New Resident Orientation

Years ago, before this all began, no one told me that once a month, I would become homicidal, experience mood swings, and develop intolerances/shortened fuses—especially toward stupidity.   But here it is—the time of the month I dread:

New Resident Rotation. 

Yes, today is the day I began to get to know my new Residents, and they began to get to know me.

Two of the little darlin’s  came to within a DDP of being sent to a fiery place south of here today—and I don’t mean South America.  In recognition of this, I have  composed an Open Letter to my Residents.

Dear Residents~

Congratulations!  You have achieved much in your young lives. I am you Patient Care Coordinator (in nonVA-land I am comparable to a Case Manager).  I can make your month-long rotation through my ward, one of intensely gratified learning, or it can become your living nightmare. The choice is ultimately up to you. 

I’d like to take this opportunity to explain to you why I don’t call you  by your first name as you insist on introducing yourself, and to share three truths with you. 

First,  I call you Dr. (insert your last name) as an outward sign of my respect for you. Not because I am your “handmaiden” (I am not), but because you have worked hard for that title and distinction.  By refusing to call you Johnny-Bob  or Sally-Anne, I am bestowing upon you the honor and respect you deserve.

And now for the truths:

Truth #1:  You have forgotten more about medicine and the human body than I have learned.  I would take my hat off to you, if I wore one. That is an accomplishment. Well done.

Truth #2:  Although you are a physician, your orders will not always be blindly followed. Especially here at the VA—where, in addition to your order, you  may also be required to have the agreement of a consulting service in order to obtain what you feel your patient needs. Sorry, but even though some of you think your title of physician is synonymous with God, it is not.

Truth #3 (and this is one you should seriously consider heeding):  I know VA policies and how to accomplish what you want within VA-land. It’s not like nonVA-land. Change here takes an act of Congress. Literally. Therefore, when I tell you what the process is, don’t attempt to circumvent the process. Don’t argue with me about the process. Don’t ask me four (4) times in a matter of minutes as if you believe the process has changed. And especially don’t think you can wear me down and I will relent and give in to your demand—if I relent and do it your incorrect way, you will not succeed in obtaining the needed service or evaluation for our patient (see above for the reason the process has not changed in the last decade, let alone the last hour).  Please, just follow the process as I have outlined it for you. You  will be happier. Your patient will received the evaluation or service he qualifies for and needs. And I will not have to resort to killing you and disposing of your body. I’m running out of ideas. And DDPs

Sincerely,

Mary Lou  

Freedom Loving Moggy

Last week I gave Moggy his freedom. He wants to be an outside cat and I was tired of fighting it.  I can't continue to protect him from the Big Bad World if he's intent to putting himself out there.

Every morning he escapes, stays out while I'm at work, and returns--usually running to greet me when I arrive after work, but sometimes waiting until Bandit and I go out at 10pm. Thursday  he didn't come back. I decided to accept this and not worry myself sick about his whereabouts.

I wasn't exactly successful not worrying. But I limited my worry time to the time I actively searched for him. Then I limited the active search time. I called his name each time I was outside and I looked at a few of the places he likes to rest.  Moggy was nowhere to be found.  Bandit and I made a trip around the neighborhood to make sure he wasn't hurt by the side of the road. Still no Moggy. We went back inside and I forced myself to settle in for the night.

I dozed in a fitful sleep peppered with dreams of hurt animals and helplessness--both mine and my dream characters. About 2:30am I was awakened by the sound of a horrible cat fight. I shoved on a pair of shoes and went outside to see if I could find Moggy. The neighbors cat was slinking away but Moggy was not to be found. I called his name quietly and looked in the neighbors yard as well as I could--they are new and I didn't care to meet them looking for all the world like a Peeping Tomasina, in the wee hours of the morning, wearing only my nightgown. They have plenty of time to learn my eccentricities.

I looked in a couple other neighbors yards as well.  Nothing. I finally went back to bed.

Around 4am Moggy showed up. Not bloody or hurt as I had feared.  Maybe he observed the cat fight between two other cats; however, the next morning he stayed inside rather than rushing to escape into the world after his breakfast.  Perhaps he was in the cat fight after all...

This weekend I watched Moggy jump into a crouch when he heard an unexpected noise outside of his line of sight. It was not a playful "I'm getting ready to pounce on Bandit" crouch, but rather the scared slink of a "fright or flight" crouch. Soon thereafter, he came to me for a little scratch under his chin. That's when I noticed a little knot on his head and a place near his eye.  Still no blood. But definite evidence he has, in fact, been in a brawl.

I monitored him over the weekend--he won't let me check out the knot--it's a little matted so there may be a slight hematoma or dried blood under the fur.  Moggy has exhibited no neuro symptoms, no nausea or vomiting, no active bleeding, no guarding of tender internal organs, etc.  He's tolerating his diet, his bowel and bladder function remain intact, and he's moving without difficulties. I'm pretty sure the  cat fight did not result in a major trauma or concussion.  He appears subdued, but not majorly worse for wear.

However, Moggy stayed close the rest of the weekend. He ventured out, but returned pretty quick each day.  He was also a little less antagonistic towards Bandit. Perhaps he had tried his aggressive play on the other cat and got put in his place. Or perhaps a territory fight ensued. I probably will never know.

I wondered if Moggy would venture out this morning. I needn't have feared, As I left for work, I spied him watching the world from atop the privacy fence.

When I returned this evening Moggy also returned--meowing to slow my steps until he had arrived as I was getting ready to open the door. Smart cat. He's trained me well in less than a week of freedom.

The Great Cool Weather Apparel Migration

And it so begins: The Great Cool Weather Apparel Migration.

The migration is an annual phenomenon in which normally docile sweaters, light-weight coats and jackets,  gloves, hats,  wraps and scarfs of all weights and sizes exert their independence.  Yes,  even as we work long hours to supply them with laundry detergent, fabric softener, or dry cleaning, the ungrateful apparel dare to plot their exodus.

Oh, they might appear to meekly accompany us to work in the chill of the morning. However, make no mistake about it, they have observed their Sock Cousins and will bail on us at the first hint of warm weather.

It begins innocently enough.  A scarf or wrap, carried on the arm rather than worn,  is left at work or in the SUV on a frost-free evening.  It progresses to a  missing hat or singleton glove a day or two later. Before you realize what has transpired, you go to your Coat Closet and note your favorite hoodie is MIA. You assume it’s in the dirty clothes hamper awaiting Laundry Day. But it’s not.  The mornings and afternoons continue in the  warming trend and thoughts of hoodies and gloves are replaced with frantic calls to the spa for long neglected waxings and pedicures.  

However, the weather is like a fickle woman who changes her mind often.  After the threat of frost is past, an unusually  brisk Nor’Easter  prompts a return visit to the Coat Closet. This time the Coat Closet appears noticeably less congested—not only is the favorite hoodie missing, so are three coats, a jacket, two hats, six scarves, a pair woolen gloves, and a singleton of the extravagantly priced leather gloves, bought on sale with a Birthday Gift Card, and only worn once.   The singleton is found, bloated beyond recognition, the morning after a monsoon.  A Google search ensues on how to repair the damage.  The glove is blocked with absorbent towels, and left to air dry for several days.

To complicate matters, Laundry Day has come and gone, the hamper stands forlorn and empty, and the hoodie, and remaining missing items have not been located. 

Where could everything be?  Is a question that perplexes  sweater owners through the ages. That,  and Where did the sock-mate go?  But that’s the topic for another post, another day.  Now I’m off to corral my miscellaneous cool weather apparel—most of which have escaped and migrated to my SUV or office.

Georgetown Intersections

I almost died twice today. Okay, it was really only once and the other time was really just almost a fender bender. They both involved Georgetown intersections.

The first intersection was inside a shopping center. We were at a four-way stop. Everyone politely waited their turn. Finally, it was my turn. As I started to make my left-hand turn, the woman on my right ran through her stop sign and cut me off. She was inches away from hitting me. Had she hit me, it would have damaged my SUV; however, I likely would have been spared injury. I breathed a prayer of thanksgiving for safety.

I went on my way and had a great day shopping at two of my favorite HalfPrice Books. At the first, I found a bundle of 4 books for $2 and another book for $1. The girl at the counter was really trying to increase their email data base. I told her I was already in, but she acted like she didn't believe me since I wasn't using my 20% off email coupon. I tried to explain to her 20% of $3 is $0.60.  I finally succumbed and used the coupon to make her happy. So my 5 books cost me $2.40 plus tax.

Driving around I found a Bed Bath and Beyond and went inside to see if they have different colored  handles for the large insulated Tervis glasses.  They didn't.  But, they did have a really cute Oh the Places You'll Go glass. It's my favorite Dr. Seuss book (as an adult--my favorite as a kid was  Green Eggs and Ham). 

I decided to go to one more HalfPrice Books before I tried to decide on what I was hungry for.  No bundles at the second store. But I did find five individual books for $1 each. And again the counter help insisted I use the coupon to prove I was in fact on their list. So my five books cost $4 and tax.

All in all, $27 for a large Tervis and 10 books.  Not bad.

I thought I might eat at the Monument Cafe on the way back through Georgetown, but when I drove through an intersection, a black F350 came barrelling through his red light and slammed on his screeching breaks.  He was so close to slamming into me, if I had backed up, I would have torn my driver side-mirror off.  If his breaks had failed or his tires had lost traction, I have no doubt, I would have ended up in the hospital and my SUV would have been totalled. As it was, it was the second time today I breathed a prayer of thanksgiving for safety. I'm thinking my guardian angel is deserving of a raise--or at least a vacation.

Now I'm home, Moggy has been fed, Bandit has been outside, and I'm going to read a little before bed. I'm thankful to be home safe and  sound.

It's a dangerous scary world out  there--especially the Georgetown intersections.

Epic Tantrum Failure of the Bully

Once upon a time I knew a man who threw tantrums and bullied his way thru life. Very few limits, if any, were placed on him. He avoided personal responsibility at all costs. He expected, demanded, and received the care of others for his well-being, because according to him, to take responsibility for himself would result in a "loss of his money and freedom.”  

He was perfectly content to allow others to meet all his needs—and most of his wants. Perfectly content to abuse the system. Perfectly content to pitch fits until other people  picked up his slack. Until other people took care of his needs.

His lifestyle of entitlement, personal irresponsibility, bullying, and tantrum throwing served him most of his life. But in the end, a failed bully-session and a temper tantrum gone awry cost him everything he sought to keep—his money, his freedom, and soon his very life.

Who is at fault?

Him—because he was doing what had worked for him his entire life?

Society—because we allowed and enabled the behaviors to continue?

As much as we hate discipline, and as much as we balk against rules and limits—and answers other than "yes" (like "wait" and "no"), these unpopular answers, rules, and limits  are important.

There are reasons, we should work for our food and housing. There are reasons we should pay our taxes, wear our seat belts and helmets, and keep our insurance up to date. There are reasons we should not pass in low visibility roadways, or speed in certain conditions.  These limits keep us safer from harmful situations. These expectations help us to live productive lives and avoid the most destitute of situations.

Does following the rules and regulations, or living up to societal expectations ensure we will be prosperous, or have easy lives? No. But they enhance the probability. Are all rules, regulations, policies, and procedures right and good?  No. But we change them by going through the proper channels. We demonstrate peacefully. We vote out poor excuses for leaders. And when we are forced to fight as a last resort, we do so. However, we don’t start with the fighting, or the entitlement mentality—or at least we shouldn’t.

Don't be deceived—there are consequences for every action and choice we make (even those times we make passive "non-choices").  We sometimes forget about consequences because we don’t always see them. But there will be an ultimate day of reckoning each and every one of us.  

I hope my own disregard for rules does not end in tragedy like it did for this man. I want a Happily Ever After.

The Death Zone

It’s been a strange few days  in the Death Zone—starting with an early morning game of Words With Friends on Thursday, continuing with the death of not one, not two, but three of my discharge plans and barreling through a clinic death on Friday, and ending, I hope, with the death of my ride.  Okay, that’s kind of melodramatic overkill—the year-old SUV didn’t actually die. But it is in the shop. With an engine light on. And two factory recalls…

Thursday morning started ordinarily enough. I was playing an early morning game of Words With Friends with a woman in Scotland. For over a year we just played. Then about a year ago we would message back and forth about the words (up until she contacted me, I thought she was a middle-aged Engineer). In the past 9 months or so, I’ve learned her husband had a stroke a few years back and his health has not been the greatest.  This past year they have started assuming the care of their teenage Grandson, who is doing well with the new structure in his life.  The night before Wendy had asked how my week had been. I flippantly remarked about some minor annoyances.  Thursday morning I read her next remark. And had to reread it. Several times to ensure I had read it correctly.

Wendy had risen during the middle of the night and gone to the bathroom where she found her husband “dead in the toilet.”  I reread it several times to see if I could discern some sort of a cultural thing. Nada. She actually found him dead in the bathroom. Kind of like Elvis.

I remained in the Death Zone on Friday at work. No one died. However, I was tempted to kill a few Residents. The Social Worker and I had worked hard on several difficult discharges and three of our most difficult cases were falling apart.  I looked forward to leaving early to attend my own health care appointment, and have a relaxing evening.

As I hobbled to the clinic I passed  two cars parked in the drop off/loading zone. Another minor annoyance, but I was off for the weekend so it didn’t bother me. As I entered the building the owner of one of the cars was exiting with three staff members. I overheard her saying she had been driving with her Husband and all of a sudden “his breathing changed and then he passed out.” Not good. (But on a personal note, it reminded me, I’m due to renew my CPR Certificate this month.)  Sure enough, they ended up performing CPR on the gentleman.  Right on the  ground outside the building. One of the staff called for assistance of a clinic physicians,  and then 911. Unfortunately, the  gentleman did not make it. On the way home, I stopped at  a friends house and picked up her mail and newspaper so the  bad guys would not know she was out of town.

Saturday morning, I awoke and started in on our normal routine:  I fed Moggy (our rescue kitty) and took Bandit (my Hairless Chinese Crested) outside to potty.  Moggy gets a little time to eat his food in peace.  And Bandit and I have a little Moggy-less time together. I don’t think he’s really forgiven me for bringing Moggy into the family. Every once in a while he gives me a look that clearly says, “Was I not enough?” Saturday, it was a  cool morning and Bandit was very quick to do his business, so I thought I would drive over to remove the newspaper from my Friends driveway, even though I was still in my night clothes—which that particular day consisted of sleep pants and a t-shirt. I figured  sleepwear that can pass for WalMart-ware, would be fine for the country birds I might encounter.  We didn’t see a soul.

After I completed the task, we took a relaxing Saturday Morning Drive. We ended up  in a neighboring town when my  check engine light came on. Great!  My brand new SUV is dying, I’m in my PJs, I have Bandit with me, and the dealership is only open half days on Saturday.  I raced home, washed up , changed clothes, unloaded a weeks’ worth of stuff from my car, and grabbed my wallet and a book—next stop: The Dealership  Service Department. 

As expected, they were busy.  My normal Service Advisor was off, probably playing with his new daughter. The other Service Advisor, told me I would have at least a two hour wait, and he wasn’t sure if I would even be seen.  I waved my book at him and said, “I’ll wait. I don’t want to drive my SUV with the check engine light on—been there, done that, killed a car.”  He checked me in, while also checking to see if  my SUV is under warranty (it is), and he noticed there are two Factory Recalls out on my SUV. I knew about one, and had been meaning to get with my normal Service Advisor, but the second recall was  news to me.  

Just before they closed shop for the day, the Service Advisor came to tell me my problem  was a dead fuel vapor sensor. They of course would have to order the part on Monday and assuming it arrived by Tuesday, my car would be fixed by Tuesday evening after work. They would give me a loaner and take care of the sensor and the two recalls. I agreed.

The loaner is another SUV like mine—but unlike mine, it is without all the bells and whistles.  Tuesday and the departure from The Dead Zone can’t come quick enough to suit me.