Assorted

Mom had her colonoscopy this morning -- and an endoscopy at the same time -- and the doctor says that everything looks more or less okay, allowing for age and preexisting diverticulosis. He doesn't see anything dire, anyhow, although he did take some biopsies. So this is a huge relief, even though it also means that we don't have an answer about her lack of appetite.

Meanwhile, I told folks at the hospital about the lovely card, and -- although it really is a lovely card -- they're a bit perturbed. No one there would have given out my last name or home address, and we can't figure out how the family got it (especially since my last name was misspelled). So I'm going to write back to the family and ask. Everyone at the hospital said, "Let us know when you find out, please, because if there's a security leak here, we need to know about it."

Knitting-wise, I'm about fourteen inches into a very pretty shawl for myself, and about five inches into a balaclava for myself; that one isn't turning out as well as Gary's did, but it's for me and doesn't need to be perfect, so I'm going ahead with it anyway.

Tasks for today and this weekend:

Write recommendation letters for students.

Start writing my annual performance summary.

Write my Christmas homily.

Work on Faith&Health columns.

Answer ten zillion e-mails.

Wrap Gary's Christmas gifts.

Clean my study, at least to the extent of being able to see the surface of my desk again.

We'll see how much of this actually gets done! But right now, I need to swim.

Wow

I just got a lovely and very unexpected Christmas card, from a family I'd spent time with after their husband and father died in the ER.

Our ID badges don't include our last names, so the family had to do some research to get mine (not to mention my address!). Taped into the card was a "card of thanks" from the paper; it specifically mentioned me among the many people who helped them that day.

I'm very moved by this, and also humbled.

I don't keep many Christmas cards, but I'm going to keep this one.

Balaclava Field Test

It's chilly and rainy here today. Gary went hiking anyway -- he's hiked in worse weather than we had today -- and when he got home, he reported that he'd worn the balaclava. He says it's warm and comfortable, and that he likes how flexible and adjustable it is.

Yay! It may not be a beautiful garment, but it's a practical one.

How to Make Susan Happy

I just received two Christmas gifts from my sister and brother-in-law.

One's smoked salmon. The other's delicious dark Belgian chocolate.

I am a happy, happy woman. May everyone's holidays be this delectable!

And on that note, off to the gym!

Grand Rounds in Haiku

This week's edition is up, with each post cleverly described with a haiku. I'm very pleased to be included.

Happy reading! Hard to believe that next week's Grand Rounds will fall on Christmas Day!

More Knitgeekery

Although I don't like Lion Brand yarn, they have a fabulous website, including e-cards featuring knitting and crocheting images. This painting is by Vincent Van Gogh.

They also have a section of parody cards: the Mona Lisa knitting, that kind of thing. But I prefer the classics!

One of their images is an ad for a WWI popular song called, "I Wonder Who's Knitting for Me?" I sent that to Gary, to go along with the WWI balaclava. They also have the oldest known portrayal of knitting, at least in the West: the Madonna knitting Christ's seamless garment on four DPNs. I'm going to use that in my Christmas homily. What fun!

In other news, I just booked a flight to go back to Philly for a week in January. These days, I like to visit my parents whenever I can. Best of all, the fare was only $288! And I'm flying through Phoenix -- which, with any luck, means I won't get stuck in blizzards -- with plenty of time to make connections. Nothing's a guarantee of a smooth trip this time of year, but I've done as much as I can.

And I can knit on the flights. Yay!

Behold the Balaclava!

Here are Darling Hubby and the Balaclava of Doom. This shot gives a nice view of the ribbing, your basic K2P2 version, which is fun to knit and has a good solid feel to it.

I know, it's a pretty dorky looking piece of headgear, but it's going to be warm when Gary's hiking on cold, windy days up on the mountain, and that's the main point. As he says, "The deer won't make fun of me."

And anyway, it may be a dorky piece of headgear, but it's a lovingly handknitted dorky piece of headgear. A lovingly handknitted, dorky piece of headgear with poignant historical significance, since I used the pattern the Red Cross distributed during WWI to civilians knitting for men at the front. And lovingly handknitted historical significance has to count for something, right? Gary has been very complimentary about his balaclava, praising my ambition in tackling something this tricky while I'm still a beginner. I praise his noble disregard of fashion in wearing it, even if only in the company of deer!

And here we have a front shot. I kept trying to get Gary to smile, but he refused. (Maybe he'll smile for the deer?) I think he looks a bit Jedi-esque in this shot. "I am not the hiker you are looking for. Move along. Move along, I tell you, because if you don't stop pointing at my dorky piece of headgear and giggling, I'll have to demonstrate my skill with the light saber."

Here's another side view that shows the main portion of the head covering, the part knit in garter stitch. The balaclava was actually pretty easy to knit, once I figured out how to juggle the doublepointed needles. I like DPN work because it's very portable: small projects are ideal for carting to meetings, coffeehouses, on planes, and so forth.

And here's a shot of the top, on this headform thing Gary cleverly rigged up from various household objects. The top looks really dorky because of those two little raised bits resembling ears. (It's a cat! It's a bat! It's a . . . dorky balaclava!) That happened when I started joining the top to the sides, and I'm not sure how I could have prevented it. I suspect it will go away when the balaclava's been worn for a while.

Now I'm making a smaller one for myself, in lovely crimson wool.

And after that, I'll attempt socks!

A Walk on the Beach

The patient was in our ER for a medical clearance before being admitted to a psych hospital. As I've discussed here before, this process can take a very long time (I gather that's true in other parts of the country, too). The patient and a family member were in one of our less comfortable rooms, the one with dentist's chairs instead of beds. The patient wasn't suicidal, but was sufficiently depressed and anxious to have decided that hospitalization was a good idea.

Being there of your own free will doesn't make the interminable wait more pleasant, though, especially when you can't even lie down. Among other things, psych patients always have all of their personal effects taken away. This doesn't make complete sense to me: while some items, such as nail files, could be used for self-harm, others couldn't. But I guess the rationale is, "better safe than sorry," even when a patient has said, "No, I'm not suicidal."

In this case, the confiscated items included two types of medication. One was an anti-anxiety med.

The ER was a zoo that day. Two other hospitals in town were on closed divert, so we were getting a steady stream of ambulances. This meant that waiting times were even longer than usual.

I'd prayed with the patient, who believed in God but wasn't conventionally religious. I kept stopping back to see how things were going. For a while, the patient and the family member were fine; if anything, the family member seemed more on edge than the patient did. But then I looked into the room and saw the patient's face contorted, as if tears might start pouring at any moment.

"Are you okay? You look really upset."

"I'm just -- I'm really anxious. I think I'm starting to have a panic attack. I really need my anxiety meds. Can you see if there's any way I can get them?"

I checked at the nursing station and was told, "No way!" (The thinking here, I believe, is that the psych hospital is in charge of psych meds, and that the ER staff isn't about to give the patient anything that could be used to OD.) I went back to the room to report this. The family member, very understandably, glared at me and said, "This is ridiculous! They can't do something that's going to help? They want a patient to go into a fullblown attack?"

I tried to find the patient's nurse, who was doing a procedure on another patient. I went back to the nursing station and was told to look for the doctor. I found the doctor, who listened very attentively -- especially considering how busy the department was -- and then said, "Have them put the chart up. I'll check in as soon as I can and see what we need to do."

But more ambulances were coming in, and I had no idea how soon anything was going to happen. So I took a deep breath, went back into the room, and said, "The doctor's going to come in, but in the meantime, let's try to get you calmed down. You've told me how much you love the ocean, and I do too. I want you to close your eyes and imagine that you're walking on the beach."

I've been on the receiving end of plenty of guided meditations, but I'd never guided one myself. I included lots of instructions about slow breathing ("breathe in . . . now out . . . now in . . . now out") interspersed with sensory description. "You can smell the salt air and hear the seagulls, and as you look out at the incoming waves, you know that you're part of God's good creation and that God loves you. You feel the cool water on your feet and the sand between your toes. In the distance, dogs are running into the surf, chasing sticks their owners have thrown for them, and when they've retrieved the sticks, they race back onto the beach and leap for joy. The sunlight is warm on your shoulders."

I'd closed the door to the room, and because the patient had also complained of an oncoming headache, I'd turned the lights off. The hubbub of the department had faded. The only sounds were my voice and the soft rhythm of breathing: the patient's, the relative's, mine. The patient's face had relaxed, and when I described the dogs, I saw a smile.

At the end of the meditation, I said, "How do you feel now?"

The patient, eyes still closed, smiled again and said, "I feel like God's with me."

Score one for guided meditation.

I'll definitely be using this technique again, and I recommend it to anyone who needs a way to calm someone who feels panicky. I'm sure meds are more reliable, but this was a very effective stopgap measure.

When I left the room, the patient was napping, and my shift was over. I wish I knew what happened after that -- unfinished stories are one of the occupational hazards of ER ministry -- but I hope, and trust, that the patient's doing well now.

Buffy-Pup is Growing Up!

Buffy's new mom sent me a set of photos a week or so ago: she's still an adorable puppy, but she's definitely getting much, much bigger!

I wonder if she's going to be one of those dogs who always think they're lapdogs. I imagine that Nancy and Gene will train her better than that, though. Some friends of ours have a beagle (a large beagle) whose idea of bliss is jumping into your lap and thwapping your face with his tail. He's a sweet dog, but the tail's a bit much.

And here's another. What a good puppy!

I still hope she's going to be a therapy dog someday. If I'm ever in the hospital, I definitely want a visit from a Golden Retriever, or some other large dog with floppy ears.

A visit from a cat would be even better, but so many people are allergic that I don't think they're allowed in hospitals. I've never heard of a hospital therapy cat; have you?

Knitting News

The balaclava is finished! I hope to get some photos to post tomorrow or Sunday; we're getting ready for company right now, so Gary's not available to pose.

Also, I've been experimenting with different seating. The ideal knitting chair has excellent back support, but no arms. Knitting on our various couches was making my back unhappy, and dealing with chair arms was making my back unhappy in another way. I solved this by resurrecting an old chair from college: a small folding rocking chair, wooden with a caned seat and back, without arms.

Perfect! It was just what the doctor ordered.

Except that it's twenty-five years old, and the caning on the seat has started to give way. I can still sit in it, but that probably won't last long! So now I have to figure out if it makes more sense to have it recaned -- I'm not even sure where I'd have that done -- or to try to find a new one.

Nertz!

Thanks, Library Journal!

Library Journal has included Shelter on its Best of 2007 list. You have to scroll down to get to the SF/F section, but since there are only five books listed, I'm very pleased.

The Necessary Beggar was on the same list for 2005. Have I mentioned lately how much I love librarians?

Dive into Grand Rounds!

This week's edition is up, with a diving theme that makes me homesick for Maui! I'm very happy to be included in this edition.

So head on over and dive on into the best of the medical blogosphere!

Sensitivity

I was recently informed by an ER patient that I need to take sensitivity training.

The patient was educated, articulate, dignified, and clearly suffering from a mental illness. The mental illness wasn't the presenting complaint, though; a small physical injury was. When I stopped by, as part of my routine rounds, and identified myself as the chaplain, the patient requested prayer, but didn't give me the chance to offer it. Instead, I became the audience for a long, winding, alternately convincing and bizarre narrative about family history, the injustices this person had suffered at the hands of police and paramedics, and the events leading to the ER visit.

The patient wasn't white. This is important.

I sat and listened; that was clearly my job in this situation. When the medical staff entered the room, I left. When I went back in, the patient was ranting to a nurse about how the doctor had been racist. The doctor had called the patient by first name; the patient found this disrespectful.

Trying to help, I said, "That's how we do it here; he'd call any patient by first name. I'm sure he didn't mean to offend you." But the patient was on a roll. The doctor was racist; police were racist; paramedics were racist; the nurses were racist.

The nurse gave me an imploring look and said, "I'll go find the doctor." I followed her out of the room and asked if she wanted me to talk to the doctor too; she said, "No, that's okay. He just has to go back in there and make nice."

I went back into the room. The patient was talking to someone on a cellphone. I left, and wound up in the middle of a cluster of nurses who were muttering about the patient.

"You know, that makes me angry, being called racist."

"It's a symptom of mental illness," I said. "Has to be. Something's wrong there."

Everyone agreed, but the staff was still angry about the accusations. This was all complicated by the fact that the patient had been discharged, but showed no signs of leaving. The doctor had evidently suggested a security escort, which wasn't going to make the patient feel better about anything.

I went back into the room. The patient, off the phone now, had spread a bewildering collection of personal items out on the countertop and was arranging them haphazardly into small piles. Things kept falling onto the floor. "I need to get all of this organized so I can go get my money." I offered to help pick up the things on the floor, but the patient said, "Oh, no, my lawyer's going to fly in and lift all the fingerprints from that. We can't touch it."

"How about if we wear gloves?" I asked, but the patient -- while moving things back and forth on the counter -- said that we had to leave everything where it was. The nurse came back and started explaining discharge instructions.

"You're standing up! You're talking down to me!" the patient said. "You're racist!"

I'd been standing the whole time. "I've been standing; I'm sorry if that bothered you -- "

Whereupon the patient whirled to face me and said, very calmly, "What you need is, what do you call it? Sensitivity training. That's it. You don't know what it's like to be black."

"That's true," I said, "I don't," whereupon the patient treated me to a long lecture about racism.

The nurse left. The patient calmed down. Through the open door, I could see three security guards (two of them white), and my heart sank. But the patient had evidently forgotten about lawyers and fingerprints, and gave me permission to pick up the things on the floor. "Oh, it's fine if you do that. I don't have a problem with you. Have you seen my driver's license? I think the ambulance people stole it."

I was trying to lift a very large plastic bag of personal belongings. Was this well-dressed, well-groomed person homeless? "I can't pick this up," I said.

"Neither can I. I can't lift anything."

So a helpful, smiling security guard stepped in to give us a hand. Perfect! Exit patient, with a helpful, smiling security escort. An audible sigh of relief went up from the nursing station, and the nurses started teasing me. "Hey, Susan, so you need sensitivity training, huh? Yeah, of course you do, because you're so insensitive."

"Well, I've had that training through church, but I guess it didn't take."

"Yeah, you must've flunked."

"Hey!" a tech called. "I found the driver's license! It was on the floor!"

"I'll take it out there," I said.

"No," said the tech, "I'll do it," and did. But a few minutes later he came back, fuming. "So I hand over the driver's license, and then I say, 'You can't smoke in here because it's a hospital,' and what response do I get? 'You're racist!' So I say, 'It has nothing to do with race! You couldn't smoke in here if you were purple or yellow or green!'"

"It's a symptom of mental illness," I said again, weakly.

"Yeah, I know, but it still makes me angry. One of the admitting clerks came up to me when I was out there and said, 'You know, I've been called everything, but being called racist really made me angry!' And I said, 'I know! Me too!'"

Later, I talked to a nurse, who observed ruefully, "When people say things like that, nobody's as nice to them, and then of course they think it's because of racial issues."

"It's a self-fulfilling prophecy," I said.

"Yes, exactly."

Meanwhile, I was frustrated by our complete inability to address the psychiatric issues. This patient lives out of the area and hadn't come in because of psych issues, which made them off-limits. And it would only have made things worse to tell the patient, "No, we aren't racist; you're mentally ill."

I'm sure the patient's encountered genuine racism in the past, and now sees it everywhere. Something -- personal history, the psych issues, a combination -- has left that patient oversensitized to the possibility of prejudice. The medical staff, meanwhile, were reacting far more defensively than they usually do to insults, insisting to me and to each other that they aren't racist. The patient's obsession had sparked some collective psychodrama, some group wrestling with anger and guilt, in the nurses and techs.

And I was in the middle, having very little luck communicating with either side. The patient's accusations didn't worry me, because I really did see them as symptoms; but precisely because I viewed them that way, I had trouble empathizing with the reactions of the medical providers, who were taking this symptom far more personally than they take most others.

Which means, I guess, that I really do need sensitivity training.

Brief Update

I've been meaning to post more, but it hasn't been happening. The last day of classes is tomorrow, but various kinds of committee work -- several involving heavy reading -- continue until the 19th. There's also, of course, grading, and tomorrow's the deadline for applications to my spring fiction workshop, which means that I have a pile of manuscripts to read and weigh. My semester will end late this year!

So what did I do yesterday? Christmas shopping! Most was online; some was at a local art gallery that's nowhere near any malls. (My holiday resolutions include not going near shopping malls until mid-January at the earliest.) The good news is that I'm now done, although I may still pick up a few impulse items for Gary. The bad news is that none of the academic stuff got done yesterday, despite my best intentions. Aaaaargh!

A Worthy Campaign

Lee, who has a pretty good feel for my politics, sent me an e-mail about one of the latest action alerts from the Episcopal Public Policy Network. They're supporting a bipartisan bill called The Second Chance Act to develop reentry programs for prisoners.

I've listened to inmates in the ER talk about how scary and hard it is to get out of prison and have nowhere to go, no one to offer help, no new skills to use to get a job. I have many friends who do prison ministry, and who are very disheartened by the cuts in education programs inside prisons. No wonder so many people go back to their old ways when they're released! This bill could help a lot of them.

EPPN has provided a handy online letter, which you can edit and personalize; EPPN will send it to your elected representatives, urging them to back the bill.

My liberal friends often lament the fact that the Christian Left isn't as politically outspoken as the Christian Right (although I imagine this bill will appeal to at least some people in both camps). This is a good way for the Lefties among us to make ourselves heard. The EPPN website has a lot of information about other causes, too.

Social justice is one of the pillars of authentic faith, Christian or otherwise. Oddly enough, it's also good politics. Who knew?

Today's Knitting Discovery

The lowly safety pin makes an excellent stitch marker: you can slide it on and off the needle or open it to insert it between stitches, and when you're not using it as a stitch marker, you can use it for other things. And you can acquire many of these at a time very inexpensively.

Before I discovered the magic of safety pins, I'd been using supermarket twist ties, which work fine too. So why do people spend money on fancy stitch markers?

Katharine said, "Because somebody decided to sell them." Unless I'm missing something (always possible!), this is a fine example of the triumph of marketing over common sense.

Gary's balaclava is coming along: I've finished the ribbed neck portion and, with Katharine's advice on how best to redistribute stitches among needles, have started knitting the back and sides. It may even, fingers crossed, be done for Christmas, although Gary's been following my progress, so it won't be a surprise!

Grand Rounds, and Mom

This week's edition of Grand Rounds is up, and I'm delighted to be included. Happy reading!

And in family medical news, my mother's in "hurry up and wait" mode. The gastroenterologist said that her weight loss and lack of appetite could be caused by many things, and she's scheduled for a colonoscopy on December 21. I'm glad this doctor doesn't seem to think the situation's as urgent as her primary-care doctor did, but I'm not thrilled that she has to wait so long to get answers. I asked her if there's any plan for maintaining her weight in the meantime, and she said there isn't.

So we're in a holding pattern, or trying to be.

Thanks for the tag, Laurie!

Laurie Edwards very kindly tagged me for the "Seven Random Things" meme; since I already participated in this meme back when it was "Eight Random Things," I'll refer you to that post.

Tag, anyone who's reading this. If you haven't already participated in this meme, you're it!

They Won't Be Better Off

One of our local hospitals recently had a tragedy: a man walked up to the ER triage desk, handed the nurse a signed note that said, "I want to be an organ donor," pulled out a gun, and shot himself in the head. He died.

Apparently the victim did not, thank God, threaten anyone else: nor were there children in the area to be traumatized by watching the shooting. But I can't imagine what the triage nurse must be going through. Clearly there wasn't time for anyone to stop the man who died: he was determined. He had a plan and carried it out. Everything happened very quickly. But people who were there -- especially the nurse -- must keep seeing the incident over and over, replaying like a film behind their eyes. They must be haunted by it.

I wonder if they'll ever not be haunted by it, even though they didn't know the suicide victim. And those who did know him, his family and friends, will surely struggle for years, if not decades, with his death.

My paternal grandfather killed himself before I was born. The family doesn't talk about it much, but the impact on all of us -- even those who never knew him -- is still profound. There have been other suicides in and around our circle. A good friend of my father's jumped out a high window when I was a little girl; Dad's second wife was a widow whose first husband shot himself. I barely knew my father's friend and didn't know my stepmother's first husband at all, but their deaths still chill me.

Others hit closer to home. In 1987, a brilliant and charming young coworker at one of my temp jobs in New York orchestrated an elaborate final journey that culminated in his shooting himself in the head at the base of Mount Denali in Alaska. In 1988, one of my college roommates -- an even more brilliant medical student -- jumped out of her apartment window. I still think about Joel and Sumi at least once a week; during my own dark times, I think about them every day.

Although I suffer from depression, I've never been actively suicidal, partly because I'm keenly aware of how many people would suffer, would grieve and rage, if I killed myself. When I find myself flirting with the idea, I draw up a list of those people, stopping at twenty-five or thirty, but knowing there are really many more. I'm quite certain that neither Joel nor Sumi would have put me on any such list; nonetheless, the sorrow of their deaths has never left me. I think about them, and I think about their families, and I think about the people -- construction workers, in Sumi's case -- put into the horrible position of finding their bodies, of having those images burned into their brains.

The week after I heard about the hospital suicide, I visited a suicidal patient during my own hospital shift. The patient told me, "I wanted to kill myself so I'd stop hurting my family."

Usually I deal well with suicidal patients; I'm compassionate to them, and I'm pretty good at getting them to open up. But with this patient, I did all the wrong things. Those words pressed a nerve, one that was rawer than I knew, and I found myself lecturing. "Killing yourself would hurt your family much more than anything else you've done! If you want to stop hurting them, please stay alive and find ways to make amends!"

The patient withdrew, no doubt put off by the heat of my words. The terrible ill-logic of depression -- "they'd be better off without me" -- is a symptom of illness, not a rational thought process. Arguing with someone in that state doesn't help. It's like arguing with the wind. I knew that.

I knew that. This patient needs medication and psychotherapy, not a hectoring chaplain. I handled the visit badly, and realized afterwards that the words came out with such force because, for years now, I've wished I could have said them to my grandfather, to my father's friend and my stepmother's first husband, to Joel and Sumi.

The holidays are hard on people; Joel killed himself during this time of year. And so, even though it may do no good, this is my message to anyone struggling with such profound despair that death seems preferable, such great pain that it seems as if everyone in the vicinity will be better off if you're no longer alive:

The people who love you won't be better off. The people who hate you won't be better off. Casual acquaintances, co-workers, and the strangers who have to deal with your remains will not be better off.

Please don't kill yourself. Please call someone and ask for help instead, even if you think nothing can ease the pain. Give hope a chance. Read this page from the Mayo Clinic. Call a friend. Call 911.

Please choose life.

Mythies Rule!

Last night, I was the guest at a meeting of Crickhollow, the Reno chapter of the Mythopoeic Society. They were discussing my novel The Necessary Beggar and thought it would be fun to have the author on hand.

Each meeting starts with a potlock dinner, with foods based on the book they've read. So the carrot above (which I got to take home with me) represented the carrot taken away from Macsofo in the refugee camp. Someone brought a roast chicken, because the family in the book is put off by the belief of some Christians that the damned "roast like chickens;" since the family's culture has Middle Eastern elements, someone else brought pita bread stuffed with lamb and herbs.

The hostess made Gandiffrian Chicken Stew, described on this card (which I also got to take home with me). Someone brought a Blue Moon pizza, since Zamatryna and Jerry eat there. Another treat was venison salami, donated by a hunting family who'd finally gotten a deer after many years of trying. They'd written a card thanking the deer for its bounty, in accordance with the family's beliefs, and the entire buffet table was decorated in a Thanksgiving theme.

And -- I couldn't believe this, but I was delighted! -- someone had actually made jello with chicken and broccoli, the unappetizing casserole given to the family in the camp after Darroti dies. Unfortunately, this dish suffered a mishap in the car on the way to the meeting, so we didn't get to see it, but I made the cook promise that if she made it again, she'd send me a photo. I asked her if she'd actually have been willing to eat the concoction, and she admitted that she'd made up a card for it that read, "For Display Purposes Only."

Anyway, it was a fabulous meal, and the discussion was great, too: lots of thoughtful comments and smart questions. Nobody in the room thought Jerry was a dumb jock -- I never intended him to be, but many readers have taken him that way -- although one person had developed an abiding, unshakable dislike of Stan because of his religious beliefs, even though he changes at the end of the book. But hey, that's like life, right?

It's such a pleasure to talk about one's work with engaged readers!