Update

Hi. I didn’t realize that it has been so long since I last posted. Life has been crazy for the past year since I took the clinic manager’s position. I am restraining myself from bitching about it online because I am afraid my employers might end up reading it. I’m not very good at masking the truth and whatever I write would be too easily identifiable. There is no such thing as anonymity on the Net and I have given up trying. I need to talk about what I am going through and have ended up back in therapy to do so but I really want to write about it and get feedback from other people. I need to think about this for a while and do some research. More later.

An Example of Why Our Healthcare System Is a Mess

I grind my teeth in my sleep. Due to that habit I have thousands of dollars worth of reconstructive work in my mouth. In addition to that I suffer from TMJ problems and resulting migraines. I have had several
bite guards through the years and have managed to destroy them by grinding them until they cracked.

Yesterday morning I bit into some food and spit out pieces of porcelain. Went to my dentist who looked in my mouth and said I was putting 800-900 lbs of pressure on my teeth due to bruxism and had cracked two porcelain bridges which will have to be replaced again. He also told me that traditional night guards just intensify the problem because they don’t do anything to prevent pressure against hard surfaces. He prescribed a new bite guard, custom fitted over my top front teeth with a bar that prevents my teeth from coming into contact with each other.

It’s maybe 50 cents worth of plastic, heated and fitted to my mouth and polished to get rid of the rough edges. It cost me $500. I guess it can be considered a good investment if it prevents further damage and it is a patented design. . . .but $500? And my dental insurance will not cover it.

Playing The Ipod Shuffle Game

The meme is:  put your iPod on shuffle and write down the first 15 songs that play, include artists, post, tag friends.

Okay. Here goes. . . .

1.  The Boy In The Bubble- Paul Simon

2.  The Dreamer-Betty Smith

3.  Forgiveness-Krishna Das

4.  Life During Wartime-Talking Heads

5.  Blue Ridge Mountain Blues-Jean Ritchie and Doc Watson

6.  Spirits In The Material World-The Police

7.  Tying A Knot In The Devil’s Tail-Norman and Nancy Blake

8.  Kindred Spirit-Norman and Nancy Blake

9.  Copperline-James Taylor

10.  Heaven-Talking Heads

11.  Broken Hearted Blues-Etta Baker

12.  Pretty Saro-Jean Ritchie

13.  Daniel Prayed-Doc Watson and Clarence Ashley

14.  My Little Carpenter-Uncle Earl

15.  Lully:  Ballet De Xerxes – The Aracadia Ensemble

Tagged:  Rick Henderson, Dan Patterson, Vera McGraw, Venka Anderson

Today’s Adventure

It was hard to get up and get going this morning . . . I had absolutely no interest and no enthusiasm for going to work . . . hump day  . . .just get through it and it would be a downhill slide until Friday afternoon. . .so, I thought.

First off, a patient met me at the door when I got to the clinic.  His girlfriend had dumped him and he had no one to help him with his home dialysis treatments. . .hadn’t had a treatment since Saturday  (going more than 2 days without a treatment is extremely risky) and had been turned away at the ER the night before.  Another patient had been dropped from her insurance.  Another patient with admission planned for Friday could not be verified by our admissions office because he was not showing up on the Medicare website and I had to have everything finalized today or I could not admit him and he would have no care.  Never mind that he is 70, has sickle cell anemia, has no transportation, and needed dialysis rather suddenly.  Wednesday is the only day I have a full staff as I share a dietitian and a social worker with 2 other clinics and we had a bridal shower planned for this afternoon for our medical assistant who is getting married in 3 weeks.  And then there was the issue with the patient who was on his 4th machine in as many weeks and the new one was being delivered and my nurse needing help putting it together. . . . I could keep going but I think you get the idea. . .all of this hit before 9:00am.

At 9:00 am I was in the midst of preparations to stick 2 15g needles into a patient’s arm when my medical assistant came into the room and said I had a visitor and handed me a card. . . . it was an inspector from the state department of health services.  A visit from a state inspector strikes fear in the heart of every dialysis manager because these are the people who determine whether or not the clinic remains open.  It. is. a.very. very. very. BIG DEAL.  They show up at any time with no warning and some of them can be really nasty.

I dropped what I was doing and walked out to the lobby to greet her.  She was very pleasant and smiling and explained that she was there to inspect me for recertification.  I warned her that all hell had just broken loose and she laughed and said she was used to that. . . .a good sign.

She followed me around all day watching every thing I did and asking me to explain it to her and to justify my actions.  She interviewed every patient that was there and every other one that came in today . . .in private when their visit with me or my nurse was done.  She interviewed every staff member in the facility.  She went through the medical records of every patient she interviewed and quizzed me about them.  I had to provide refrigerator temperature logs, water analysis results, machine maintenance records, lab results on both patients and staff, vaccination records, CPR cards, disaster training information….in short, she examined and questioned everything.  We were going through personnel records at 7:00 pm and I had to call a staff member at home and have her answer questions about her certification to practice in California.  She took lots of copies of lots of stuff.

At the end of it all the only thing she had to criticize was that a certain door wasn’t locked when it was supposed to be and she said that wasn’t worth writing down.  We passed with NO DEFICIENCIES!!!    It is very rare that a clinic goes through an inspection without a list of corrections to make and a follow-up visit planned.

I’m so proud of my staff I could pop.  Now I have to figure out how we are going to celebrate.  Ideas???

Today’s email from another nurse

Actual Medical Charts

- The baby was delivered, the cord clamped and cut and handed to the pediatrician, who breathed and cried immediately.

–Exam of genitalia reveals that he is circus sized.

- The skin was moist and dry.

- Rectal exam revealed a normal size thyroid.

- She stated that she had been constipated for most of her life until 1989 when she got a divorce.

- Between you and me, we ought to be able to get this lady pregnant.

- The patient was in his usual state of good health until his airplane ran out of gas and crashed.

- I saw your patient today, who is still under our car for physical therapy.

- The patient lives at home with his mother, father, and pet turtle, who is presently enrolled in day care three times a week.

- Bleeding started in the rectal area and continued all the way to Los Angeles.

- Both breasts are equal and reactive to light and accommodation.

- She is numb from her toes down.

- Exam of genitalia was completely negative except for the right foot.

- While in the emergency room, she was examined, X-rated and sent home.

- The lab test indicated abnormal lover function.

- The patient was to have a bowel resection. However he took a job as a stockbroker instead.

- Occasional, constant, infrequent headaches.

- Coming from Detroit, this man has no children.

- Examination reveals a well-developed male lying in bed with his family in no distress.

- Patient was alert and unresponsive.

- When she fainted, her eyes rolled around the room.

A Birthday Present

  Himself is not the demonstrative type.  Birthdays, holidays, and anniversaries do not register on his radar.  When we first got together I cried for 3 days because he did not acknowledge my birthday.  He is thoughtful.  It’s just on his own peculiar timetable.  This year he gave me Valentine’s candy in January.  We are likely to celebrate Christmas at any time during the year and maybe more than once.

Yesterday when I got home from work there was a large brown box on the doorstep addressed to him.  I did not think anything of it as we both shop on-line frequently.  This morning he presented me with said brown box and announced that it was my birthday present.  My birthday was in February.

Before I reveal the contents of the box I have to wander off into another story.  For the past several years there have been 2 22-ounce plastic glasses in our kitchen. I think I may have picked them up at the grocery store for a dollar each.  For me they are the perfect size to fill with ice and Diet Coke or  tea and nurse for a couple of hours as I putter around.  There is almost always one at my elbow.  They have a nice pebbley texture that does interesting things with the light and facets that make them easy to grip.  They are lightweight and fit my hand perfectly.  Much to the amusement of Himself, I have been known ignore all the other glasses in the apartment and take one of these out of a dishwasher loaded with dirty dishes and wash it so I could use it.

The contents of the box?  24 glasses exactly like my favorite ones, 12 clear and 12 bottle green.   Do you think I should have anything to say about his fondness for a particular blue willow patterned coffee cup?

Maker Faire 09 San Mateo

Put several hundred creative , uncoventional people together  and you will have a Maker Faire.  It bills itself as a DIY festival.  All of the exhibiters are people who “make things”, everyone from beekeepers to farmers to electronic experts to musicians to knitters (of course).  Some people have described it as a grown-up science fair.  Sustainability and recycling are strongly emphasized as well as good times.

 I was with my pal, Kelley,of Ceallach Knits fame. (It is the Irish version of her name and is pronounced the same.) Kelley has her own business selling solar dyed yarn so I was pimping yarn and helping demonstrate the solar oven.

I’m fascinated by the steampunk aesthetic and it was a dominate theme of the faire.  This was across the parking lot from our booth.Wind coming off the Bay would cause it to rotate  and people would stand on the small platform in the central ring to pose for photos.  I couldn’t help but think of Sufis whenever I looked at it.

People were very friendly and open and did not mind posing for photos.  As someone who was making her own clothes before she was in high school I was fascinated by the steampunk costumes.  I want to dress like this.

There was the steampunk motorcycle.

Coming. . . . 

and going. . .

 

And the grandaddy of steampunk was fired up and driven around the fairgrounds in the evening after the crowds thinned out.  When they blew the whistle we all wished for earplugs

Alternative methods of transportation were popular.

There were a lot of musicians there.  Some we wanted to put out of their misery, others were quite good.  One of the most popular was Shovelman.

I thought of my electric-guitar-building brother-in-law when I saw him. (Andy, I have several other pictures if you want more detail  I don’t know if you can see it, he had a slide on his left hand.)  His music is featured in the video on the Maker Faire page linked at the beginning of this post.

Kids loved this guy singing pirate songs. (This one is for you, Judy.)

I haven’t figured out what this instrument is.  He played it with a bow and was accompanied by a guy with a banjo.

I don’t know who they were, but these guys were pretty good.  I couldn’t get the jug player into the frame from this angle.  There was also a rock band whose instruments and amplifiers were powered by people on bicycles.  The crowd was so thick around them I couldn’t get a good shot.

Robotics were big.  R2D2 toured the fairgrounds chasing little kids.  They loved it.

I enjoyed the remote controlled rolling balls.

Speaking of recycling, these are 2-liter soda bottles.

 

 

The flaming lotus was made by a group of female metal workers.

Farmers and gardeners were well represented.

As was a beekeeper and a man who sold houses for lady bugs.  I watched a woman demonstrate how to make home-made pasta and met a man from the Primitive Arts Society who is the only other person besides my grandmother I have ever seen tie a net.

 Kids had a blast playing on the big pink pillows.

There was a brewer who sold dark, rich beer that people said was good.  I think the brand was Devil’s Canyon.  His set-up reminded me of my Wilkes County heritage.

  I spent most of the two days in the booth with yarn and talking to knitters and was on overload at the end of the weekend.  This is only a small sample of everything that was there.  There were lectures and classes inside the exhibit halls, a Bizarre Bazaar for vendors of hand-crafted items, a Swap-o-Rama for used clothing and sewing machines set up to make alterations.  One of my favorite crafters made silver jewelry designed after molecular diagrams. ( I couldn’t decide between serotonin or chocolate.)  After my 8-5, uptight, buttoned-up, corporate job being at Maker Faire was like being on vacation.  It was an enormous relief not to talk to anyone about anything remotely medical.  I have resolved to make an effort to hang around more people who appreciate this kind of thing in order to keep my sanity intact and my outlook balanced.

 

 

Vacation Stories: Merlefest

Meh. If I had wanted heat and crowds I would have stayed in the Bay Area.

Merlefest is the largest Americana music festival in the South. It was founded 22 years ago in memory of Doc Watson’s son, Merle, after he was killed in an accident. If you don’t know who Doc Watson is google him.

Starting on the Monday night before the festival officially opens on Thursday the Wilkes Acoustic Folk Society leads free, unadvertised jams every evening on the festival grounds. IMHO, that is when you hear the best music. There is a lot of local musical talent in Wilkes County, many with international reputations, and this is the best place to hear them. They are relaxed and playing for fun, not for an audience. Festival performers also tend to drop in and you will hear everything from old-time to blues to rock. Emmylou Harris may show up, or the Kruger Brothers, or the Lovell Sisters, you never know who is going to sit down in the circle.  My favorites are the old-timers who have been back-porch picking all their lives. Unless they are working at the festival, you may not hear these people again after Wednesday night.  This is also the time to see some fine home-made instruments.  One of the members of WAFS has a 2 year waiting list for one of his guitars.

Once Merlefest starts I like to spend time hanging out at the picking tents.  Again, they are open jams lead by WAFS.  Performers sit in often.  This year Duck Holmes wandered by and demonstrated Bentonia blues.  You may not see many locals there unless they are working with WAFS and the mix is very different from earlier in the week.  I saw a little guy, maybe 10 or 12 years old, sit down with a mandolin and pin everybody’s ears back. Sierra Hull sat in one session, asked to swap mandolins with one of the other players for a number, and I thought he was going to faint.

A long-haired, bearded, yet very clean-cut young man hung out at the edges of the circle.  He was obviously not a local and as soon as he opened his instrument case I could tell he was a “violinist”, not a “fiddler.”  He was obviously classically trained as his tuning and fingering were nothing like the other fiddlers.  He was also not familiar with old-time music.  It was interesting to watch him evolve and loosen up as he learned the songs.

Sewerfest is a gathering of campers at the water treatment plant who play together at night after Merlefest.  I did not get to go by this year.  Maybe next time.  There is a well-known musician/luthier from Finland whose name I can’t pronounce who raffles one of his guitars at Sewerfest every year to pay his way to Merlefest.  I heard him play at one of the jams one night and the boy has Doc’s licks down.

There is a small, unadvertised, festival that happens in Wilkes in October aptly named Carolina in the Fall.  It is advertised by word of mouth and is very informal and not as structured as Merlefest.  You never know who is going to show up there.  I’ve been trying to get to it for the past few years and have not been able to get off work.  Maybe this year.

I also saw an advertisement for “Chickenfest” while I was there.  Apparently it is a gathering of musicians sponsored by the local poultry producer. That is one that will require further investigation.  As the poultry processing plant is one of the largest employers in the area and having worked there myself I can only imagine what that will involve.

Re-entry

Moving between a large urban area with a population over 6 million and a rural county of 65 thousand can lead to a little bit of culture shock. I’m back from vacation, jet-lagged, exhausted, and already homesick for NC. I saw green grass, experienced thunderstorms, heard good music, shopped like a fool, and caught up with people I have not seen in over 30 years. I need to process all of my various adventures and have spent the morning writing about them. The post turned into one long purge and I deleted it. I’m not sure yet what I’m going to do about it, think about it a while before I spill my guts. I have lots of stories to tell, am just not sure what format to put them in. One long post divided into sections or lots of little posts?

It Is What It Is

It’s a shame that I have gone back to a regular sitting practice in response to stress after 10 years away from the cushion. I’m sorry I ever gave up the habit but I found it intimidating to live with someone who doesn’t understand the process. My loss.  I was too lazy to deal with the distraction.

Anyway. . . .I bought myself a buckwheat filled zafu and a zabuton and I plop myself down once in a while and sit there doing what the monks call “riding the breath”.  I have become a beginner again.  One of my teachers would say that is the right way to approach the cushion, always as a beginner. 

The technique I practice the most, vipassana, is also called “insight meditation” and it is called that for a reason.  There will be days when it is a struggle to sit there and other days when the insights come so fast and furious you get high from the endorphins.  The trick is not to grasp at any of it, not to cling, not to try to hold on to anything.

This morning was one of those “duh” moments.  I found myself wondering why I ever forgot and laughing at the way I have been trapped.  I used to work with a guy who had the Second Noble Truth tattooed on his wrist.  I may follow his example.  ”Suffering comes from attachment.” 

I have been stressed and suffering because of my job.  Why?  Because of attachment to outcomes, of wanting to control, of  wanting things to be different from what they are.  No wonder I have been driving myself bonkers.  The old monkey mind has had full rein, jumping around and screeching, grasping and clinging.  I’ve wasted too much time and energy resisting the circumstances rather than just dealing with them.  Too much time whining, too much emotion and ego tied up in it.  Okay. . . breathe in. . . breathe out. . . one. . . .breathe in. . . breathe out. . . two. . .thinking. . . breathe in. . .breathe out. . .one. . . breathe in. . .breathe out. . . two. . . sensation. . . acknowledge the thought, don’t react. . . .breathe in. . . .breathe out. . . one. . . breathe  in. . . breathe out. . . two. . . watch to see how far I can get before losing count. . . . . thinking, thinking, thinking. . . .let it go. . . breathe in. . .breathe out. . . one. . . . . . .