details. I am planning to attempt to write a novel during the month of November. So starting Monday, I plan to write (almost) daily, and post to NovelBound.blogspot.com - (click there and bookmark it!!) where you all can read my work in progress. I expect it will be rough, and quite stream-of-consciousness, so probably not worth the paper it's printed on, so to speak, but I figured the only way I would stick with it is if I told you all and you hounded me mercilessly when I fell off the wagon. So, feedback welcome. I may hit you up for ideas if I falter. So consider yourself warned...

Anyway, I have been relatively quiet recently because I am tired out from yet another new job. This one is pretty good, and despite the fact that it is my fourth in two years, I do quite like it and may just stick with it for awhile. The last one, where I gave chemotherapy treatments, was a term position, and this one is permanent. So I could conceivably work there for the rest of my career (although I am the lowest on the totem pole at the moment, seniority-wise). T laughs when I say that. I think that he thinks I am unsatisfiable. Or that I have ADD or something when it comes to work. Anyway, I now work with two radiation oncologists in their clinic. I think it should be interesting. I still can't believe how many lung cancer patients still smoke (thank you, btw, for your feedback on that particular blog... it is still something I can't relate to but it is fascinating).

So I am off to prepare myself for the writing marathon that will be the month of November. I have no illusions that I will actually write 50,000 words in a month, but I am hoping I will use the momentum to get to a point where I feel I need to finish it. Or you harass me until I let you know what happens. We'll see. If I bail on it, I will have to eat crow. I'm committed now - if I don't write, it will be my fans and my conscience that will punish me.

Oh, and I will probably do updates here on the nights that I don't contribute anything... so if there is no post to the novel, check here for my excuse.

Residents

I have started the new job, the permanent one (as opposed to a term position, which I was in), in the same facility but a different area. Now, I work with a doctor, a radiation oncologist, to plan and organize treatment for people who need radiation for their cancer. So far, it seems like it will be interesting, and fairly challenging. And, interestingly enough, I am now in quite constant contact with doctors, by whom I have historically been intimidated, so this is good for me. And, in a teaching hospital, which this is, with doctors, come residents. Residents are fun, in that they are lower in the pecking order than even I, as New Nurse, am, and, moreover, I generally know more than they do, so I get to intimidate them for a change. Plus, some are nice to look at, and most haven’t yet developed their Doctor Ego, and are actually good teachers, when they do know more than me (I can now pick out a possible tumour on an x-ray, thanks to a nice resident).

When there is a medical emergency in our facility, a “25” is called, where there will be an overhead page stating “Adult Medical 25” and the exact location. This is a step down from a Code Blue, during which someone is without pulse and/or respirations, but no less attention-grabbing for the staff of the facility. Any doctor or nurse available is required to attend. Inevitably, ten or fifteen doctors and as many nurses swarm the poor patient, likely dragging them back from the brink as much by their overwhelming presence as by any medical miracle they might perform. In our facility, medical emergencies don’t often happen, because, despite it being a cancer treatment centre, most of our patients are not acutely ill. Few suffer from life threatening events necessitating a 25. Occasionally, in the chemo room, someone will have a reaction to a drug and a 25 will be called, but the nurses have so much experience and so many standing orders at their disposal that often, it is controlled before a doctor even arrives.

In any event, there was, indeed, a 25 at work today. And the location stated on the page was quite nearby. I was in a clinic full of nurses, and doctors, and, the ubiquitous residents. In seconds, the patient was surrounded by curious onlookers and more doctors than a golf course on Friday afternoon. The residents were the first out of the room. I watched their faces as the page sounded “Adult 25”, and I have to say that they positively lit up with glee. I think I saw one rubbing his hands together. Now I’m sure they would describe any type of code as a Learning Experience, but what I saw when they ran toward the action were men (this time it was all men) who were absolutely delighted that they were the ones who would have a quasi-legitimate reason to be right in the thick of things. I think I heard one hoping for a Code Blue so he could practice his CPR.

When my buddy nurse and I saw 30 people running around, some even with useful roles, and saw that it was not a patient of ours that was on death’s door, we went back to work, as much to stay out of the way as anything. When a few minutes later, all the residents returned to the clinic, rehashing and analyzing the event, we knew it could not have been too serious an emergency.

I guess those guys enjoy what they do. For me, at this point in my new learning curve, work is a series of tasks I need to perform correctly. For them, it is a series of events, of which they are the authors. It is apparent that most of them thrive on the adrenaline of needing to know what to do in an emergency, and being the one to do it. That they appeared to take such delight in the possibility of a medical emergency right in their very own foyer, speaks volumes for the wisdom of their choice in careers. I am truly hopeful that this, or some other career I might find, may allow me to experience the joy, the thrill that they appeared to get from our 25. I hope I am never thrilled by a similar experience. Maybe something a little less emergent, a little more human. I'll let you know when it happens.

Smoking

This blows me away.

Today I saw a guy standing on top of a big No Smoking sign that is painted on the sidewalk outside the hospital so that people don't have to walk through smoke to get into the building. He was smoking. Better yet, the hospital he was smoking outside of was the Respiratory Rehbilitation Hospital.

I have also recently looked after a woman, in her 30s, diagnosed with lung cancer, in her 30s, who comes in in a cloud of that sour, stale, ashtray smell that comes from being in enclosed spaces with many burning cigarettes, who is practically ripping her IV out the second her chemo is in, so she can go out and smoke. Lung cancer. In her 30s. So addicted she reeks of it, and can't sit still for an hour so she can get the chemo that might actually cure the cancer, if she stops feeding it carcinogens.

I also looked after a lady today who was successfully treated for lung cancer, who wants her port-a-cath (a catheter that goes into the big vein near her heart so she can get chemo and bloodwork easily without needle pokes every time) taken out because she can't afford the cab ride in once a month to have it flushed. When she was rooting around in her purse, though, I saw a pack of cigarettes. $10 a pack for smokes, but can't afford a monthly trip to the cancer treatment facility for maintenance on the access device that delivered the chemotherapy that cured her. Of lung cancer.

This blows me away. I guess I have never been addicted to anything, so I really can't relate. I can't understand a need that defies logic, that defies health. Do these people not make the connection? Or is it that they know that smoking causes cancer, but maybe just not to them? Maybe they believe that their lung cancer is the kind caused by unfortunate genetics or smog. It seems like that invincibility factor should wear off sometime in the late teens or early twenties, especially for people who have faced their mortality head on, via cancer.

I would really like to understand this. What does a craving feel like? Is it a conscious thought that you need a smoke, or is it some disquiet, some anxiety, maybe butterflies in the stomach that you know will go away if you smoke? Is it a physical sensation? Or an emotional one? Conscious or subconscious or unconscious? Maybe it's just that the cravings are so intense that it's not worth enduring them for the sake of health. Maybe the actual state of being addicted means that the hell of changing that state is, literally, worse than death.

There are several reasons I do not smoke. One is purely vanity. It makes you ugly. You can tell at a glance someone who has smoked a lot for a long time. They have that stereotypical smoker face, the face that almost seems like it's been left in the hot sun too long and has melted, just a bit, with deeper, longer lines than there should be. I spend lots of time and energy and money trying not to look 33, I certainly don't want to do anything that will make me look my age, or older.

Another reason I do not smoke is emphysema. I feel claustrophobic at the thought of having to gasp for every last breath. I panic at the idea that I might not be able to walk to the bathroom or speak three words in a row, or eat a meal because I was too breathless. I can't even stand the thought of scuba diving, because of the possibility of running out of air (although interestingly enough, I would consider climbing mountains, where there is little air), let alone the idea of being breathless at rest, on dry land.

The other thing about smoking is that I am fundamentally cheap. I cannot fathom scrounging nearly $100 for a carton of cigarettes, however fast or slow they would be consumed, when there are (for example) so many pairs of shoes out there, looking for good homes, that can be enjoyed over and over. I wonder how many pack of cigarettes would equal the cost of my new kitchen?

Anyway, if anyone can enlighten me on the subjective experience of addiction, I am interested. I would like to be unjudgmental and understanding. I would like some insight. I am consumed by curiosity about the sensation of a physical need so overwhelming that one would be willing to die for it, however concrete or abstract the risk might be. So, to those addicted to something, anything, share your experience with me. Privately or publicly. I am fascinated. Help me understand.

Blankets

We have these blanket warmers at work. They look like big, stainless steel fridges, but instead of making food cold, they make blankets warm. We use a lot of warm blankets with cancer patients. I guess when they lose weight and get all cachectic, they are always cold.

One night, when I was still working at the hospital, I was doing a shift on the orthopedic ward, and I had a patient, a woman, who had just had a hip replaced. It's quite a painful surgery, as I understand it, and she asked in the middle of the night if she could have a warm blanket. They discourage us from using them in the hospital because they are expensive, apparently, but, since this lady was in pain and I had already given her all the drugs at my disposal, I figured I would blow the budget on a warm blanket. So I brought it down to her, I might have even brought two. I tucked it under her existing covers and whipped them up on top to keep in the heat as long as possible. "Oh, God," she said. "This is better than sex!"

Last week, at work, I was looking after a particularly thin woman with a good sense of humour. I got her chemo dripping and asked if she needed anything. She asked for a warm blanket. Thankfully, this forward-thinking institution actually encourages us to comfort our patients in whatever way works, so I got her a blanket and tucked it around her. Her eyes rolled back in pleasure, just like my ortho patient's did. So I told her about the other patient's comment about how much she liked warm blankets. It was a risky story to tell; I didn't know this woman well, and for all I knew, she may have been a religious zealot who didn't believe in pleasure, so I was risking offense. Luckily, we did end up sharing a good laugh about it. I think she even commented that she felt sorry for the other woman, if her sex life could be outdone by a blanket, hewever warm.

A couple of days later, I was looking after the same woman. I got her chemo rolling again, and asked if she needed anything. She said, "You know, I could really use a warm blanket. I haven't had a "blanket" in at least three days." Then she winked at me.

I think she is my new favourite patient. I hope she gets better.

Bed

I love my bed. It may be the posession I love most in the world.

I spend a good part of each day thinking about when I can next get into my bed and curl up, or stretch out, depending on how chilly I am. The more fatigued I am, the more persistent these thoughts are.

My bed has a history. When T and I moved into our first house, the bed would not fit up the stairs. We had to saw the boxspring in half to get it into the bedroom. For a while, it held with a few screws, then it needed a little support at each end where the cut was. Eventually, it needed to be flat on the floor to prevent a major crevasse, and we got rid of the frame.

Recently, I decided that we needed a grown-up bed, seeing as we were grown up people. But I am too cheap to buy a whole new mattress and boxpring, so we screwed a piece of plywood to the bottom of the mangled boxspring and it has once again become quite functional. We have a real headboard and matching nightstands and everything.

When I worked a lot of night shifts, I longed for my bed the way a starving man fantasizes about food. Some mornings the only thing that got me home from work was the thought of my big, empty bed, just waiting for me. I used to climb in and roll around and say, "I've missed you, bed!" (it's true, ask T). Or on the last morning before a set of nights, I would sigh longingly and tell it when I'd be back, as if it missed me as much. I love my bed so much one might almost accuse me of infdelity.

My bed has healing properties, too. Yesterday I was home from work with a nasty cold. I lounged and snoozed all day, and guess what? My cold is practically gone! And no, it had little to do with chicken soup and sleep... it was all the bed.

My bed has a feather bed on it and a down comforter on top. I have a body pillow and all the pillow cases match (I sleep better when they do, really). Of course I have a fondness for the bed; my husband sleeps there and both my children can trace their origins in its direction. It has also been the scene of several rousing games of Scrabble, buckets of morning coffee, usually delivered by my one and only, and a lot of snuggling, tickling, roughhousing family fun. Plus a few unmentionable moments, needless to say (how could an ode to my bed pass without mentioning the unmentionables?).

I would bet that most people love their beds. Bed is better than your favourite comfort food. It is always comfy, warm, welcoming, and generally pleasant. Even when you feel rotten, your own bed is where you want to be. It's why our outpatient cancer treatment facility works so well... people do much better when they can go home and feel sick in their own bed than in some cold and sterile hospital room. Comfort increases well-being, which in turn improves health. People recover faster when they are home in their own beds. I wonder if that's ever been studied. Sounds like a good Master's thesis to me.

Well, I am off to complete the most basic of household tasks necessary to remain a contributing member of this family before I... well you know... I'm sorry. It's past my bedtime.

Survivors

Today was The Run For The Cure, a 1 or 5 km run/walk event sponsored by the Canadian Breast Cancer Foundation. A large number of cities across the country host it on the same day each year. Here, I would bet there were 8 or 10 thousand people out to raise money for breast cancer research.

It was a cold morning. The sun shone briefly during the run, but the wind was wicked. The kids and my mom walked the 1 km route, T and my dad and I ran the 5 k. It was a brisk run, a good pace. At the finish, we saw the kids there waiting for us and ran over and grabbed their hands and we, all four, crossed the line together. All in all, it was a good, wholesome experience of fun, fitness, and a good cause.

The route for the 5 km run went over a bridge and then looped around and under itself before doubling back. The crowd was so massive, that we could still see people streaming over the bridge as we went under it, as thick as at the front of the pack. All for the same purpose. There were people out there who had never run a step in their lives, but came out on a frosty, windy morning, because they knew or loved someone who had breast cancer.

There is something to be said for feeling like you've made a contribution to a good cause, and, hey, I also got a run in, too (no, I probably woudn't swim or cycle for the cure). But I have to say that it is the survivors that have inspired me to come back for three years (and probably more).

It is kind of overwhelming to be part of such a huge crowd of people, all there for the same reason. Thousands of people, each donating or raising money for "a future without breast cancer". Many participants had signs pinned to their shirts that said "I'm running for", and each person wrote in the names of the people whose breast cancer experience had touched their lives. I saw many "I'm running for" mom, sister, aunt, grandma. Some had photographs pinned to their bibs, others formed teams in memory of someone. Too many young children were running for their mom. Each of those signs brought a lump to my throat.

I admire each one of those survivors, for what they have endured, and what they live with each day. Survivorship starts with diagnosis, and it changes a person fundamentally. There are experiences that only survivors can have, and although it is a club to which I do not aspire, I see how they are made better people by and for their experiences. Survivors themselves often say that they would never want cancer, but the experience of it ended up being a positive one, for the legacy of strength and "knowing what you're made of" it leaves behind. Each participant today got a t-shirt for their $35 (or whatever more you could raise) donation; the breast cancer survivors' shirts were pink, everyone else had white. Their shirts were somehow, to me, and I hope to them, symbolic of their struggle and their triumph: a badge of honour. Even those who didn't, ultimately, survive, were survivors for a time, and their experience was significant to them and their families.

So when I ran today, I ran for the cause, for the exercise. I ran for the families of cancer, because, in a way, all those kids are survivors too. But mostly, I ran for the survivors themselves, however short their survivorship might be or have been. I ran for their courage and the strength that every one of them found, somewhere, within themselves. I can only hope that if I were thrust into that club, I could find the power to make it into a positive experience, and to Survive.

Milestones

Today was a monumental day in our house. Two major milestones occured.



First of all, Aimee lost her first tooth. It has been loose for a while, but she never seemed that interested in getting it out of her head. I remember being terrified that losing a tooth would hurt, so much that I actually swallowed one in my sleep, I was so nervous. My sister, on the other hand, was so excited at the prospect of Tooth Fairy loot that she would work at any tooth that had the slightest inkling towards loosening, until it was gone, usually within a day or two.

I figured we were good for a while before we needed to deal with such bittersweet milestones. Aimee had not a tooth in her head until she was well over a year old (the reason she had the benefit of breast milk until she was a full year). I was always told that the later they get teeth, the later they lose them, and the better able they are to take care of them. Ironically, it was Aimee whose last two molars came in rotten (congenitally, I am assured, not necessarily due to all the crap I allowed her to eat as a young child) and had to be capped at age 3.

But now, there is a gap in her smile, a gap of which she is extremely and justifiably proud. She was goofing around on the trampoline with the next door neighbour, an 11-year-old boy, and they were roughhousing a bit. She says he bumped her and she suddenly noticed the tooth was gone. They found it on the trampoline, and she kept it in a ziploc bag the rest of the day so it wouldn't get lost. She was so excited that the tooth was out that she didn't freak out that it was bleeding a bit (as she would with that amount of blood from any other source).

I thanked the neighbour, because I know that if it was up to Aimee, that tooth would have stayed in until it leapt from her mouth in protest, so like her mother, nervous to pull it out.

Tonight, when it came time to put the tooth into the Tooth Fairy pillow (generously provided by Grandma recently - leave it to Grandma to be this prepared... I would have been scrambling), she seemed reluctant. She kept kissing her tooth through the plastic bag, or digging it out of the pillow just to make sure it was still there. When I asked if she wanted to keep it, she hesitated, and I told her she could wait until tomorrow night, after she showed it to grandparents and great-grandparents. She instantly agreed, and it remains in the ziploc up on her shelf of Treasures. I guess the Tooth Fairy gets a night off. But the Tooth Fairy is carrying around two bucks in her jeans pocket, just in case Aimee changes her mind (what is the going rate for a tooth these days, anyway?).

Our other momentous occasion is one that marks a significant change in our family dynamic. Jack has, today, at four-and-a-half, mastered all aspects of riding a two-wheeler. Yes, it's true. He can now transport himself anywhere he might need to go, provided it is within sight of the house.



He is as proud of this accomplishment as Aimee is of her newfound toothlessness. In fact, it was such a big deal for Jack that I wonder if Aimee knew on some level that she needed something in the order of either a broken bone or a missing tooth to compete with the attention he was getting. But he has it down pat. He can stop, start, and turn around. He proudly dons his helmet (without protest; his doctor told him he needs it) and drags whatever poor, unsuspecting (sucker) adult he can find out into the road with him. The rule is that because he is on the road he must have a grown-up along, in case there is a car that he doesn't see. Thankfully, our bay is pretty quiet, and this week has been full of street hockey and bike riding. The autumn weather is on us with a vengeance, but they are out, more happy than they have been all summer. He must have gone up and down our stretch of road about fifty times today (and complained bitterly about a chafed crotch later on). Needless to say, he fell asleep within seconds of getting into bed, protesting mightily until he could no longer keep his eyelids open.

Even though we have a full day planned tomorrow, I expect we will have Jack at our bedside at around 6:00 begging us to go outside and ride bikes. And while I am all for wholesome activities that involve fresh air and exercise, I am not at all likely to wake the neighbourhood with Jack's triumphant whoops as he careens perilously down the road with the wind in his face.

There is very little more parentally satisfying than two healthy, happy kids. One has a six-year-old's gap-toothed smile, one has helmet-hair, and both sport cheeks rosy from the fall chill, breathless with the thrill of their own celebration-worthy milestones. I am proud but mourning a little the passing of their infancy. They are no longer babies; they are kids. My kids. Great kids.