soul mate.

I have a song that's mine. When I need it to, it completes me. I can listen to it on repeat 100 times (and I've come fairly close) and notice something new about it every time; it never loses its luster. What I like most about it is its immunity to negative association. When I hear it serendipitously I always feel good. Rather than remind me of the state I was in when I last sought it out, it reminds me of feeling better. Free. Whole.

Everyone deserves such a mate. What's funny is that it chose me. I heard it once and let it go with a 'meh', and it kept coming back, there for me, until I realized what it was and that I needed it more than ever.

red.light.green.light.

Robin Hood tells me fairly often that he doesn't like grey area. He prides himself on not seeing grey unless he has to. My life, (except apparently when it comes to group projects), is grey area. I like the shades of grey in things and they comfort me.

Sometimes though, I miss the absoluteness of childhood. I remember when things were either right or wrong; traffic lights were paramount examples of the concreteness of things. Red means stop. Green means go. Orders came from the powers that be, and provided you had consistent parents, it was clear what would happen when you crossed the line from right to wrong. Laws were laws and you didn't break them because you just can't break laws. The simplicity of this life is something I miss from time to time. I'm just realizing that I'm more than a little bipolar about grey vs. black and white (isn't that ironic...) and that as I'm getting older, I'm valuing decisions that only involve two choices more and more. It is so much easier to decide rather than deliberate, consider, weed out and choose. When there are only two options, your decision is made once something becomes better than the other.

It's annoying that as we grow up and become more intelligent and experienced we're always creating more choices for ourselves. Things aren't right or wrong, they're situational. You can decide how you feel about something, only to add a context that makes you change your mind. It's no wonder we're indecisive as young adults (and old adults), and often seem frozen like deer in headlights with possibilities: we have so many.

I can't blame Robin Hood for trying to make everything he can black and white when the alternative is paralyzing numbers of options. When red means stop, except when it's blinking (which means stop, then proceed with caution) or has been red for five minutes (and means it's broken so proceed with caution when able) then it's not all that different from green, which means proceed with caution, except when there is an ambulance behind you (when it means stop) or someone runs a red light (when you should put that caution to good use and stop before you hit them). How can we move forward when there are so many pathways there? Won't some of them, inevitably, take us sideways? Is there a direct route of dichotomous choices to take us where we want to go? I think even Robin Hood would agree there's not. So it is and will continue to be: complicated.

serendipity.

Awhile back I had a patient who was young, in his mid twenties, which was memorable because I hadn't spent much time on units that get patients younger than 50 very often. I remember he proudly announced it was his birthday when we came in at 7am to introduce ourselves, a trait you don't normally see in twenty somethings - this much pride, in fact, gave him the air of someone four times his age. He asked if it would be okay if some friends and family came during "patient siesta time"(quiet time enforced from 2-4 to ensure patients get some rest despite the commotion of the nursing station) because it was the only time they could make it. We told him it would be fine.

As we brought him in a piece of cake (you see he was going NPO in just a few hours for surgery the next day) and clapped and sang in a makeshift choir of nurses, he grinned (and you could tell this was unusual, it was easy to see he was "too cool for school" on the outside). But he and his family were celebrating. What were they celebrating? His car accident.

An unusual thing to celebrate... a car accident. But you see, it was perfect, because he sustained no visible injuries and claimed upon regaining consciousness not to be in any pain. Protocol requires tests to rule out insidious injuries, so they performed a battery of tests not otherwise indicated. When doing an abdominal CT, they did indeed find damage. It wasn't from the car accident however, no, it was a tumor. This tumor was quite large (8cm), and was at just the right point to be taken out before it started to wreak havoc on his organs. What could have been fatal in just a few years was found because of serendipitous bad luck, and that birthday which could have been one of his last will hopefully be one of many, many more.

Lucky.

These days, when I'm at the hospital I'm on a surgical unit. I pride myself on feeling grateful for the many gifts I've been given without needing to be reminded and not a day goes by that I don't realize how lucky I am. I do absolutely get bogged down with unimportant things from time to time, which is why I like nursing. If there is a day that goes by as a nurse on a unit like mine where you don't have to pause to give thanks at least once then we're spending our time in very different places. I try to think of ways every day to never lose sight of the fact that the people I see at the hospital are going through one of the worst (if not the worst) time in their life, and the day I do it will be time for me to move on towards a different venue for nursing.

Every patient reminds me how lucky I am to have my health, my friends and my family, and each case gives me a new way to count my blessings and be mindful of how quickly things can change. I admire their strength and their courage and hope that if the tables were turned I would be as strong as they are. Please, though, don't misunderstand: I don't pity them at all. In fact, I realize daily how much I have to learn about life in general; they teach me how to be a better, braver, nicer person in their own unique ways. I can only hope to return the favor by making their day just a little more tolerable.

Today, though, instead of being grateful to be spared a car accident, personal violence, organ failure or chronic disease, I want to take a moment to pause and be thankful for something I take for granted 99.99% of the time: my skin. 'Skin integrity' is a buzz phrase thrown at nurses from day one- it's something we've grown weary of being concerned about (have you ever seen a nurse manager come out of her office waving a piece of paper saying, "HAPU. WE GOT A HAPU. GOOD GRIEF, PEOPLE, THIS SHOULD NOT BE HAPPENING?" If you do, run.) But you see, this is the status quo for good reason. I see a wound, tunneled, deep, wide open and grossly infected and know it didn't take long to get that way. It wasn't long ago that the skin that is so mangled and angry looked like mine, except now it will take months to heal, if ever, and it will never be the same. As I run my hands smoothly over my body, pain free and without obstacle I marvel at how put together it is [knock on wood].

I say, sincerely, thanks.

syndicated.

Do you ever think about what would be happening if your life was a sitcom? When I was little, whenever I was doing anything stereotypically age and gender appropriate I would pause what I was doing, turn my head to the side and smile at the (pretend) camera like the child stars in the opening credits of sitcoms (full house was my inspiration). In order to quell my fears of the wrath of mom or dad I used to play that sappy "teachable moment, I messed up but I learned from it and you guys still love me" music in my head as we hugged it out after the delivery of the punishment. I guess childhood was my very own imaginary Truman Show...

Whenever the main character in a sitcom grows up to a new stage, she/he/they get a new theme song, new friends, and a more up to date wardrobe since they've been stuck in the same stage for about twice as long as normal kids to re-attract new viewers. It comforts me to imagine the new "cast" as I approach life stage changes, and it always proves amusing to compare the real thing to what I'd imagined they'd be in hindsight. I watched Zach, Kelly, Screech and Slater get new friends in Saved By the Bell: The College Year (yeah, only lasted one season), and Sabrina the Teenage Witch also got all new friends when she moved on to college. Even though these friends weren't the old ones we'd grown attached to, the benefits of real life mean your old friends aren't subject to contract negotiations so they'll (hopefully) still be around once you get your new ones.

It's funny though, the 'in-between' time after college and starting off in the job world is a pretty untapped market for sitcoms. Have you ever seen one that centers around law school, med school, or seeking employment? Could it be, maybe, that the stresses are legitimate (and predictable) and it's just not all that funny? I guess in TV land we jump from starting off college to having steady friends (Friends, Seinfeld), jobs (the Office), marriage and parenthood (every other sitcom) and only then when work becomes steady and life becomes more predictable can we find humor again. No one is laughing at the realities of staying in to study, babysitting for spare funds, grad school debt, unemployment and being the low guy on the totem pole...except for those of us there laughing nervously, hoping it works out for the best. I can't wait to look back at my new cast as I look towards the end of grad school and my first days as a real nurse. Perhaps my own cast of co-workers will be a little bit Mercy meets Nurse Jackie....

Cue the teachable moment music.

different strokes.

Growing up, I never, ever got to lick the brownie batter bowl. Granted, my mom didn't make brownies a lot, and I can't think of one time when she ever made cookies. I don't say this with a tinge of anything other than understanding, she worked full time, drove us around, made dinner; there just wasn't time for baked goods unless it was a special occasion, when it would be brownies or cake. We always had ice cream and store bought cookies, so I'm not suggesting we went without.

I remember one day I was at a neighbor's house - their mom was a stay at home mom - the very best kind of mom - and she was baking. She called us downstairs to come and lick the bowl. At the time, being about 8, this was a foreign concept to me.

"Come on! Before my brothers get there!" Beth had squealed. I was confused. I got down there and watched her and her brothers literally lick the bowl with their tongues, all three of them, like it was the last drop of water in the watering hole before the dry season. Mrs. Mom encouraged me to step in before it was all gone. I asked if it had raw eggs in it, as I had been so carefully trained. "Well yes, you can't really make good brownies without raw eggs. Why dear?" I dismally told her I wasn't allowed because of salmonella. She did her best not to stare at me in disbelief. "Oh, well that's good of you then. Sorry about that. We'll make sure you get a warm brownie before you go."

That changed things. Granted, even if I had been a bowl-licking aficionado like I am now, I probably still wouldn't have joined in. I developed an intense dislike of germs at an early age and never found myself able to share food with anyone other than my dad without gagging. But I didn't realize this phenomenon of licking the bowl was so widespread until that point.

Wanting to eat the batter of something delicious doesn't need to be modeled to be considered because of course we'd asked our mom if we could. But she always said no, because we could get sick. "With what?" "salmonella". Before I could even pronounce it, I was aware of this evil little microbe. This germ- and we know I don't like germs- was apparently present in all delicious uncooked things. "What does it do?" "It makes you toss cookies like you've never tossed them before. All day. And you want to die." Now as far as I know, my mom has never had salmonella. And she loves raw brownie mix. But to her salmonella might as well be kryptonite.

So, I inferred from that exchange that like most fun and delicious things, there was a forbidden aspect that prevented them from being enjoyed at all times. So, I was surprised when I found out that most people do indeed lick the bowl. I've spent the better part of my time after college baking so I can have the batter, making up for lost time and savoring every fingerful. Honestly though, the thought of taking my tongue to the bowl still makes me queasy with disgust, so I'm of course very dignified and use the spatula.

I don't mean for my mom to sound uptight or unreasonable. She has her moments, as all moms do, but I mostly think its funny that this forbidden act, perhaps the sin of all sins (and risk of all risks) that I remember from my childhood is actually something that most people do regularly. As for my mom, well, she did let us have ice cream for breakfast, which definitely counts for something.

and one day, things were different.

I've listened to my own heart and breath sounds a hundred times since I've gotten my stethoscope. Tonight, I felt some bronchoconstriction coming on, and rather than reach for my inhaler, I reached for my stethoscope.

I'm shocked. I heard stuff. Not even lung stuff, my lungs sounded fine. HEART STUFF! Mostly, when I listen to hearts I hear, "bumpbump, bumpbump", (if I'm even lucky) and because I'm a freak and a [self-proclaimed] murmur prodigy, I might hear "bumpbumpshhh, bumpbumpshhh." But thats IT. I mean, you can hear a mechanical valve with a naked ear practically, so I can spot those, but thats the extent of it.

Tonight, when I listened, I heard lub DUB, or lub dub or LUB dub or LUB DUB based on where I moved my hand. AND I heard my heart rate speed up as I breathed in. I've never heard any of those things on my heart or anyone else's.

Is this how it's supposed to work? One day, you just wake up and hear stuff?

footprints.

I went running for the first time in a long time outside today. It felt so good.

I wasn't able to run this time last year. I had hurt my knee. I was stressed out and going through a rough time. All I wanted was to run it out, so maybe I would be too tired to be sad or stressed.

Then, as my knee got better, I impulsively signed up for the marine corps marathon. Training was a bumpy road replete with setbacks and injuries. My life in almost all of 2009 was a roller coaster. I had some highs, and some amazing times, and I hit rock bottom lows and felt like a bottom dweller. I felt separate from myself, confused and off kilter and was trying to get the hang of this nursing thing which seemed to knock me down more than it built me up.

The only time I was truly happy in some stretches of last year was when I was running. My confusion and angst would bubble to the surface and pop, leaving their debris in my wake. Sometimes, I would even cry when I was running and arrive back home, 10+ miles later with nothing left...physically...mentally...emotionally. It was a nice change.

Running a marathon was a goal I'd had since I started running one mile with my dog summer evenings back in middle school. When else was I going to have the time but in grad school (well, maybe not the time, but a flexible enough schedule that would allow me to fit in 3 hour training runs), and when else would an exciting marathon run right by my house? I couldn't wait a year for my knee to get better. The time was then, 2009. This goal meant so much to me, I was impatient to achieve it... and I did.

The days I don't think about that marathon are few and far between. I'm all about looking for literary significance within real life, and the marathon is every thing symbolically and metaphorically to me that it sounds like. Despite my overwhelming sense of imbalance and not knowing, I pulled it together enough to complete that marathon. Every one of those 296 minutes felt heavy with importance (yet tense because I was so close, finally), and when I crossed the line, the pressure was lifted, and above it all I was proud of myself. (Well, to be fair, once I became more certain I wasn't going to drop dead, I knew that this particular rainy season had passed). Things seemed a lot simpler after that.

Now, when I run, I have a sense of relief that the goal has been achieved. I can run and not worry about how far I'm going. Maybe I'll run another, maybe I won't, I'll have to see. Most of all, I love repeating my routes. On occasion I'll step in a spot that must be exactly where I've stepped before, and a flashback overtakes me. I know how I was feeling that very minute I was last running to this beat or on this step and I feel it all over again. Even those tough memories make me smile, because I got through them myself. For every difficult memory, though, there is one of running the marathon; the innervation and excitement I felt when I was running it and the pride and joy I have looking back on it.

Things are different now. Nursing still kicks my butt and on occasion knocks me down, but it's not so one-sided anymore. I'm getting the hang of it, and finding myself surprisingly prepared for what's to come (and deliver my own one-two punch from time to time). I found the me I was missing, and I feel... better. More balanced. I'm truly happy even when I'm not running, and I think running showed me a happiness when I was having trouble finding any. I came out the other end of the tunnel, weathered the storm and I can't imagine having done it any other way than running through.

intrusive thought.

Just when I get in a groove working at the library the caffeine begins to wear off and my stomach starts eating itself.

It's times like these that wish I could have TPN and IV caffeine to minimize these interruptions on behalf of homeostasis...

...and then I curse Georgetown for giving me a reason to think that awful thought and say, "forget all of this work I'm going out to eat on this gorgeous day."

memory.

Scene: My Aunt's wedding. I'm four years old, the flower girl, and in a puffy white dress. I'm standing in front of my mom, a bridesmaid. About four feet in front of me, off to the side of the bride and groom, there is a microphone sitting on the ground to pick up the sound of the proceedings. Vows are in progress, meaning the ceremony is about 15 minutes in, and my attention has been gone for about 14 minutes.

Me: (to no one in particular, eyeing the microphone) I sure would like to sing right now.

Believing I could lunge for the microphone at any minute and regale the crowd with "Tomorrow" from Annie, my mother grabs my hand and gets a firm grip on my shoulder as she smiles radiantly at her sisters in law standing beside her (silently cursing her decision to ever get me a tape recorder...)

Roo and I did get this one, eventually. But my first one was red and more vintage looking circa 1988...

productivity.

There aren't many things I enjoy about being a student that I wouldn't trade for a salary, regular hours and leaving work at work. One of my favorite things though, is waking up early on a day I don't have class, going to school even though I don't have to be there and settling in to be productive knowing I will. I can say with certainty that I know I'll be productive because unless I have to, there is no way I'll be out of bed before 945 on a day I don't have class unless I have a ton to do.

So, I go to school, and rotate work sites. I treat myself to a warm breakfast and a latte and wait for the caffeine to work its magic and lift the fog, and when it does I embrace that feeling that I'm a rockstar for being up so early and get to work. I leave campus later in the day feeling smug and wanting to keep up the momentum when I get home... which is a 50% reliable prediction of what will actually happen when I get home.

Sure, until the fog lifts, I'm not studying... but I mean, looking at facebook is warming me up for looking at powerpoint slides and blogging is warming up my mind to do some quality paper writing... I promise.

motivation.

Sometimes, (and not very often mind you) when I do something just right I can hear the sound of a baseball bat hitting the ball in just the right spot with that perfect, crisp, crack and feel the home crowd roar in my head.

That's my real motivation for doing most things, for those once in a blue moon, hit it out of the park moments.

Taps

As I lay me down to sleep,

I do not count those wily sheep.

I think about the day that's passed

and all the skills I have amassed.

I do not think I hear a sound

except for footsteps on the ground.

I listen closer and I hear

a thoughtful sound that brings a tear.

At eleven every night

they play those Taps with all their might.

"Fading light dims the sight,
And a star gems the sky, gleaming bright.
From afar drawing nigh -- Falls the night.

"Day is done, gone the sun,
From the lake, from the hills, from the sky.
All is well, safely rest, God is nigh.

"Then good night, peaceful night,
Till the light of the dawn shineth bright,
God is near, do not fear -- Friend, good night."

wishes.

Today I absentmindedly wished our freezer would lose some of its coldness so I could better separate the ice cubes from the ice rock in our freezer.

An hour later, the power went out for several hours.

Wish granted.

foreshadowing.

Have you ever had a moment that seemed innocent enough but looking back was creepy in its literature-grade foreshadowing?

I was in the supply room at a DC teaching hospital, the one where I do my clinicals (we'll call it DCTH), and despite having been in many of these rooms on no fewer than five different units, I noticed for the first time the morgue kits. Inconspicuous enough, in their blue plastic containers and sterile white packaging, just like everything else. I shuddered with their implications, and had a flash of having to zip one of the white bags over a person I had just talked to. I prayed silently I wouldn't ever have to.

And then, a few hours later, a patient on our unit had no pulse. Lucky for everyone, the kits stayed put and for now, at least, there is a happy ending. Although, I suppose, happy is relative.

egocentrism part II

Lindsay Lohan.

egocentrism.

Scene: University Transport Shuttle, 4:15pm on the Friday afternoon that kicks off spring break.

Aside from the regular riders, there are several students with large suitcases checking their watches to calculate if they are going to make their bus/flight/train. On the second stop, an undergraduate female struggles to board with her large suitcase that is too cumbersome for her to handle with grace. The driver waits patiently for her to get everything inside the bus, and the man in the front seat reaches down to help her with her suitcase. She smiles distractedly at him and whispers an entitled thanks. She sits down next to an older gentleman in the third row reading the newspaper and leaves her suitcase in [blocking] the aisle. She appears annoyed rather than flustered, and has an overall arrogance about her.

The bus approaches traffic, routine for this time of day, and the tension rises as the infrequent riders worry they won't make it where they need to be in time.

Gentleman (looking at the college student): What time is it, please?

She looks at him. She looks over at the girl on the other side of the row. She looks down at her purse.

Girl: What time is it...? What time is my flight? [long pause when she doesn't get a response] ...or do you mean, like, now?

She glances at the graduate student on the other side of the bus, as if for validation of the audacity of the question. The girl doesn't meet her glance. The man nods curtly at the latter. The girl scrambles to find her blackberry in her purse even though she's wearing a watch.

Girl: Oh. Well, it's, um, 4:20,

She says with a scoff, and stops as if mid-sentence as if she had something more to say but thought better of it.

Man: Thank you.

confession.

Sometimes, when I'm exhausted at the end of the day, I see things in my peripheral vision that aren't really there. They're usually bugs. Except lately it's been every day. Starting in the afternoon.

Also, when I get REALLY tired, when I move my eyes from one side to the other the picture stays burned on my retina for a millisecond creating a laser effect like the hockey puck on tv.

So, either I am too utterly exhausted to process visual images... or a nighttime schizophrenic...

...maybe both?...

bygones.

Is it better to forgive but not forget, or forget but never forgive?

Can you ever actually, forgive and forget?

Just wondering.

in like a lion.

The beginning of march is never any fun. Tension builds; everyone is testy, tired of cabin fever and relentless chill, ready for the warm sun and long days. The only thing that keeps congenial politeness is the imminence of vacation... and then overnight, everyone turns happy because a break is upon us. Paradoxically packing flip flops and bathing suits while wearing uggs and long johns, we prepare for a much needed change. Overnight, people shed their layers in exchange for a bright cooked-lobster burn as the aura of coconut sunscreen and cucumber aloe follow them for the rest of a week. Some are left behind, grumpy still about the dreary and missing out on a week of warm, but soon enough everyone returns ready to glide out the end of march, friendlier and more calmly.

We grow tired of winter and embrace spring, the days get longer, and we are revived by being awoken by tweeting of birds at 6am when just a few weeks ago we were akin to the north pole. We're waking up from hibernation and making decisions; dating, breaking up and getting engaged. The annual baby boom begins (seriously, April-June), a string of birthday celebrations commence and weddings pop up on calendars like flowers in bloom. We get an isolated warm day (or two...) to bring us outside of our homes and offices, squinting, chubby and pale and our moods lift...and with a barrage of sweet jelly beans and chocolate bunny eggs march is out like a lamb, our moods much softer, friendlier, loving.

...Unless you're in grad school when you're just in the eye of the storm...