Touch the Kitty - Kahneeta

With a 4 day holiday in our grasp, we determined that seeking a change of pace from the steel gray drizzle that permeates this area in the Fall and steal away to Warm Springs. Neither of us had been there, and the expectations were modest. It lived up to what I had hoped it would be.

The first thing you notice about the place is the isolation. For about 15 miles around it, it is sparsely peopled. We actually saw wild horses and cows walking along, if not upon, the roadway. There is a certain alien beauty to the high dessert, even in the winter. Plants in muted khakis and greens, low slung scrub brush, and jutting rock formations the color of burnt umber that dapple the landscape. I think the high desert is amongst the most beautiful I have seen, you can argue amongst yourselves the merits of that assertion however.

As for Kahneeta, well, it had its roses and thorns.

Roses:
- The staff were extraordinarily friendly. When we complained of some boisterous neighbors, they not only moved us, but moved us to what the front desk person termed as his favorite room in the hotel.
- The restaurant (the only one open and on site) was generally quite good and moderately priced. Love Indian fry bread!
- The pools were nice and warm, fed from the hot springs.
- Met a fun and interesting Portland couple there who we hung out with on Friday night.
- Walked out with more than $175 in winnings and hours and hours of entertainment.
- The weird casino people and all their bizarre rituals ranging from touching all over the screen, talking to the machines, and a woman who encouraged me to 'pet the kitty' to a digital image of a cat on a bonus game on one of the slot machines.
- Free HBO........got to see some Flight of the Concords and a movie or two I hadn't seen before.

Thorns:
- Even the 'nice renovated room' we were switched to had a certain cheapness to it. The showers varied from a shower head that was installed for pygmies in the first room to one that can best be described as akin to a spray nozzle on a hose in the second room. Low end fixtures were quickly showing there lack of durability. Pool towels that were actually smaller than the room towels and less absorbent. Thermostats that controlled rattle-trap heating and cooling elements and had very non-specific temperature settings. I would not say the place was falling apart, but it was definitely showing it's age.
- The non-smoking part of the casino was actually quite ample compared to other casinos, however it was designed poorly. The upstairs was non-smoking and there was no barrier, physical or air, that prevented the smoke from wafting upwards to the second level. Our clothes reeked and my throat was raw, though we had not been within 50 feet of a cigarette the entire evening.
- The expensive spa. A lot of dough for spa services in the middle of nowhere. I will grant there is no competition, but it would seem to repel demand as well.
- $4 to go on the slides, even while staying at the hotel (they do comp you the charge for pool entry at least). We didn't use it because it was WAY too cold, but still very odd to nickel and dime for something like that.

I think that fairly covers it. It was cold, but brightly sunny. It was restful and fun. It was, all in all, a perfect getaway that could have only been made better had we won the car they were giving away (it went to an elderly couple instead).

Now to start dreading tomorrow..........I can only imagine what troubles people managed to get into, and not bother treating, over a 4 day weekend. I am already starting to twitch nervously.

If you think it, it is so

The crux of a lot of medicine and psuedo-medicine is, in part, based on how much you believe it will work, known as the placebo effect. There is a story, I believe from the second world war but don't quote me on it, where nurses had to use saline instead of morphine for soldiers when they ran out of the latter. The summation of the story is that the ruse, by and large, worked. The soldiers believed they were getting morphine and reacted as though they got morphine. This is not to say that placebos work as well as the morphine itself would have........but it worked a hell of a lot better than if they had informed the soldiers they were out of pain medication.

Unfortunately doctors cannot utilize the placebo effect. They are pinned to the wall of legality.......should they not pursue anything and everything to treat, they open themselves up to possible legal ramifications. So, the placebo effect lies largely in the hands of Naturopaths and analogs thereof. That isn't to say that none of their medications/treatments have proven effect, but it is to say that they do utilize in large part the belief that their treatments will cure to, well, cure.

Why do I mention this, well because I went to see a mental health professional today for stress and she used some rather, well, a little new age for my general tastes, techniques. I don't wish to cast dispersions on the practice because I know there are many fervent believers and a multiplicity of success stories. Much like religion, if you are a believer, everything sounds plausible, but if you aren't, it just all sounds a little crazy. However, I am going to try to suspend my disbelief for my three sessions and see. Maybe I will become a believer too.

Indulge me

So, as I was perusing the latest Costco e-mailer I noticed this product: Shelf Reliance Thrive. Tia has explained to me that this has something to do with the Mormon's and their belief in some not too distant dystopian future in which some plague, natural disaster, or what have you will require all of us to have on hand a full year's worth of food. A LOT of questions spring to mind not the least of which are 'where does one keep all this food?' and 'how will you be protected/safe from said apocalyptic events?' and 'Why just one year?' The mind boggles. In the meantime the question remains: is death better than subsisting on a year's worth of freeze dried veggies and TVP and then, ostensibly dying yourself (or whatever their version of future events is)? Ponder it, but please don't spend much time doing so.

Two funny calls today or as I like to call them 'young men are dumb'.

- First call: young guy "I got an ammonia (sp) shot the other day and my arm is totally numb" Me: (stifling a laugh because an ammonia shot would hurt like hell I imagine) "Are you a patient at our clinic, because I am not finding you in our system."
YG: "Uh yeah, I saw a doctor there..........years ago"
Me: "Do you remember the name, because if your not a patient here, I can't offer you any advice except go to Urgent care to see a doc."
YG: "I said it was years ago and I don't remember."
Me: "Years ago you would have been a pediatric patient and we don't see pediatric patients in our clinic."
YG: "Screw this man, this is bullshit!" and hangs up.

Question - how the hell did he even figure to call us the clinic in the first place?

Second call related to a young man who, upon contracting an STD that was thankfully curable with an antibiotic was given a 7 day course. This call was a week later and, in essence, the following dumb things occurred: he stopped the antibiotics early because the symptoms went away (1), he then had unprotected sex again with someone he suspected was a carrier for an STD (2), and finally he then took the remaining 3 days worth of antibiotics the next AM to prevent the STD again (3). This was a college student who clearly did not understand how STDs were transmitted nor how antibiotics worked. Scary.

thankfully only 2 more days of it............I guess its more interesting that cold/flu and diarrhea at least (the bulk of my calls).

And in other news

I thoroughly dislike the local news. Because of it, I admit to being fairly ignorant of local events and developments. To me it is a fair trade. Local news pushes too much negativity and fear mongering for my tastes. It paints an exaggerated picture of theft, avarice, and violent crime that I find revolting. But, despite this heightened sense of negative reality, they always manage to find some positive piece of puffery that they inevitably shoehorn in the last segment before they bid us adieu. Whether it be a piece about a local kid selling his comic collection to send presents to the troops, a portrait of someone who has worked to effect positive change in the community, or a water-skiing squirrel, they try to leave us with a bit of a mental palate cleaner after force feeding us trash for the previous 29 minutes. The proverbial mint after your turd sandwich. Considering the negativity of my past few posts, lets call this the mint.

I write a lot of negative things about work, and there are enough of them to be sure, but much like the local news, it does tend to distort things by exaggeration. Most of the calls I get are genuine concerns and most of the people I speak with are fairly pleasant a grateful for advice. My coworkers, MAs, RNs, and docs alike, are by and large really good people. We all share and commiserate and deal with the same burdens which makes us a lot closer than some other workplaces I have been in. We do, when we can, have a lot of fun together even if just sharing some gallows humor. It makes a tough job much much more bearable.

On top of that, our little group in Pod 1 has been garnering an unusual amount of accolades. One of our docs said it makes her happy to come to work because she works with us all, and another two (who have been there for better than 15 years) have told our manager that this was the 'best group they have worked with.' It is certainly nice to be part of those comments. Also, I get more personal accolades than anywhere I have worked previously (or at least that I recall). I am sure I don't make everyone happy, but by and large they seem to find me competent, good with patients and staff, and generally easy to get along with. All those things just make me wish that I enjoyed it more..........and I am truly trying, despite how my blog might read.

Back to my lazy weekend (partially because I have a nagging suspicion that I am fending off another minor outburst of cold symptoms that seem to be traveling through our clinic).

Rigidity

One of the longest tenured members of our clinic is being forced by a shoulder injury to call it a career on the 1st of December. She has been with the clinic for better than 8 years and seen her share of changes along the way. She is a wealth of information and a valuable resource who knows seemingly all the ins and outs of the clinic. So, why is it that with near unanimity people are more than happy to see her go?

Well, the simple answer is rigidity. She is as inflexible a person I have ever met. There is clearly one and only one right way to do things. For example, I walk to work, and though I always leave from the same place and arrive at the same place, I kind of decide on a whim how I will get there and what streets I will meander down, sometimes based on mood and sometimes in such a fugue state I honestly don't know why I go the way I do. However, I don't doubt that N (lets just call her that) would walk the exact same way day in and day out. This in itself would be fine except she is not content to just do that and call it an idiosyncrasy, she would also take pains to point out all the reasons why her path to work was in all ways superior and point out all the flaws in the method in which you decide to get to work. And she does this constantly and to everyone: doctors, staff, or peers.

Everyone has a story about her, and none are positive. Doctors roll their eyes. Staff swap stories about past conflicts. And I, and the new nurse, both asked to have our training with her cut short because we could not stand to be around her. Better to be ignorant and learn as we go than to be bullied and belittled as we learn. She doesn't teach, so much as lecture and scold. She is the kind of person that, when you talk about a rough patient or a bad day, does not empathize but rather talks incessantly about how much tougher a day she had or how much worse it was before. It is almost pathological.........and you wonder how none of this penetrates. How can one person be okay with being so universally disliked? I know I couldn't.

There is certainly a part of me that feels a bit badly for her, or would if she wasn't always so self-satisfied. But mostly, like everyone else, I just want to see her gone. I don't love my job and I have strong doubts that I ever will, but I do genuinely like my coworkers and I think we will all be much relieved to not have her standing behind us, ever critical.

So long N..........may the door hit you where the good lord split you.

Mistakes and McRibs

mis·take (m-stk)n.

1. An error or fault resulting from defective judgment, deficient knowledge, or carelessness.

Now that I have been at my new job for more than 4 months, I feel confident in calling the move an unmitigated mistake. An error. An eff up. I try not to blame myself too much for it because, of the possible definitions of the word mistake, deficient knowledge is assuredly the culprit and you can do little about that. I tried to perform due diligence and shadow, ask questions, and o/w do everything I could to try to understand what the job was, but it was too much to believe that I truly knew what it was I was getting into. I couldn't.

The only thing I can compare it to is test driving a car. You can get a feel for the car's performance and a general idea about its accessories..........but until you own it you can't know that the cupholders are not in the ideal spots or the seat is too hard on long trips or that certain things rattle and on and on. Only in this case, using the car analogy, I think I bought a lemon altogether. The cupholders may be annoying, but it is nothing compared to your engine perpetually catching fire.

I think the major issue is really that the actual job is so very different from what it was purported to be. I knew I would be sedentary and that it would be M-F and that I would largely spend my day staring at pixels on a screen with a headset strapped on. But what I didn't know (couldn't know) was that, while I do primarily triage, I also do a whole lot of customer service, serve as a mouthpiece for both good and ill news for the doctors (generally the latter), and deal with a lot of people who are pissed off about something or another related to their health care that I am obligated to placate when I really want to just tell them to go eff themselves. Oh yes, and filling out copious paperwork and typing extensive notes about all of it. It is exhausting mentally and emotionally. I feel worn and frail. I vacillate between anger and a kind of deep overwhelming sadness because, well, what the hell can I do about it anyway? I have quite literally painted myself into a corner and there is nowhere to go without making a mess of everything. Honestly though, I more and more question whether that would really be all that bad.

In the interim, I am putting out multiple applications a week and ever broadening my search parameters because, well, the more trapped I feel the more open I am to any means of escape. Like the movie 127 hours, the protagonist didn't start by deciding to sheer his own arm off, but he did it eventually because he had little other choice. I am definitely encroaching upon that proverbial point because I am finding the cost of my displeasure to be too high. I hate the way I feel in my hours away, that I am already dreading tomorrow, and that Tia has to deal with all of it. Physically I am chronically headache ridden, my stomach is an acidic mess, and I find myself leaning further and further towards accepting pharmacological solutions as a means to subsist. Updates to come as they warrant of course.

In other mistakes, after being bombarded by ads and recommendations from people I work with, I tried a McRib. I think I may have had one before, but it has been a decade or so. I have to say, it may take another 10 years for me to forget this experience as well. The texture was off putting and the taste was somehow worse. Just altogether unpleasant. I just don't understand the clamor.

We also got to try a Portland institution this week, Stanich's. It was actually quite good and pretty darned inexpensive. For 4 adults, we ate well with a beer and 2 sodas and the tab was a mere $30. Not a one of us left less than stuffed. The burgers themselves are fairly pedestrian, but the cheese and sauteed onions were sublime. The fries were winners too, and appeared to be freshly cut with skin on (always a bonus to me). Not the best burger I have had in Portland, but dollar for dollar, among them to be sure.

I think it is time for a Sunday nap. A rare but necessary guilt free pleasure.

Fierce chops and other stray observations

I suppose every city represents juxtapositions of some kind or another. Certainly Portland does. I live in a place called the Pearl......which is a fairly upscale part of the city proper. We don't live in the thick of it, but we live there. Much like saying you ONLY got the base level BMW, you are still driving a damn fine automobile. Despite this, we are surrounded by the homeless. It is a startling contrast seeing someone begging for change outside an establishment that has the temerity to sell 'couture' t-shirts for better than $75 apiece. But yesterday, well, that had to take the cake. On my way to work someone had literally pitched a tent on the sidewalk, parked their cart out front of it and said 'fuck it, I am sleeping here' and then proceeded to do so. The difference from anyplace else I lived to here is that no one thought twice about it, they just stepped around. Odd indeed.

Speaking of odd, you have to love the 'individuality' of our denizens, even if they often end up trying to look so different from the mainstream that they end up looking kind of the same as each other. I had to go to work earlier than normal last week and both days I walked past a gentlemen with the fiercest pair of mutton chops I had ever seen outside of civil war reenactments. He was otherwise young and moderately dressed, certainly not traits one would associate with such a bold facial hair accoutrement. One wonders what kind of work he does and how this choice came to be. I am not one to state that you cannot express yourself in any way you choose, but I also understand that you also self limit your career options by doing so. Even if you boast sterling credentials, it is unlikely your neck tattoo, grizzled neck beard, and affinity for cranial accessorizing will net you a position of much import. Individuality does not need to be nakedly displayed. It should, in fact, run deeper than that. So, to mutton chops, I salute you sir, but I also have to wonder what you do with your days.

On Friday we saw some friends we had not seen for seemingly ages. It happens that way as a grown up (adult............er, teenager x2.........whatever). You end up not seeing people for months and then, when you do, you question why it has taken that long. Before long it has been another three months and the cycle repeats. One of the bummers about getting older is that you now have the money to do the things you couldn't when you were younger, but now you don't have the time. Then, at the point you retire and have the time, you probably won't have the money. Rather than go down that treacherous path, great food (Foster Burger is quite good), good friends, and I forgot how much Scattergories can be.

Time changes in the NW suck btw. I like the idea of walking to work.........I like less the idea of walking home in the pitch dark while it is cold and wet and I have to tromp over a slick mess of rotted leaves. The good news is this should all be over in just a scant 4 months or so (sobbing quietly to myself).

Speaking of slogging off to work, I best put myself to the task of sleeping so I can do it again tomorrow.