A Party for Jack

Jack was a big guy. He was big-boned, with a big belly and a big laugh.

He had come into the hospital with abdominal pain from badly inflamed intestines. So badly inflamed, in fact, that he’d had to have a bunch of his intestines removed. Like, half his colon. A hemi-colectomy is a big surgery. But he was going to be fine.

His wife and his brother sat at his bedside. “I don’t have a colon like you guys anymore,” he joked to them, eyes twinkling. “I have a semi-colon.”

“It’s okay to have a semi-colon, Jack,” his brother quipped back. “As long as you don’t have a period!”

That was Jack and his family. A bunch of jokesters.

Jack wasn’t laughing for long, though. He ended up with a complication, an ileus. His remaining intestines went to sleep, temporarily stopped functioning. His big belly swelled larger. We had to put a tube down his nose, into his stomach, and attach the tube to wall suction, to decompress his abdomen. And just wait helplessly for his intestines to wake back up.

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How To Give Tylenol Rectally

My patient had a fever. He needed Tylenol.

He was a confused little old man, bedbound. And he couldn’t swallow. He was NPO, meaning no food, no water, nothing by mouth. He would choke. Choking was not good. Even a new nurse like me knew that.

So I needed to give it rectally.

I asked the more experienced nurses: “How do you give Tylenol rectally? Just … ???” Wondering how you put a little pill up there.

“Yes!” they assured me cheerfully.  “Just give it rectally.”

I wanted to be clear. “Just put it in? Just … ??”

Their confirmation was unequivocal, unanimous. “Yes! Just stick it up there!”

Sounded easy enough. Unfortunately, the experienced nurses left out one small but vital detail: Tylenol comes as a suppository.

I was a new nurse. It would have been helpful to know that.

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How To Administer An Enema

I was a student nurse, and my preceptor was watching as I filled up an enema bag with warm water. “Just insert the tubing carefully into her rectum, up to this little black mark – see? – and then open the clamp,” he advised me. “The water will flow in. If she experiences any cramps, stop the flow for a minute.”

I nodded gravely. I was a serious student, learning how to administer an enema. I wanted to do things right. I went over it in my mind: Insert the tube. Stop at the black mark. Open the clamp. Pause if she cramps.

Got it.

We approached our patient, an alert and oriented, bright-eyed 82-year-old lady, slight, bird-like, cheerful. We explained what we needed to do. She nodded. No one much likes an enema, but she knew she needed one.

I lubricated the tip, then gently inserted the tubing up to the black mark. I opened the clamp. Warm water gushed and gurgled noisily into her. She didn’t report any cramps.

But perhaps I should have noticed her expression.

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How To Clean A Patient

I was taking care of the sweetest little lady. She had Alzheimer’s disease. She didn’t know who I was, who her daughter was, what her own name was.

But she beamed delightedly at everyone she saw. “Well hello!” she would exclaim joyously. “How very nice to meet you! How very nice of you to stop by! What a pleasure! Tea?”

She had been admitted to the hospital with constipation which had now resolved, as evidenced by the copious liquid stool that she was freely passing. She certainly hadn’t needed that stool softener I’d given her earlier that morning, I thought regretfully. Drat.

That afternoon, glancing in as I passed her door, I saw her standing uncertainly in the middle of the room. Uneasy, sensing something was amiss, I entered her room and cautiously looked around.

And I saw her hands were covered with stool.

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How To Set Up A PCA Pump

I was setting up a PCA (Patient Controlled Analgesia – a “pain pump”) for my new patient.

I didn’t really have time to be doing this. It was one of those busy days. Everyone was calling me. The pager in my pocket rang constantly: Pain meds! Anxiety meds! When will the doctor be here? I want to go home! Move my Kleenex box two inches to the right!

I would leave a room, and would get called right back in. I couldn’t make any forward progress.

My new patient had just had surgery, and was in pain. She called me every five minutes, telling me the pain medication wasn’t working. I was pouring morphine into her, and finally called the doctor for a PCA, so she could push a button and receive a dose of pain medication whenever she wanted.

Taking the time to set up a PCA would ultimately be better than being paged to her room every five minutes. I could get to my other patients, who were also calling constantly. And she’d have better pain control. Win-win! If I could just get it set up quickly!

Because I really didn’t have any time.

The pump already had batteries in it, located on its underside. As the pager rang in my pocket, I turned on the pump and programmed it with the settings given to me by the doctor. Hooked the tubing up to the patient. Explained that she could hit her button whenever she wanted, that the pump would prevent any overdoses. Stepped back to admire my handiwork, satisfied – Did it! Got it done! – ready to move on to the next room –

And pop went the battery door to the PCA.

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Poem: Teaching In Samoa

The Backstory

I was a 25-year-old Peace Corps volunteer, teaching human biology and general biology in Samoa, a coconut-tree-fringed, green dot-of-an-island in the middle of the gloriously blue South Pacific ocean.

I loved it there.

I loved the turquoise lagoons and lush vegetation and brilliantly colored flowers. I loved the papaya and mango and banana trees, laden with delicious fruit. I loved all the chickens and pigs wandering freely around, scratching and rooting through people’s yards. One resourceful hen took up happy residence in my bedroom, laid a clutch of eggs, and proudly hatched out ten fluffy chicks. I loved it.

I loved watching Samoan boys shimmy breathtakingly high into coconut trees to pluck its fruit. I loved watching Samoan girls skillfully and artfully weave baskets and placemats from coconut fronds. I loved the food. I loved the people. I loved the languid pace, the warm nights, the silvery-peachy color of the lagoon as the morning sun rose above the water.

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I’m Always Hot, Baby. (Or: Oh No, More Hot Flashes.)

I was trying to listen, I really was. But it’s nearly impossible when you’re on fire.

On. Fire.

I was in an important meeting to discuss my little sister Becky, who has Down Syndrome, and her future welfare. I’d been anticipating this meeting for months. The social worker was talking about finances and trusts and legalities.

But my attention was dragged away when I felt the sudden spreading heat. “Oh no,” I thought. I shifted uncomfortably in my chair. The heat started, as usual, at my neck and spread like wildfire across my back and chest, through my core, over my whole body, radiating fire from my skin.

Fire!

Women: You know what I’m talking about.

Men: Hello! Keep up. We’re talking about hot flashes.

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Kauai: Going Home

To read my Kauai journal from the beginning, click here

Every good thing must end, I guess. Especially perfect vacations.

Martin went out to photograph his last Kauai sunrise while I started packing for the trip home. All the recent biking, kayaking, and hiking was making itself known today: Every muscle was sore, every movement induced a wince. We hurt “nose to toes,” as Martin put it. Like a couple of old people, we hobbled around.

We said goodbye to our pretty condo overlooking Wailua Bay and went out to breakfast at the Ono Family Restaurant. The Hawaiian word ono – “oh no!” –  means, counterintuitively, “delicious.” It reminds me of the car “Nova,” marketed to Hispanics, which translates from Spanish, unfortunately, as “Doesn’t go.”

Sounds matter.

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Kauai and the Na Pali Coast: Wow! Crazy! Impossible!

Kauai and the Na Pali Coast: Wow! Crazy! Impossible!
To read my Kauai journal from the beginning, click here

Parking at Ha’ena State Park was a breeze, with none of the chaos and congestion (not to mention $35 parking ticket) we’d encountered last time we were here, when we went snorkeling. We parked right at the edge of Ke’e Beach, at the Kalalau Trailhead.

Scary-looking signs greeted us: “Danger! Falling Rocks!” “Warning! Stream Crossings!” “Alert! Narrow Trail!”

“Careful!”

“Look Out!”

We took a deep breath, bravely tightened our daypack straps, and started up the dangerous-sounding trail.

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Kauai: Superwoman Goes Kayaking

Kauai: Superwoman Goes Kayaking
To read my Kauai journal from the beginning, click here

The alarm clock rang, unwelcomingly, at 5:30 AM. When Martin cheerfully tried to roust me from bed, I groaned. I rolled over. I put the pillow over my head. Go away! Go kayak by yourself!

But he was patient and persistent, and once I was up, and showered, and eating a big hearty breakfast burrito outside on the lanai, lovingly prepared by my loving husband, watching the sun stream golden light through dark clouds onto the silvery lagoon below… well, that was okay.

All that weather over the Wailua River, though– the heavy clouds, apparent slashing rain, whipping wind– hmmm, not so inviting. Not what I hope for when I think, “Let’s go kayaking today!”

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Kauai: Way Down Deep. Actually, More Like: Beached.

Kauai: Way Down Deep. Actually, More Like: Beached.
To read my Kauai journal from the beginning, click here

We were nearing Tunnel’s Beach, and traffic was getting really congested. Cars were lining both sides of the road, parked illegally, according to both our guidebook and all the “No Parking Any Time” road signs. People with beach bags and swim suits were walking along the narrow road; cars going both directions squeezed in the constricted space between parked vehicles and pedestrians. We got worried. It was crowded; parking looked grim. At Ha’ena State Park, the end of the road, a sign declared “Road closed,” and we were turned around. Crews were doing clean-up work after the recent heavy rains. That’s why parking was such a nightmare: all the parking at the state beach was unavailable.

Thinking that maybe the cops (who were also inching along the clogged roadway) were turning a blind eye to the parking situation today because of the parking lot closure, we parked right under one of those ubiquitous “No Parking Any Time” signs, like everyone else.

We were wrong, like everyone else.

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Kauai: Way Up High. Actually, More Like: Flying.

Kauai: Way Up High. Actually, More Like: Flying.
To read my Kauai journal from the beginning, click here

We were standing on the helipad of Jack Harter Helicopters, watching helicopters land and take off.

It wasn’t perfect weather. The sky was full of dark clouds and it seemed awfully windy. Orange airport flags flapped wildly, their slender poles bent over. But the pilot (who’d been flying for something like fifteen years, including two years in the Army) didn’t seem concerned with the weather, so why should I?

Martin and I were ushered into the two front seats, grinning our fool heads off, and strapped down. The propellers roared overhead, competing with the wind.

And then suddenly we lifted smoothly off the ground, sliding sideways. Nose pointed down, we skimmed along the outskirts of the airport, and then rose miraculously and breathlessly up into the sky, where dark mountains and green fields and the blue ocean opened up before us.

Martin and I squeezed hands tightly, grinned wider and wider, pointed here and there. Martin was shooting lots of video footage and lots of photos, although I’m not sure how he did all that composing and metering and camera-fiddling while simultaneously holding my hand, pointing out sights, and hanging out of the helicopter.

Oh, did I mention that there were no doors on the helicopter?

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Kauai: Waimea Canyon and the Kawaikoi Stream Trail

Kauai: Waimea Canyon and the Kawaikoi Stream Trail
To read my Kauai journal from the beginning, click here.

When I was packing for this trip and eyeing the weather forecast calling for day after day of rain, friends and family kept saying, “It will be a warm rain!” and “You won’t need a rain jacket, you can get wet and still be comfortable,” and “Don’t pack long-sleeved clothes, you won’t need them! Trust me!”

They were all so totally wrong.

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Kauai: Tranquil Pools and Flooding Anxiety

Kauai: Tranquil Pools and Flooding Anxiety
To read my Kauai journal from the beginning, click here

Today was the Jungle Hike day – an attempt to find a poorly-marked trail and follow it to a picturesque waterfall cascading into a tranquil blue pool. So we piled into the Jeep (and of course it immediately started to rain, the skies seem to watch our every move), and drove back up to the arboretum.

When the road disappeared into the Wailua River, Martin kept driving, as we did that first day – right into and across the river. But instead of parking on the far side, Martin shifted the Jeep into four-wheel drive, and started inching up the steep dirt road in front of us.

And so our adventure began! We crawled up impossible inclines. We jounced over jumbled rocks and boulders. We navigated deep ruts. We splashed through muddy puddles.

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Kauai and the Kuilau Trail: Fighting Anoles. Pesky Wives.

Kauai and the Kuilau Trail: Fighting Anoles. Pesky Wives.
To read my Kauai journal from the beginning, click here

This morning, Martin, ever-hopeful, went out into the wind and stormy cloudy weather, hoping for pretty sunrise shots. I took up happy residence on the lanai, watching the surf and heavy clouds, admiring the flocks of birds.

Sunrise, Kauai

A pretty good sunrise in Kauai

I teased Martin when he arrived home – wow, how about that sunrise, huh? Pretty nice, huh? – and he silently reached over and flicked on his camera, displaying dramatic shots of orange light streaming through darkened clouds.

Oh! Well, yeah!

That’s a pretty good sunrise.

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Defective Dangling Dongles

I am sitting in a charge nurse meeting at work, listening to the Information Technology (I.T.) guy explain why our computers are so slow.

“It turns out,” he says, “the trouble is with their dongles, so  – ”

My eyes pop open.

“Dongles?”  I burst out involuntarily, incredulous. “Did you say dongles?”

The I.T. guy misunderstands my reaction. “Yes,” he says earnestly. “Little antennas that plug into – ”

I’m not listening anymore. A whole new continent has just been discovered, a brand new world has opened up before me, ripe for exploring.

Computers have dongles!

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Kauai: Capricious Rain, Conflicting Emotions

Kauai: Capricious Rain, Conflicting Emotions
To read my Kauai journal from the beginning, click here

Martin was up again before sunrise and out of the condo in his quest for Sunrise Pictures. Hope does spring eternal. By the time I rolled out of bed, several very-civilized hours later, the sky was as it’s always been: grey, with darker grey patches and slashing rain on the horizon. Heavy brown surf pitched in the bay, and wind whipped through the coconut trees.

3-10-013_01And Martin is out there somewhere, facing bravely into the wind, camera optimistically set up, waiting to see if the sun just might burst through the heavy bank of black clouds.

I just love him for that.

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Kauai: Crossing Over

Kauai: Crossing Over
To read my Kauai journal from the beginning, click here

Martin and I awoke to pounding surf, grey skies, and threatening rain. We stood on our little lanai in the dark, overlooking the leaden bay, listening to the roaring surf and howling wind, and watched the sun struggle to come up.

Despite such iffy weather and threatening skies, we decided to venture out, driving up Kuamo’o Road to ‘Opeaka’a (“Jumping Shrimp”) Falls. We admired the view of the thundering waterfall, then drove on, stopping frequently at other overlooks along the road and admiring the flocks of handsome “red junglefowl” (really, a bunch of chickens) pecking freely through the wet grass. The Keahua Arboretum was at the end of the road, where the road plunged into the Wailua River.

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Kauai: Getting There

Kauai: Getting There

Los Angeles Times, March 8, 2012: “Anyone dreaming of a sunny winter break in Hawaii this week can forget it. The governor has declared a disaster area on Kauai after days of relentless rain that caused flooding, mudslides, water-spouts, hail, and dangerously high surf. The weather service said a low-pressure zone is getting ready to dump more rain, including possible thunderstorms.”

Ah yes. Of course. The forecast is for rain.

Lots of rain. Every weather website displays icons of black clouds and slashing rain drops, usually graced with fierce lightning bolts. Day after day after day.

The Beebees must be going on vacation!

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