Assorted Memories (involving Emergency Rooms)

Assorted Memories (involving Emergency Rooms)

While working in triage I had two patients come in. One was a 20-something black lady with some routine complaint like abdominal pain or cramps or a bad hair day or something. The other was a 20-something white man who complained of something equally vague. I asked them both to provide a urine specimen so I could start their workup while waiting for a room in the ER to open up. The woman came back with a cup full of normal-looking urine. The man handed me a cup filled with black ink. “This is your urine?” I asked, eyebrows raised to the top of my head. “Yes,” he said. There was one open room in the ER. “Come with me,” I said as I led the man back. The woman observed me leading him back first, even though he had arrived after her. “Oh, I see how it is!” she hollered, following me to point her finger in my face. “You takin’ the white guy back before me!” I calmly turned around and stuck the jar of pitch black urine two inches from her nose. “Ma’am, this is his urine. If you can top that, I’ll be happy to bring you back first.” She looked at the vial of horrible liquid, turned around and sat quietly in the waiting room, no doubt thanking God for not having whatever causes black pee.

Working in the ER. There were five psychiatric patients admitted to the emergency room with nowhere to go. That particular hospital didn’t do psych, so the psych patients basically just wait there for a few days till their commitment papers expire. I had zero interaction with any of them all night, besides breathing the same air. At one point in the night, I was talking to a few of the other nurses. One of the nurses’ eyes opened wide as he glanced behind me and he muttered something like “Oh, shit!” Naturally I turned around to see what was happening. As I did, one of the psych patients was literally in mid-air, hurtling towards me, about one foot from me. He landed on my torso, surrounding my head with his arms and wrapping his legs around my waist. In a tiny instant I briefly toyed with the idea of asking him if he needed a hug, but then wondered if he might have finagled some sort of weapon which would currently be in his hands behind my head. The only thing I could think to say as I placed him on the floor and restrained him was “Again?!” as this wasn’t the first time something like this had happened. I am quite literally a freak magnet. (Click here and here for more freak stories.)

Though I had technically finished my shift, I decided to stay a little later to help with a patient who had just arrived. He had gotten a rubber ball stuck in his rectum. He saved himself a lot of embarrassment by being straightforward to the question ‘How did it get stuck there?’ He simply said “How do you think it got stuck there?” Well, OK. As the doctor pried it out, the guy had a good sense of humor and laughed as I congratulated him on the delivery of his bouncing baby ball. The doctor asked “Do you… um… do you want it back?” He replied completely straight-faced, “No, that’s ok. I have another one at home.” It was the first time I had seen an emergency room physician collapse on the floor in a fit of laughter.

A Beautiful Day For a Crackhead

On My High, Thoroughbred Horse

Today is a beautiful day to go to Jazz Fest! Temperature in the low 70’s, nice breeze, low humidity and not a cloud in the sky! But I won’t be there. I doubt I’ll ever be there again. You see, I fell out of love with Jazz Fest some years ago. I was there with some friends trying to enjoy ourselves. It rained, but that didn’t bother anyone; rain is just one of those things you expect sooner or later. In fact the rain provided some entertainment. It was a hoot watching all the tourists slip down in the mud. But I took a look around me - we were high up on the track at the fairgrounds near the Acura tent, listening to some well known band. We couldn’t get any closer because of the throngs of hip-to-hip hippies (or wannabe hippies), most of whom stunk and were now covered in dirt. We couldn’t see the band, but we could see them on the big TV screens. They played with as much enthusiasm as they would at their own mothers’ funeral. I could hear the music clearly; it could be described as mediocre at best. We were near the port-a-potties and a beer tent. It smelled like Bourbon Street after a particularly debauched night. Even the [very expensive] food we had consumed had been so-so at best. Another tourist fell in the mud in front of me. I laughed and pointed out the poor soul, who also was laughing. I realized then that the muddy falls were the only thing that had made me smile in hours at Jazz Fest, perhaps all day. I didn’t spent all that money and effort to come to the thing to watch tourists slip in mud, yet that was the most entertaining thing I found at the festival. It was then that I realized I had fallen out of love with Jazz Fest.

I guess a big part of my disdain these days is hypocrisy, or at least false marketing. Back in the old days, twenty or thirty years ago, rarely would you see a singer or musician from outside the realm of the Deep South. Many were up-and-coming artists, hoping for a chance at fame, but happy that crowds were listening to them play and sing. Accidentally strolling by one of their stages and being captivated by their previously unknown music was one of the most appealing aspects of Jazz Fest. A couple of times while working the medical tent, Galactic, from Baton Rouge, would play their funky jazz at the stage behind us, and later I’d go buy their music. At EMS headquarters located right next to the Fairgrounds, we could hear Jermaine Bazzle, Fats Domino, Dr. John and the Nevilles. And in those days, there’d be maybe one nationally known pop singer or band on one stage on the last Sunday of Jazz Fest, without any particular ties to Louisiana or Jazz, like Paul Simon, but no one really minded.

That, it turned out, was the downfall of Jazz Fest, in my humble opinion. Now, the music schedule is peppered with nationally and internationally known singers and music with absolutely zero connections to Louisiana or jazz or anything to do with our heritage, for which, ironically (or hypocritically) the New Orleans Jazz & Heritage Festival is named. Oh, you can still see and hear the local bands and rich musical heritage for which New Orleans and Louisiana is famous. But those artists (and I use the word “artists” sincerely) take a back seat to the crowd-pleasers and big-draw names. Look at this year’s schedule. Kid Rock? John Mellencamp? Tom Jones? The Strokes? Lauryn Hill? What do any of them have to do with jazz, New Orleans or Louisiana heritage? And don’t get me wrong - I like each and every one of them and their music. What irks me is that when you hear people saying why they’re going to JazzFest, it’s because they want to see these performers, not our home-grown artists. JazzFest itself is culpable too, booking more and more of these types of acts as headliners while our fantastic local artists take a backseat, functioning as mere opening acts for the bigger names.

It’s to the point now that even the local news find it remarkable that local artists are playing at Jazz Fest. WDSU news plastered this headline: “Jazz Fest Thursday Opening Has Local Flair.” Local flair? We need to be reminded that the New Orleans Jazz and Heritage Festival has local flair? Gone are the days when the “local flair” was the Jazz Fest. The news article specifies that the festival is presented by Shell. This does not mean that Shell Oil felt the need to subsidize Jazz Fest to make the entrance fee free or reduced, out of appreciation for our oil-dependent local economy or out of a sense of responsibility of "giving something back;" it merely means that their ads are plastered over everything, like a pimp tattooing his own name on all the prostitutes he manages. It feels as if I had to cut off ties with a good friend or beloved family member because they got too dependent on drugs or alcohol. Or fame. And this is what makes me sad.

Random Thoughts (Regarding Transportation)

When I was three, I was at the airport with my parents seeing my dad off for a business trip or something. Maybe it was a business trip, I was three, so who cares, right? I decided to explore the airport while my parents were busy with tickets, baggage and the like. “Here’s an interesting doorway” I thought. “My, what a long hallway!” was my impression after entering the interesting doorway. After venturing down the long hallway, I found a big, comfy seat and climbed up into it to make myself comfortable. A few minutes later, Patsy, my dad’s secretary, came and whisked me away from my comfy seat and brought me back to my mother and father who were visibly disturbed. Apparently in 1968, it was very easy to climb aboard any old plane bound for Las Vegas. There were no x-rays or full body scanners or whatever, Yet, somehow, civilization as we know it continued.

In fifth grade, my class had sold the most “America’s Finest” candy, and hence we were entitled to a pizza party at the nearby Shakey’s Pizza place. It did not occur to me to wonder at that tender age why the Corporate Executive Officer of the establishment might be named “Shakey.” Anyway, we had no school bus to transport us to Shakey’s, only four blocks away, so we walked. After having our fill of impossibly bland pizza (during which I distinctly remember singing along to Foreigner’s “Cold As Ice” [or was it Journey?]) while waiting for our pizza, my entire class walked back to the school. Upon arrival, we tarried at the entrance, during which time I decided to hop up onto a low wall bordering a garden. My butt overshot the trajectory and landed upon four feet of nothingness, causing the rest of my body to hurtle forth to the ground. Upon impact, my left arm struck a concrete cinderblock bordering the garden. When I arose from the tumble, I noticed that my hand was four inches lower than my arm - my wrist was broken!. This caused me no slight consternation, so naturally I screamed like a schoolgirl. Later, after my mom had collected me and brought me to the doctor, I had a splint wrapped with ace bandages around a rigid arm support. Since the outer covering of the splint was merely ace wraps rather than plaster, it was impossible for friends to sign, as friends of the cool kids did when they wore a real plaster cast for broken bones. With this physical and obvious reminder that I was not a "cool kid" to this day, I curse mere splints.

When I was eight, my mother and my two sisters flew to Tampa to visit my mother’s brother, my Uncle Merlin. Yes, Merlin, as in the wizard in the Knights of the Round Table. Don’t say anything bad about my Uncle Merlin; he’s one of the coolest people I know, and I’ll kick your ass if you do (cool kids be damned). My mom, my two sisters, my aunt Mimi and I were flying on National Airlines. During the flight, the plane was hit by lightning. All the lights went out. Since it was our first flight, my sisters and I thought it was just part of the ride. My mom and Mimi sort of freaked out.

At age twenty-eight, I got married. My dad died the next year and my Mom gave us his old Dodge K-Car. I had been driving a 1990 Ford Ranger, which I had kept nicely. The K-Car had been parked for years under the pine trees in front of my parents’ house, and was coated in the dried sap of the evergreens. It was a car preserved in amber. It could have been displayed in the Smithsonian alongside the prehistoric dragonflies and mosquitos that have been preserved through the millennia by the same mechanism. Shortly after having been bequeathed to me, the amber-preserved K-Car was my vehicle, while my new wife tooled about town in my nice pickup. I didn’t complain; something about a woman who drives a pickup always... stimulated me.

In 1998, my wife and I invited my mother and our friend Ingrid to join us in a trip to Ireland to visit my wife’s parents. Long story short, the airline owed us an upgrade for bumping us off the flight across the pond and subsequently losing all our luggage. On the return trip to the United States, we were bumped up to Business Class, which I highly recommend. But on the flight from Atlanta to New Orleans, we were back in pigs-and-chickens class, which I recommend not so highly. My mother was several rows behind us during the rather turbulent flight, which seating arrangement I highly recommend. During the bumpy parts of the flight, I could hear my mother, who has a fantastic singing voice, singing “Lady of Knock” to the other woman sitting next to her. At the baggage carousel, I gave that woman what I hoped would be interpreted as an envious, yet simultaneously apologetic, glance.

During my elementary school years, I rode bus number 22, driven by Mr. Jimmy, who was also my Catechism teacher. In the last year of school before Sam Barthe Athletic School For Boys was sold to Ecôle Classique, my younger brother also rode Mr. Jimmy’s bus number 22. Having seniority, and determined to take full advantage of it, as a seventh-grader I sat sullenly in the back of the bus with the upperclassmen, while I forced Patrick to sit in the front of the bus with the kids his own age.
Note: I had absolutely zero talent for athleticism, while Patrick was the quintessential athletic paradigm. I have yet to forgive him for that.

Would finding E.T. change our view of God?

The following is a comment I made on an article addressing the question in the title of this post. The question has been posed for a while (I hesitate to say "millennia") and much effort has been spent anticipating humanity's reaction to the discovery of extraterrestrial intelligence (ETI). But I seldom see opinions discussing the alternative. So here's my two cents:

Humans may be going down a road with the destination forever far in the distance with this question. If we find ETI (or they find us), great, the question is answered. Chat show pundits, theologians, atheists and philosophers are in business for life (to paraphrase Douglas Adams).
On the other hand, what if we don't find ETI? When do we call it quits? At what point will we say "Yes, humans are alone in the universe"? What if the time comes when we've colonized every habitable planet in the Milky Way galaxy and still haven't found life? Right now, we look at the billions of stars out there and think "Surely, someone else is out there." But if humans are ever spread across the whole galaxy (unlikely) and no one else is there, will we say then that we're definitely alone or will we look to the trillions of other galaxies, each with billions of stars, and think "Maybe they're out there?" and devise ways to investigate that possibility? Given the virtually infinite size of the Universe and possibilities of life to examine, it seems that if we don't find other intelligent life, the search could easily continue till we die - all of us.
If you've ever looked for something that wasn't there (but you didn't KNOW it wasn't there), when do you stop looking? You looked under the bed, in the fridge, between the cushions and in your pockets. And later, you looked again in all those same places and some new ones, didn't you? Even when you said to yourself "I quit!" the question still gnawed at you. Where could that thing be? The same goes for the search for ET. Even if humanity, as a collective, "quits" searching, someone will still be wondering what else to try.
Until definitive proof is found that there is ETI out there, it seems that humanity's search will continue. If that search takes however many billions or trillions of years the Universe has left, I don't doubt that there will be someone who keeps searching.

The Not-So-Violent Toll Of Internet Shutdowns

So today you can hardly turn on the media without hearing about Egypt. Protests, riots, tear gas, police cowering on rooftops... the works. One other noteworthy thing is that Egypt’s internet access has been shut down according to multiple sources, such as here. Now, this internet blackout isn’t noteworthy because it happened. It’s the response that’s noteworthy. This was brought to my attention by @BurbDoc on the Twitters. As he puts it, “Iran shuts down Internet, we get our panties in a wad. AssMubarak does the same shit, we DO NOTHING.”

As anyone on Twitter or Facebook can tell you, when Iran shut down internet access last year, vast swathes of humanity protested the lack of access. Thousands put up little green avatars (reminiscent of Iran’s flag) in “support” of their internet-deprived Iranian brethren. But as @BurbDoc puts so succinctly (which is kind of necessary in the 140 characters Twitter gives you), we who are flush with internet service now collectively say “Egypt’s internet is off? Oh, okay.”

I have no words of wisdom or inspiring quotes from Mohandas Ghandi, Thomas Jefferson, Jesus or Mohammed to quell the riots. I have no special insight into Egyptian thinking. In fact, I don’t even know what the Egyptian uproar is about (and I’d wager that the vast majority of Americans don’t either). But I do have a great imagination. And my imagination brings me to a special place where I envision the rest of the worlds’ reaction should various countries be deprived of internet access. 

For example, if the headlines read “American Internet Access Shut Down!” the country would be in turmoil. A deep, sonorous hue and cry would be voiced. But since there’s no internet access, the voices would carry no farther than the next room, since no one could post their indignance on Facebook. The rest of the world would cry out against the shutdown, but secretly rejoice that the USA isn’t taking up all the bandwidth with their silly ignorance. China would offer us expensive, long-distance dialup internet, which we’d happily pay for.

“United Kingdom Loses Internet!” The rest of the world would protest the blackout, citing England’s long history of contributions to the world’s intellectual knowledge base (but forgetting that Wales, Scotland, Northern Ireland and the Isle of Mann are also part of the UK). The people of the UK would grumble mightily, but only over many, many drinks at the pub.

“Russia’s Internet Goes Dark!” The rest of the world offers condolences. “We’re so sorry for your loss,” they’d say, much as one uselessly offers the same line at a funeral while secretly hoping to sleep with the hot widow. The rest of the world quietly emails one another, saying it’s probably for the best that those Russians can’t get on the net.

“China Has No Internet!” The Chinese people are duped when the government immediately puts up fake “websites” that extol the virtues of China and Communism to which every Chinese internet user is rerouted. World of Warcraft gold farmers go bankrupt, since the only people that buy their game-gold are other Chinese Warcraft players. In the rest of the world, the entire real global economy collapses.

“Sweden’s Internet Is Shut Off!” The rest of the world writes, emails and protests the appropriate parties until the steady stream of Swedish internet porn is restored.

“France No Longer Has Internet!” The French are saddened but quickly resolve themselves to their fate, accepting their national loss. The rest of the world brings them restored internet access. As usual.

“Ireland Can’t Get in the Internet!” The Irish people immediately assume it must be their own fault and confess their sins to whoever will listen. Fifty billion “Hail Marys” and “Our Fathers” later, the Irish feel better and celebrate and/or drown their sorrows at the local pub. But still no internet.

“Argentina Loses Internet Access!” Access is quickly restored when five billion soccer fans get rowdy over their inability to check up on their team.

“Brazil’s Internet Is Shut Off!” The gay community creates their own internet and ships the entire structure to South America specifically so Brazilian guys can restart transmitting their photos and webcams.

“No Internet in Italy!” Nobody notices. Including the Italians.

“India’s Internet Goes Dark!” The rest of the world, looking for customer support, also completely loses internet access. The dark ages resume globally.

“Jamaicans Can’t Get on the Internet!” The rest of the world says “Jamaica had internet?” Jamaicans say “We had internet?”

On My Soapbox

No really, I'm literally on about soap. You'd think it wouldn't be that challenging. All I want is a decent bar of soap. Not anything like "Dr. Ganja's Super Organic Earth Soap With Genuine Cannabis Naughtiness" or "Miss Victoria's Soothing Tiny Bubble Body Cleanser With Exfoliating Aromatherapy Modules" or even "Ultra-Macho Sweaty Guy Bodybuilder Body Wash With Genuine He-Man Pheromones (Women will throw their vaginas at your armpits!)".

I just want a bar of soap. Not body wash. One that I can get at the grocery store, not have to go to a boutique, or order from a stupid catalog. I've been trying various soaps and can't find one that's decent. Here are my experiment results:

Irish Spring: Smells nothing like Ireland or spring. Perhaps they mean the bed spring from an overly-scented Dublin whore's boudoir?
Safeguard: For when I want to smell like an old men's locker room.
Olay: Dead fish. 'Nuff said.
Ivory: 99.44% pure toxic chemicals. And what is that weird itch afterwards?
Lever 2000: For when you want to announce your presence to everyones' noses while you're still out in the parking lot.
Camay: For when I want to smell like an old ladies' locker room.
Dove: Out, out, damn'd soap! I need to use a loofah afterward to get the "moisturizing" cement off.
The dogs' shampoo: Remarkably, the least offensive surfactant in my bathroom!

So, those are the soaps that are commonly available at the store. If I've overlooked any, please recommend your suggestion so I can try it. Until then, I'll be enjoying my shiny coat and freedom from fleas.

My Living Will

My “Living Will”

I, Sean Fitzmorris, being of sound mind & body, and the fact I’m posting this on the Internet notwithstanding, do hereby make this my request should I ever be incapacitated by injury, disease, or other life-threatening process.

Under no circumstances are any healthcare providers, paid or volunteer, to perform CPR on me, including artificial respirations or chest compressions. There are exceedingly few people that survive such therapy and frankly, I’d rather use that slim chance to win the lottery.

Should the preceding request go unheeded and I am on a ventilator, under no circumstances should artificial ventilation continue for more than one week. If I cannot be taken off the ventilator in that time, please remove the endotracheal tube or whatever artificial airway is in my body and turn off the ventilator. I will take my chances. 

Under no circumstances am I to be fed. This includes tube feedings via any port in my body including intravenous, nasogastric, orogastric, percutaneous endogastric or duodenal routes, or even if someone should offer to cut up my food and/or feed it to me. Should the recommendation for such a form of nourishment be mentioned as part of my care, I summarily refuse it.

I refuse any procedure involving a cerebral angiogram. 

I refuse any “clot-busting” agents, including tissue Plasminogen Activator, streptokinase, retavase or any other drug used for this purpose. I do not want to hemorrhage in my brain or any other organ I am using.

Any of my organs or tissues may be harvested for donation. However, if it is recommended that I receive any donated tissues or organs, I summarily refuse. I’ve seen those poor souls after getting an organ transplant, and it may be life, but not as I know it or want it.

Under no circumstances am I to be dialyzed, in any way, shape or form, including hemodialysis, CVVHD, SLED, or CAPD. I am a happy person, and dialysis is just sad.

Should the recommendation be made that I have artificial holes created in my body for the purpose of breathing, eating, nourishment, or excreting waste of any kind, I summarily refuse it. This includes tracheostomy, tracheotomy, cricothyrotomy, colostomy, nephrostomy, ileostomy, suprapubic catheter,  PEG tube or any other ostomy.

Should the time ever come when I cannot clean my own anus under my own power, all medicines I am receiving are to be stopped, all nourishment is to be halted, and all hydration, oral or intravascular, is to be ceased. I will either get better or die; either is preferable to me.

Under no circumstances am I ever to be placed in a nursing home, skilled nursing facility, long-term care facility, or any other place of similar ilk. Allow me the dignity of dying in my own home or that of my loved ones. 

Should the circumstances of my death be attributable to stupidity of my own causing, feel free to laugh and poke fun at my corpse. I would have loved the joke, too. But do not subject me to any of the situations I have outlined above. Thank you.

Sean Fitzmorris

7 December 2010