Boundaries, microscopes, and shoes

Upon my friend Anoop's urging, here is an update to my blog.

I have actually been meaning to update for a long time now. Sometimes I see or experience something that I end up thinking about for a while and I think to myself how I would want that moment, or that vision, saved someplace in writing for me to share with others, or for me go back and read sometime. But it never really happens as I would like it to. The small little sweetnesses of life are tossed around and eventually engulfed by the waves of other shit in my head, like bread crumbs in an ocean.

I saw the movie "Julie & Julia", which was better than I had thought it would have been. Something that stuck in my mind was the fact that Julie kept a blog of her own and at some point came to the realization that there are way many more people out there who read her blog than who comment on it. It made me think because I have received a few comments here and there from readers, but the counter on my blog reveals 500-something hits. I wonder who all of you are :)

I was searching the web today to try and find the perfect pair of black knee high waterproof boots. Boy, are they expensive! I have narrowed my search to about 5 pairs. Winter isn't here ...yet! So I do have a little bit of time left to be picky.

There are some patients on my unit who wish to be on comfort care, which means that they want no more medical interventions except pain relief. No vital signs being checked every 4 hours, no medications except morphine, no CT scans, no MRIs, no antibiotics, no ultrasounds. Just comfort and care. Sometimes what happens, especially right at the point of there being no more hope for recovery, is that the families of such patients, who may be well aware of the patient's wishes for comfort care, start to panic. They begin to think to themselves how different life is going to be without mom around, for example. Just imagine: the same woman who has existed on this beautiful planet for 80 or 90 some-odd years, who has been there throughout your entire life, is now going to leave you and suddenly you feel like a child even though you may be in your 5th or 6th decade of life. You are rendered totally helpless at the thought of losing her, and you will do anything to protect the idea of your mother still existing tomorrow. Anything, including ignoring her desires to spend her last remaining days on earth without the tedium of medical exams and medications, which are essentially useless at this point of her life (What are you going to discover in a 95 year old woman's body that has not been discovered before? And furthermore, what the hell is going to be done about it that won't push her closer to the end of her life anyway? As an example, an operation to remove a tumor in a frail, dehydrated body will probably cause more damage than the tumor itself). What happens then is that your mother ends up laying alone in a hospital bed, wondering why she has to be woken up every 4 hours for a blood pressure, why she has to keep taking pills she cannot swallow. To make it worse, the doctors become scared to allow the patient to receive even the smallest doses of narcotic pain relievers like morphine, because in a dehydrated, aged, 90 pound female, there is a chance that even 2 milligrams can slow the systems down to the point of failure...which is a chance mom is willing to take, to get rid of the pain, but a chance you are not willing to take because you don't even want to think about losing her. And the doctors will not take the chance either because they are afraid you will sue them for killing your mother. Meanwhile your mother believes her family has deceived her so, because all she wants is pain relief, nothing else, and the only relief she has from the pain of impending death is Tylenol. Away from your sight and under your realm of perceptions, she suffers, and we nurses, as liaisons between family, patients, and doctors, are unable to answer her questions, unable to relieve her cries, unable to explain to her the intricate matrix of politics and psychology that surround death in our society.