Running out of fucks to give

When I got into nursing I really, truly thought the vast majority of my time and effort would be spent on helping individuals that met with poor luck, poor health, or poor timing.  I had expected trauma, elderly, and the infirm.  What I get instead are abscesses, lots and lots of them.   A few are related to a rough cat or a pet rat or the neighborhood dog taking an inopportune nibble on someone, but most are related to injectable drugs.  And if it isnt an abscess related to drugs, it is a side effect from years of self abuse.  Wonder why your heart is failing at 50, lets look at your 30 year history of meth.  Why is it so hard to find a vein through your scar tissue and prison tats, oh yeah, the 20 years of heroin.  We have had people in their 60s and 70s that come in with drug related ailments now.

And far more often than one would think, people going through alcohol (ETOH in med speak) withdrawals.  Nothing like tending to someone going through delerium tremors and fighting their restraints.  Want to see people the color of the Simpsons, come on down and I will take you on a tour.

And even when you think it couldnt possibly be the case, it is.  That soon to be mom you just placed an IV in because they couldnt find anything to stick themselves, inevitably they are on Methadone.  If the baby is lucky, that is all they have been on during the pregnancy.

It is harder and harder to care when most of the people you see in a given day (mind you, we get called for any start that is difficult or not easily visible......so by percentage, we generally see only the worst) don't seem to care about themselves in the least.  Plus, we set up a consequence free environment for them.  If you shoot drugs into your central line, the doctor will pull it....and then shortly thereafter realize that the person still needs 3 more weeks of ABX and then order another line placed.  Want to go AMA (leave in spite of the recommendations from the doctor)?  Go ahead and feel free to come back whenever and we will do it again.  We have patients who go AMA and return later the VERY SAME DAY to the ER and then get readmitted and they order another line placement.  Its like you had a buddy who had no job and you let crash on your couch for a bit who then proceeded to eat all your food, drink all your beer, and then takes a shit on your rug before leaving.......only to then knock on your door later that evening looking for a place to crash.  And you fucking let them!

The good news is, these people are no longer uninsured.  No sir.  Now they ALL get signed up to OHP (in ORegon anyway).  So, we are monetarily contribute to this horrible little tax scam.

The ultimate fuck you in the whole situation is that we do nothing (ZIPPO) to help these people.  IF they came in homeless and drug addicted with a raging infection, they will leave without the infection but nothing else will have changed for them.  We have no plan.  Why would you repair the heart of someone who has been abusing amphetamines for 3 decades without any plan in place?  Are they going to suddenly stop?  Or are you just prolonging their ability to live a few more years within which to put more amphetamines in?

I don't claim to have a solution to this, other than cutting the drugs with antibiotics so they can stop the infection before it starts, but I am running out of empathy and growing so tired of feeling like what I do doesnt really matter.  I am doubtless far more competent in my skills because the patients are so very difficult because of what they have done to themselves.....now I just wish I could use those skills to treat people who I felt good about helping.

The university of Vantucky

I haven't posted in a LONG time.  I procrastinated it right out of existence.  Won't bother making amends.  Best to just sweep it under the rug and move forward of I will never get this out of idle.

We are now Vantuckians.  For those not in the know, here is the definition from the Urban Dictionary:

Vancouver, WA. Think Kentucky but in a different part of the county, and just a city. Just across from the river from Portland, OR the whole city seems to be a few years behind and mullets and 4x4 raised American made trucks are plentiful.

WE are close to the downtown area, which means we skew a lot more towards urbanites, but we are still rife with bleached hair, lifted trucks, and people who spend a week's pay for fireworks for any occasion they can justify.  Fourth of July was like Vietnam around here.  People do not mess around!  Its different here.  

On the plus side.....it is somewhat cheaper to live here and is still close to work.  We are currently in the throes of a seemingly endless parade of projects on our duplex (our nanny lives in the downstairs unit, which is awesome).  So, in the past 6 months I have learned to (with varying degrees of success), install a dishwasher, a new kitchen faucet, a garbage disposal, wired up some new lighting in both bathrooms as well as repainted, caulked, removed old shower doors, and refinished the cabinetry in the bathroom (that one I need to work on more), and, with the help of Diane and Tia, repainted pretty much every inch of the upstairs.  Next up will be re-doing the flooring (I would love to try my hand at it, but I think time and toddler constraints will have me shift that responsibility over to the pros) and then the yard (probably in inverted order).  

The messed up part is we havent the intention of staying here for more then a few years really.  But where to go if we left?  Tia would like nothing more than to return to Portland.  I am not opposed, but the reasons we left have not changed.  For a nice house, in a good school district that keeps us near our respective jobs, we would need to spend about $450K.  The same house in, say, Salmon Creek, might be nearer $300K.  Plus, you know, another $100-$200/mo in taxes on the PDX side with the price difference.  Ouch.  Suffice to say, the discussion rages on.  

In the interim, we are seeing lots of neighborhood flips, a slow revitalization of the downtown restaurants, and a new waterfront development in the works.  Could actually be a pretty trendy place to live in just a few short years.  

My back

Whoa!  I almost made it through the entire month of June without a post.  So far my plan to keep up with my blog is going about as well as my plan to start running again or floss ever.  Sigh.

At least presently I have an excuse for the lack of cardio, my back is effed up.  I am not even sure when it happened.  There was no moment that I thought, 'shit, that is really going to hurt later.'  Nope.  Just me and the whole getting older thing I guess.  Anyway, I came home on Sunday after my shift and felt fine (though tired.....it is hard to get used to doing 10s and pushing a cart all over the place as compared to working in the clinic where your brain is more taxed than your body is....hence the whole back thing).  Then I awoke at 3am with this horrible pain and didnt sleep thereafter.  Called out for my shift and made an apt for a massage thinking it was just a strain.

Massage was helpful, but the next day it felt like someone has spent the entire day punching up and down my spine.  I was hobbling around and it was painful to get up or down or to lift anything above my waist.  But, I thought there wasnt much I could really do and that the massage would ultimately help.

Come Thursday, I finally just went to the doc.  Pain was no radiating from the initial low back locale to my shoulder blades and my hips.  Thankfully, as I had guessed, it was just muscular and not bone related.  Also thankfully they gave me a muscle relaxer and some pain medication.  I had never been on a muscle relaxer before and I have to say they are FRIKKEN amazing!  Finally the pain abated and I could start feeling normalish again (the downside is they really do hammer you from an alertness perspective.  It felt like I was drunk).  So, hopefully this weekend shit starts to heal up.  I HATE using so much of my sick/vacation bank for actually being ill.

In other news, we are a week out from owning 2 properties.  Paperwork is signed and we take possession on the 25th.  Will be terrifying.  We dont move until the 3rd, so we will have a little time to clean, etc before jamming our stuff into the new place.  In the interim I thought/hoped to pull up the flooring and get new carpeting.  However, it turns out that new carpeting would be about 5K, so cleaning it is!  Then, once we are out of our current place, we need to get it staged and put on the market, hopefully around the middle of July.  After that it is just time to cross our fingers and hope we can sell it quickly (and full price or better would also be excellent!)  It is going to be a hell of a month for sure.

Quinn is almost 2 years old.  Crazy!  I cant believe it has been that long already.  He is really fun to be around now (well, 95% of the time anyway.........which is better than most people let alone toddler people) and is developing quite the sense of humor.  I am excited that the new place with allow us to have our super nanny, Gloria, downstairs and really hope that things work out well.

Back to packing.  Where did we get so much stuff from!

The Couv

It is looking more and more like our days in Portland might be numbered.  We appear to be very near to moving to yet another state.  All the way to Vancouver, Washington.

I think it might be an adjustment.  Legalized gay marriage, booze in the grocery store, and fireworks with no restrictions.  Oh yeah, and they are moving to legalize marijuana.  Plus they have no state income tax and they pick up your trash EVERY week. It is a libertarian utopia!   But, there is also the whole sale's tax thing.  Oh, and working in Portland does not allow you to escape the income tax thing.  Plus the state is adjacent to Canada......and you know how unstable and prone to warmongering they are!

We have an accepted offer and had our inspection today.  Also broached the subject of our nanny moving across the border with us (did I mention it is an upper lower duplex!).  Will have the report tomorrow, though nothing appeared to be significantly wrong.  Of course, they can also see what is visible.  Then we will need to go back to the owners and see what, if anything, they will fix for us (or cut the price).  But I really do hope it works out.  I am tired of the general choppiness of the neighborhoods (at least the ones we can afford) and the idea of being able to walk Quinn to a decent school is very very appealing (plus, they have WAY less shootings in their area!).

More to come.

Humans make mistakes, but humans in HR just make more

So, I just got off the phone with HR.  

TWICE!

First call (they left a message):

"This is (name redacted) with HR.  It appears that your Washington RN license is expired.  I dont know how you are supposed to work your new position if this is the case (frantic).  I hope you have not worked their recently.  Please submit for your WA renewal and get back to me as soon as you do."

I call back after verifying that, in fact, this is not true.  My license expires in 2015 on my birthday.

Me:  "Hi, I received a message that my license is expired and I am looking at the website and it appears to be active.  I just renewed it in March."

HR: "Oh, I am so sorry.  I was just told this by the business office.  I suppose that will teach me to check on these things myself before I call people.  So sorry to have alarmed you.  I will print it off and correct it."

Me: "No problem, thanks for fixing it."

2 minutes passes and phone rings again:

HR: Hi this is (name redacted) and I am sorry to bother you again, but I am looking at the page and on the one page is says it expires in 2016 and on the other page is says it expires in 2015 and (realizes it is 2014)..........oh, I see now.  Oh. I am so sorry for calling you again.  You must not think much of me and HR.  So sorry to have bothered you again with this."

Sigh.  It is any wonder why I don't trust our HR at all.  This is the same group that nearly lost me the job 3 years ago when I had to re-apply while working there because they neglected to check a box.  The same group who, when I called 5 years ago ran me around and around and basically treated my phone calls inquiring about the status of my application treated me like a telemarketer calling at dinner time.

I suppose I should be grateful though.  If a day ever comes when they opt to terminate my employment, what is the likelihood that they will be able to process that paperwork correctly?  

Does it count if I wrote it in April?

Well, this is my last week in the clinic.  Last Friday was really bittersweet as all three of my afternoon patients were visibly upset that I am moving back to the floor.  Two of the three also clearly weren’t fond of the less gentle method of IV placement that my replacement uses.  However, she finds the numbing agent to make the process less effective and, given the option of using it and potentially having to re-stick, most would prefer going without.  However, I don’t find it has any impact on most people’s veins…at least those that are healthy enough to come into the outpatient clinics.  That said, I think my (temporary) replacement will do very well.  She is very intelligent, has years of experience, and has the same jovial personality that I do.  She may not engage with the patients in the same manner that I do (part of it is my belief that the experience should be made more personal and personable and part of it, as my wife and her eardrums would attest, is my inability to shut up), but I have no doubts she will provide safe and effective care (at least until she goes on maternity leave in the summer). 

As far as who will be the one to take over the clinic ‘permanently’, there are still some questions.  Though, it appears, they will be opting to put a former employee in the position over the person that they had spoken of previously from out of state.  This is fine in some regards as I do not doubt the skill and ability the former employee brings to bear and she will be thoroughly familiar with the system and the clinic.  On the other side, she is not a very committed person…kind of a nursing vagabond really.  How long she will choose to tolerate the generally languid pacing and lack of internal support for the clinic will be interesting to see.  I have not been part of the process though, so I am unsure of what (or when) someone new will walk through the door.  All I know is that, come Friday, I will be little more than an occasional fill in.  Honestly, the whole thing bums me out. 

But, as there is no plan for the clinic going forward my choices were limited.  I could have ridden it out to its termination point of course, but that would have left me with precious few options when (and if) it occurred.  With one option still being closing the clinic, I could have found myself working on call at best.  Considering my utter lack of success in procuring a position outside of the department (a fact that still mystifies me as I have been a well-reviewed employee of the company for 5 years now), my confidence in moving to anything other than overnight butt-wiping shifts was low.  My other options would have put me on evenings, which would have put undue stress on Tia (M-F from 4p-1230a?  3 or 4 days a week from 5p-230a??) or me  (Pediatrics?).  So, in the game of work blackjack, I stayed on 17.  My hope at this point is that, down the line, a clinic gig will open up at the Creek.  Until then………well, the floor it is. 

Speaking of the floor, I am excited to have coworkers again.  Though, I must say, I would dearly like them to be more consistent in their attendance and perhaps fuller in their rolls of on-call employees.  How they ALWAYS manage to be understaffed by at least one if not 2 employees is beyond my understanding considering the abundance of unemployed RNs in the area and the higher pay and better benefits that working in a hospital affords.  But, it seems we have rarely been in any other position and this is truly the eye of the storm.  When there is a sick call at a peripheral site, they pull from here.  When there is a sick call here, they pull from the thin rolls of our on-calls (we had two reliable and hard working on-calls RNs, but both had to retire to start claiming their pensions or risk losing money by working, though both expressed the desire to continue doing so).  Sigh.  I just have to remember that some days will be tough and some days will be easy and in all cases to try to stay within myself and just do my job and not worry about how many rounds or starts are ahead of me as I can only control what I do.  I am sure it will be easier said than done. 

In Quinn’s latest Quinnism, we were at the grocery checking out and the clerk said hello to Quinn, who looked at her and said “I don’t want to talk right now.”  Quinn also got have a full on sugar Sunday when he had a belated Easter at grandma and gramps with his cousin that involved candy (of course) sweet rolls, and juice.  Then, following a nap, got to go to a birthday party for a neighbor’s kid and had cake and played in the bounce house (and took a whack at a piñata).  All in all, a pretty good day to be a toddler. 

Look with your eyes

Tia was telling me her parents, when she was out, would tell her to 'look with her eyes, not with her hands.'  I am sure we all heard that at some point in our respective childhoods.  Most of us basically understood that it was strictly hands off.  Quinn, however, is a little more clever.  He then leans over and puts his eye on the item in question (generally knocking it over that way).  Parents = 0.  Quinn = 1.  He has also now figured out the round door handles.  We are truly in trouble now.

We put in our second offer on a house that was, like the first one, outbid by others.  Also, like the first one, it was in the SW.  We have also briefly (VERY briefly) started looking around in some of the Vancouver school districts.  The market there is nearly the polar opposite of the market in Portland.  Largely, this is due to the commute being really awful and the fact that they have no growth boundaries.  Where Portland is dense, they are sprawling.  And where we are building condos and apartments, they are putting in homes.  Huge homes.  Like 2000-3500 sq feet and better homes.  The damnedest thing is you can get one of them for significantly less than here, with lower property taxes to boot.  Yet, houses linger on the market there for weeks and months.  Here we compete against 4 offers on the first day.  It is strange what a river and a bridge can mean.

Though it is somewhat dispiriting, the truth is there is no hurry and letting ourselves get swept up in the frenzy will not be to our benefit.  While we love our neighbors, the neighborhood is still not quite done clearing out the debris of years past.  To whit, there is still a rental property/grow house and a nice enough group of older meth heads both within spitting distance.  Plus, the schools are pretty damn near bottom feeding.  Yet, the area is 'hot' because it is so close to so many things.  The search continues.

It appears that the clinic may soon be in my rear view.  I start back on the floor in May.  I am not thrilled about it because I will lose a lot of what I love to do, but I am really trying to focus on the benefits of working in a team and not possibly/potentially being sold and/or closed at some point down the line.  It is a gamble I felt I had to make.  Plus, there always remains a chance that something opens up at our Washington location down the line.  Then a move to Vancouver would really make sense.

Had jury duty the other day.  More accurately I should say I spent the morning getting up early, driving to Gresham, waiting in lines, watching a video, and then being dismissed along with 50 or so other people.  Sigh.  If I am going to get called, it would be nice to be part of an actual proceeding.

The sun is finally back.  Hurrahs all around!  Can't wait to spend days at parks and nights at outdoor concerts again instead of shuttered indoors with the rest of my hibernating Portland bretheren.  

Offer number one

Trying to keep up with my blog is going about as well as trying to start running again…or flossing…or cleaning out the house.  But, given the chance to rectify one of those things, I am opting for the blog because I have a patient gap and am too exhausted to contemplate the running or cleaning and, lets face it, flossing just isn’t going to happen. 

I have, finally (sorta kinda), some job news.  I have been hired on to take over a floor position.  I currently work 4-8s.  I will be moving into 3-10s, along with what I hope will be the odd shift every week or two.  The upside, obviously, is one less day.  The downside is that I will be back to working every other weekend, some holidays (tbd), and the shifts will obviously be 25% longer.  The other news is that no one, not even my boss, knows when I will be starting this position as they have to now post, then interview, then hire and train a new person for my current job.  That is unless OHSU is still picking it up in June/July, in which case I will stay here until that happens.  No one knows that either.

Why change?  First off, it was not an easy decision.  While it can be frustrating at times and while I would dearly love at least a part time second nurse, I still do like what I do.  I will miss some of my patients a great deal.  However, the stories I have heard from the nurses who did go through the transition and have since left have been troubling at best and disheartening at worst.  Perhaps they will get the issues sorted out by the time they move on to this clinic, but I was not hopeful.  Additionally, though it is indeed a good skill to have and one I would not mind having as a piece of my practice, I really don’t want majority of my job to revolve around chemotherapy.  I have worked with chemo patients before, mainly doing blood transfusions, and it is just a terrible thing to watch the effects of the medications and the disease eat away at them.   Plus, the volumes they demand eliminates the true joy of getting to know the patients in the way that personalizes the experience.  So, ultimately, I worry about losing pretty much everything I enjoy about my job anyway…so why not go back to relearn the floor and placing PICC lines? 

Other than the job stuff and how it will possibly impact everything from childcare to Tia’s sanity, is that our nanny share looks to have a finite end point.  The gal we share with is pregnant with her second kiddo and due in October.   At that point they are going to look at putting their first born into daycare.  Plus, with my schedule shifting, we may well need to alter our care needs.  Oh yeah, and we are still looking to possibly move to a better school district which would blow up the share anyway.  Sigh.  You can never fully comprehend the sheer amount of things that change once you have a kid until you have one.  It really does touch on pretty much everything.

  

We also put in our first offer on a home since we started looking.  Shooting for a much upgraded school district.  It ended up being a microcosm of the housing market here as a whole.  It was on the market for 1 day.  We were one of 4 offers presented.  We were 1% above and non-contingent, which ended up being the lowest bid.  They ended up taking an all cash offer 2% above list.  This all in 24 hours.  You gotta move fast.  Oh yeah, and have hundreds of thousands in cash on hand.  

37

This is what I wrote a few weeks ago and never actually posted it on my blog:

“I feel like hell today.  Tia and I continue to have abrasive encounters that serve only to make us both feel worse.  I know she just doesn’t know how to deal with me.  The truth is, no one can ‘know’ what it is like unless they have experienced it.  Using the near ubiquitous example of cancer; everyone feels badly you’re afflicted, everyone expresses sincere concern and well wishes, but no one can do a damn thing to help you and, ultimately, no one but someone who has experienced it can fully appreciate what it is like to live with.   It colors everything. 

This is all so much harder because of Q.  Not that he bears any responsibility, but rather that he needs attention, patience, and focused love and energy, all things that I have in finite stores.  And, there are no ‘breaks’ to recharge low reserves and no way to explain how I feel to him.  Then I feel worse because it feels like I am failing him, and not just myself.  I want to be who I imagine I am as a father, not who I actually am.  The same could be said as my role as a husband.  Sometimes I just feel like a glorified babysitter and roommate respectively; dogpaddling to stay above the waves and frequently succumbing to them, if only momentarily.”

In the intervening weeks, I have actually found some light.  Tia and I are doing a better job of communicating.  I am working with a therapist who genuinely seems to be helping me.  I am working on mindfulness and meditation techniques to quiet my symptoms.  My overall state of mind is just better.  I won’t (and can’t) call it cured, but it at least much improved. 

Other things of note: 

-          The bathroom remodel is finally finished…..er, sort of.  We are still waiting on a new part for the bath fixture and the toilet, but otherwise the hardware is re-hung, the walls are painted, and the pieces are all workable.  One final caveat though, it might all end up having to be started again.  We hired a contractor we had worked with previously.  He is nice and conscientious and punctual.  However, it also appears he is the world’s worst tile layer.  The grout lines are uneven, the tiles are not uniform in height on the floor nor the walls.  In short, it looks like someone who has never laid tile before (though he evidently has).  He has offered to come ‘fix it’ but it appears it may be beyond a fix.  It might need to be entirely redone.  WE will have to further discuss on Wednesday.  It is just hard to know where to start.  My hope is we can come to some accord and get at least some money refunded so we can hire another contractor to tile it.  Sigh.  Nothing like spending $7K and being generally unhappy.  In the future I think we will just focus on ‘freshening up’ the look (new paint, accessories) and not demoing.  More to come.

-          It appears like there will not be any clarity anytime soon on the job front.  I spoke with some new hires who had recently defected from the GS clinic and they did not have very many positive experiences to share.  They also thought that the July target was pretty much untenable as there remains to many problems with the system that need repairing before it would make sense to add any additional clinics.  They thought that early 2015 was more likely.  Of course since we have had ZERO information provided to us from OHSU regarding the clinic and the manager who I was in contact with over there quit, their words are pretty much all I have to go on. 

-          New opportunity?:  However, in the interim, a new opportunity has presented itself.  One of the floor staff tendered their resignation meaning a 3 day a week 10 hour shift shift has become available.  There are no guarantees that it would go to me as it has to be posted in the system and, IF anyone with more seniority wanted it they would have priority, but at least it offers some hope of an option outside of staying through the buyout.  I would be able to re-learn the process of placing PICC lines as well, which would be great.  I have also heard that there might be an opportunity down the line for a clinic position in Washington, but I won’t hold my breath on that one.  Essentially it would mean an employee they are less than inclined to keep would have to submit their resignation and/or do something horrendous to be let go.  But, it might be something that opens up down the line and provide me an opportunity to get back into the clinic.  In the interim, hopefully I can pop in now and again to keep my skills from atrophying.   

-          Quinn was in the backseat on a drive somewhere when he starts grunting.  He was evidently trying to take off his shoes and socks.  When I asked him about it he responded ‘Quinn frustrated.’  Nice use of the word in proper context.  I still have a hard time believing he is only 19 months old sometimes.  His vocabulary continues to impress me. 

-          Have been kind of peeking around at homes lately and touring a few.  It is a crazy fast market right now.  We went to an open house yesterday that had been on the market for one day.  The Realtor told us they accepted an offer 20 minutes before the open for over asking.  Our Realtor said there are clients putting in offers on homes they haven’t even seen (I guess banking on the inspection providing an out should they need one).  It is weird.  Makes me badly want to sell and rent…but there isn’t really anywhere to rent either, certainly nothing that would make sense to do financially.  But, worst case, we are happy where we live and private schools are always an option down the line should the local schools still be ranked as poorly as they are currently. 

-    Oh yeah, and I am 37 now.  

 

Snowpocalypse Now!

We are quickly zeroing in on our 19^th month of Quinn.  It is a strange and beautiful thing to watch, frustrating though it may be at times.  I continue to struggle in coping with his general ‘toddlerness’ which is a bit more constancy that I can tolerate without a break or two.  Oftentimes that break comes in the form of his nap (and if luck is on your side, you might get 2+ hours).  Sometimes that nap doesn’t happen at all.  Or, in the case of Wednesday, it gets interrupted after a scant 20 minutes = no rest and an unhappy toddler.  By the time Tia gets home, I am generally bleary eyed and exhausted and Quinn is going through his now routine 5pm meltdown.   It isn’t pretty.  

What am I doing to combat this, for lack of a better term, ‘failure’ on my part?  Well, running into roadblocks mostly.  I was able to see a therapist on Monday, but the next available follow up isn’t until the 28^th; nearly 4 full weeks away from the initial visit.  He also offered that they have classes I might participate in, though they are held at times and on days that only someone who either had flexibility that my job does not, or have no job at all, could manage to attend.  The other options are financially tough to accept.  Therapists seem to range in cost from about $100/hr up to around $150/hr, with most settling somewhere in the space between.  I can get a 90 minute massage for less than that and I assure you I will enjoy that far more, but, it might be the only viable option soon.  Even to further discuss my medications will take a while, as my primary didn’t have an available appointment until the 24^th.  The Kaiser system is clearly not set up to deal with mental health. 

Our bathroom project continues to be rife with complications but, thankfully, none appear (thus far) major.  Our tile is delayed until the 10^th.  This after our samples were ‘forgotten’ and had to be re-ordered delaying the whole process by a week.  Then, the day our plumber came and unwrapped the new tub, it had a crack in it.  Thankfully Tia was able to get George Morlan to figure something out and they were able to wrangle up a new one (ours took 2 weeks on order initially so we weren’t terribly hopeful).  Now the weather has further delayed things as the inspector’s office is closed and our contractor can’t make it to our house.  On the upshot, it might make it so the tile delay will work out.  It seems like every day leads to yet another delay.  If we only had the one bathroom I would be quite pissed. 

Weather has been crazy, with Portland no longer being spared the artic weather the other parts of the country have been enduring.  A few inches Thursday, another few Saturday, and then a bit of freezing rain to top it off.  Looks to be about over now.  This is yet another reason I like living close to work (and having a relatively flat commute at that).  A lot of people were stuck sleeping at the hospital.  

One thing we learned for sure, Quinn is not much a fan of snow.  Also, Quinn hates to be stuck inside.  Creates quite the dilemma as you might imagine.  So we spent a LOT of time huddled up in the house with him.  Also, Tia was ill on Saturday.  Surprisingly it went pretty well all things considered.  Just the same, I will be very glad indeed if next weekend's weather is more accommodating.  

    

   

50% percentile

So far the New Year hasn't proven to be all that great.  It started with the flu and I am still struggling with depression.  Just when I think I am up the proverbial hill, I slide right back down.   I am going to try counseling again (maybe the second time is the charm?) and see if I connect better with someone else and, this time, I am going to push harder for some medication counseling as well to see if there is anything else they can do for me that way.  I don’t want to be in a fog, but I don’t want to keep up this metronome like swinging pattern between relative ‘normalcy’ and this crushing sense of being overwhelmed by life. 

Not much new with work.  Operating under the ‘no news is good news’ paradigm for the time being.  I would assume some news would start to trickle out in the Spring.  In the interim, just trying to stay healthy and actually accrue some time off to do something I want to do vs. using it all for an array of ailments both physical and mental. 

Parents are coming in May.  Excited for my mom and dad to finally meet Quinn (my mom has met him previously, but he was little more than a bundle of needs at that point) and to be able to hang out.  Hopefully we get some good weather too.

Quinn is continuing to do well.  He is fully entrenched in the growth curve now (finally).  At his 18mo check-up, he moved into the 50^th percentile (after lingering around the 20^th at his other checkups including the one year) in height and head circumference.  He is still around the 20^th for his weight, but I think he will eventually catch up there as well (or maybe not…..who knows).  At any rate, he is healthy and that is a huge relief thinking back to his very bumpy start. 

The only downside now is he is more and more testing bounds and pushing his independence.  Add to that the innate curiosity toddlers have for EVERYTHING and a weird ability to remember seemingly everywhere that things reside in our house (he even remembers seeing a bug on the ceiling a month ago and still looks for it) and you have to keep near constant vigilance when he is awake. 

Speaking of being awake, he resides in that state more and more.  Sunday he didn't nap at all (save MAYBE 5 minutes in the car).  Friday night he didn't sleep well at all and Tia and I were barely functional all day.  He also has cut off about 90 minutes from his evening slumber.  So, he used to sleep from about 9p to 8a.  Now it is more like 9p to 630a.  This is not a welcome change.  Hopefully the sleep deprivation will eventually allow me to pass out early enough that 630 doesn't seem so cruel and unusual eventually. 

  

The results are in

I have the flu.

Shit.

One last 2013 post

Between not using my slow (and constantly updating) laptop very often and technical difficulties that have lost at least a few drafts this month, I am striving hard to get a post up before the month, and year, ends.

Is there anything more amazing and simultaneously frustrating as a little?  Watching Quinn learning things is incredible.  He is now starting to actively mimic adults.  He seems to learn at least one new word a day.  He is able to follow multi-part instructions (like please go pick up your socks and put them in the dirty bin) and uses some creative thought processes to get what he wants (such as dragging his chair to the high chair to get his snacks).  He intuits a lot of things from observing us.  He picks up my cell phone and says 'hello' and when he gets a hold of keys, he immediately tries to put them in the door to unlock it.  He is learning to share and says both 'please' and 'thank you.'   

And yet, he still bumps his head on pretty much everything, including things right in front of him.  He shrieks/cries at every minor frustration.  He can't seem to not hit our cats.  He wants to take every toy another kid is playing with and shrieks/cries when the same happens to him.  He pushes boundaries constantly.  

But, I know that he is not different from every other little.  They make you laugh and cry.  Overall, it is a pretty darn special thing to watch........though I would love to excise the shrieking. 

As for my depression, things seems to be, at the moment, improving.  I think the hike in my meds has helped as has the support from friends and family both.  I certainly appreciate it.  The counselor was a bust, providing little more than an hour of his ear and absolutely no strategies.  I will pursue it further in the coming year.  I just need to find ways to deal with things and not let my plate spill over.  

One of my major frustrations is my job.  I am weary of the lack of support I am accorded and the seemingly endless delays in the clinic being handed over.  Honestly, my one hope at this point was that OHSU would do something (anything) soon so that the clinic could actually have some forward momentum.  Instead, it remains idling for an indeterminate amount of time (latest target: July 2014).  Left with the mandate to 'be open' just in case we are needed and sending people away when we can't see them for lack of staffing is a fine line to walk and risks a huge loss of business over the long term.  Even the OHSU people were a bit taken about by the lack of volume in our patients overall.  I am left to constantly explain why that is.  I feel like a one legged man being asked why I don't win foot races. 

Between now and whenever OHSU takes over, I am putting out applications at about one per week.  I am not sure if this is a 'grass is greener' mentality, but I am pursuing it nonetheless.  What I am largely finding is that where you end up in the nursing profession is more or less predicated on luck.  I was fortunate to get a hospital job and fortunate to have been selected to run this clinic so early on in my nursing career, but it has also proven to be limiting.  I am not looked in the broader manner that might reward my initiative, self learning, and ability to work independently, but rather in a more acutely focused way that suggests I am an IV nurse period.  This is the double edged sword that exists for many of us.  Out of school, I could no more get a job in an Operating Room here than I could win a footrace with Usain Bolt for not having any experience.  Now I have experience, but not the right kind. 

I want to close by wishing everyone a wonderful new year.  I won't post my resolutions, lest I have to post how badly I fail to complete them, but they are pretty standard fare.  In the meantime, I need to roll back to bed....I am starting the new year with a lingering cold (flu?).  I guess some things don't change.  

Burying the lead

The term “bury the lead” comes from journalism. In a news story, the “lead” is the first sentence, which concisely conveys the main point of the story. A story with a buried lead begins with the secondary details, forcing the reader to continue reading to discover its main point.

I got a pamphlet from the local Jehovah’s yesterday.  As I find most religious pamphlets either offensive or comical, I general read them.   This one skewed heavily towards the latter sensibility.  You see, per this pamphlet, Jesus was a zombie. 

It should be noted that the zombification of Jesus wasn't an explicit statement, but neither was it far from it.  The entire pamphlet’s focus was on ‘raising the dead’ and how there are at least “8 instances of such” in the bible (one of which was Jesus).  By utilizing the power of transference (and magical thinking), if it happened before, it can happen again.  Following this line of logic, it states that you might be able to raise your dead relatives, presumably by wandering around neighborhoods handing out pamphlets (speaking of which, what is the conversion rate for this practice?  Most people I know are pretty horrified by the idea of even opening the door for Jehovah’s, let alone discussing their religious preferences with them.  Would it completely freak them out if you flung open the door, shouted “Let’s get our Jesus on!” and asked them what it entails to convert?).  At any rate, I am not sure what their actual point is, or if they were just aiming for that coveted target demographic of 18-29 year old zombie loving males (don’t believe me?  Check out the ratings for the Walking Dead), but I am all-in!  We can talk about it further when I show up at your door next Saturday morning, pamphlet in hand. 

I struggle with depression.  Struggle is probably the most opportune word.  As such, I know I am also stating that those around me struggle with it too because they have to deal with me.  I used to believe it was seasonal affective disorder and, honestly, that undoubtedly remains a factor.  I know that I feel worse when the sun sets before I leave for work and its visits during the day are, at best, irregular and often short lived.  But more and more I am seeing it as an extension of a more general all-consuming sort of depression: A straight up chemical imbalance.  So, the season change is more akin to making someone with a broken leg walk a mile……and then changing it to a mile up a hill: They are both difficult, but one is surely more so. 

The signs are all there.  The days are becoming a faded facsimile of one another.  I am having a harder time recalling the vague differences between Mondays and Thursdays.  Weekends seem like a desert mirage upon approach and a fading dream by Monday morning.  Sleep is only partially restive and often, while I am definitively not sleepy, I feel groggy and tired.  No amount of sleep seems to correct this. 

Work actually proves therapeutic in some regard because I can ‘put on my professional mask’ and be someone else.  I am not the depressed dad/husband; I am the capable IV nurse.  But I am having a harder time with that as well.  Wearing that mask is exhausting and I have less and less reserve. 

I actively debate taking a leave of absence, but I remain unsure if that will prove advantageous, or rob me of another little bit of who I am.  I wonder if I am not forced to be the person I am at work, will I just drift into being who I am away from it all the time?  Plus, as I am actively seeking out opportunities to bring me into a better/different position, I feel that kind of statement isn’t going to be helpful.  It is one thing to announce to friends and family, quite another to write on your shirt and parade about the hallways. 

Of course, most disappointingly, I wonder how this affects Tia and Q.  I worry about putting an undue burden on Tia’s shoulders, as I feel like she is involved in a greater and greater percentage of Quinn’s time/care as I, turtle like, retreat further into my shell.  I wonder if Q senses my lack of patience, my desire to be by myself, and the frustrations I have with him that are really frustrations at myself for not being more able to accept the mutable moods and manic behaviors of a toddler.  I hope they both know I love them dearly even when it is hard to feel much of anything at all. 

As for what to do, well we shall see what the doc offers up for ideas in a few weeks.  Until then, wait.  

If you want to read more about it from someone who explains it a whole lot better (and with illustrations) check out Hyperbole and a Half

The dumbing

I think that nurses are, by and large, a pretty sharp group.  Same for docs.  Same for most of the people I work alongside every day.  But, not everyone smarts or common sense.  For that, we all suffer. 

I have a sticker across the microwave in my clinic that rather emphatically (it is in all CAPS) states ‘POPCORN PROHIBITED.’   I have never made popcorn at work.  In fact, it has never occurred to me to do so.  I suppose it is because I closely associate popcorn with movie watching.  Sans movie, I have no real yen for it.  Evidently my personal predilections are not universal truths or other sites in the building are providing films.  I am guessing the former over the latter.  So, as seems inevitable with popcorn, someone burned it.  This led to a building clearing evacuation.  Therefore, should I someday be struck with the combination of yearning for and access to microwave popcorn, I will not be able to avail myself of such.  Sad.  

More alarmingly, there is a laminated, with pictures mind you, standard sized paper tag hanging from my O2 canister.  It politely begs, “Please do not use an oxygen cylinder when the gauge is in the red.  They are considered empty.”  To those of us with access to modern forms of conveyance like automobiles, this concept is understood.  When your gas tank is in the red, you had best attend to it or revert to more primitive forms of movement like bipedal ambulation or, at the very least, the use of your opposable thumb to flag down someone with a more comprehensive understanding of the need for fuel in order for the combustion engine to perform.  For those of us without such experience, they provided pictures (a slightly enlarged version of the gauge that appears approximately 24 inches higher up on the cylinder itself).  I guess they hope you will be smart enough to parse this information out in spite of, I imagine, a significant impediment to your reasoning and comprehension skills.    

Most recently they sent out a list to attend to when using Alaris pumps.  Alaris pumps are used for all infusion medications to modulate the drip rate.  This can be done manually, but is far less efficacious.  The email provided a few points such as “Close the Alaris Pump module door first before pushing down on the pivot latch.”  This is akin to saying, close the door before locking the deadbolt.  Dumb enough to be sure, but only the penultimate point of stupidity.  The prime example lies in another point which states, “Do NOT use the device if it is physically damaged.”  That’s right folks, do not use broken, non-functioning equipment. 

So, in summation,

1. Don’t burn popcorn in your microwave (to be safe, just don't use it at all).
2. Don’t hook up an empty oxygen tank to an oxygen dependent patient.  This will not help them.
3. Don’t use broken machines to put medication in your patients. 

I will now spend the rest of my afternoon with my head in my arms quietly sobbing to myself as I know, much in the same way that they have to tell you that even if your shampoo smells strongly of raspberry you still should not eat it, that these ‘reminders’ were sent out because someone somewhere clearly needed them.  You know what, maybe we should all have a good cry.  

Who is Quinn anyway?

I want to write a blog post.  But this, I am finding, is not the easies thing to do.  It is a simple equation that has to be in place for it to happen:

 

Subject + time + motivation = post 

 

I seem to be frequently lacking one of the three ingredients.  Sometimes two.  Sometimes all of them. 

 

Right now I have two of them, but am lacking 'subject' portion.  Hence the hedging.  I thought I might write about what Q is up to.  Then I thought, what is he up to anyway? 

 

Well, he is using more and more words.  Tia spent some time recording them, but now that seems quaint.  He seems to discover a new word a day.  It is interesting what sticks and what doesn't though.  He knows mommy, daddy, his friends Mona and Faye, but seems to never utter the name of our nanny who he spends considerable time with.  He can reliably point out airplanes, find rainbows, locate nearly all his body parts, and blow kisses, but can't remember where his nose is.  

 

He has grown incredibly mischevious, although mostly in adorable ways.  He almost always precedes his acts with a wry smile and direct eye contact before locating a belly button, tickling toes, draining the water out of his bath (repeatedly) or rifling through every cabinet without a lock. 

 

He fully understands how to play with the cats via their cat toys, but reliably gows bored with this in short order and turns them into swatting sticks (never underestimate the casual cruelty of children......they just don't understand causation). 

 

He is filling up his upper gums with teeth, but manages just the pair on the bottom. 

 

He still loves hats of all kinds and would rather wrestle on the mattress than just about anything else. 

 

He shows his affection through very deliberate (and very gentle) head bonks, which he will reliably dole out upon request. 

 

He loves to dance. 

 

He is tempermental. 

 

He is excedingly clever. 

 

He hates to be ignored, even if it just for a few minutes and was doing something on his own anyway. 

 

He loves to be outside.  He would prefer to be outside naked.  

 

He is shy in large groups.  

 

He laughs easily and often (and infectiously).  

 

He loves cereal in the morning with his mom.

 

He loves emptying the diswasher.  

 

He hates having his diaper changed.  It is like changing a whirlwind.  

 

He has discovered (much to our dismay) shrieking.  

And he changes a little bit every day.  

 

As for things that are not changing, work remains the same.  Still no help, but also little interference.  Still no idea when the clinic will pass into other hands nor if I will be around to see it go (of my own volition).  In the interim, just trying to hang on.

Found a new blog I had to share.  So funny. Check it out if you get a chance.  

 

http://hyperboleandahalf.blogspot.com/2010/07/dog.html

RBC you ain't messing with me

Competence should be the least of anyone's expectations when seeing a professional in any field.  I want my hairstylist to have it.  The chef at a restaurant.  The server.  The staff at a local fast food eatery.  My doctor.  And so on.   So why is it so hard to find?

Tia and I have been trying, largely in vain it seems, to find someone to help us investing our money.  We were with Ameriprise, but some thin skin and general weirdness turned that sideways quickly.  We then met with a fellow recommended from a patient, and he was nice, professional, and flexible, but we, for whatever reason, just lacked faith in his ability to advise us (his background did not mesh with the financial field, not even tangentally and his fees were also on the high side).  We then took a recommendation from Tia's sister, which found us is one of the fancy high rises downtown.  They were very professional, very formal, and seemed to have a good grasp on the market.   We thought about it and, though we were a bit uneasy about their investment strategy (diversification was more or less related to how they parsed the money between large and mega cap stocks, not through sprinkling money in ETFs, mutual funds, bonds, and stocks), we thought we would give it a go.  Well, their usual assistant was evidently out the week we submitted paperwork and the replacement made a few erros.  We emailed about them and they told us to just 'scratch them out and write the correct numbers.'  We felt uncomfortable with that and requested, when their regular assistant returned, new corrected paperwork.  This is the email chain that followed (edited to only pertain to the issue at hand):

1. sent to RBC on 9/29

Hi John,

I was signing the paperwork and had a few questions for you.

1) The fee you listed in the email was 1.25%, but the paperwork says 1.5%.  Which is correct?  It also says that it is the % or $500, whichever is greater.  Is the $55 minimum per account?  It looks like i have 5 accounts and Bryan has 2, so that could add up quickly if it is $500 per account.

Tia

2. Response on 9/30 from RBC

Tia,

I did not look at the paperwork before it was sent out...the correct annual fee is 1.25%; we can either send new paperwork, or you can scratch out the 1.5% and replace with 1.25% on the form.

James is back in today, so we'll work with him to get things finalized. My apologies for the goof-up.

Thank you both for your patience.

John

3.  To RBC on 9/30 

John,

I'm sure you can understand, based on our previous experience, that we're not thrilled that there is already an error right out of the gate.  Do you not have review processes in place?  Are there steps in place to make sure errors don't happen when it comes to actually dealing with our funds?

Thanks,
Tia

4. From RBC on 9/30

Tia,

Excuses are lame, but this happened during a long-scheduled week off by James Galloway, Tom's and my client associate. The woman who stood in for James does an excellent job, yet the advisors she usually supports have fee schedules that don't track with our team's. If anyone's to be blamed here, it has to be me.

While I cannot guarantee that there will never be another oversight, I hope you understand both our diligence to getting errors remedied, as well as our commitment to avoiding them in the first place.

Don't hesitate to call Tom or me should you wish to discuss this further. Once again, I apologize for the inconvenience.

John

5. To RBC 10/1

Hello,

In thoroughly reading through the paperwork we were sent to sign, there are several errors.  We don't want to judge your team on the work of someone you don't usually work with.  Can we have James complete the paperwork for us to sign and have him re-mail it?  You can leave Bryan as the beneficiary for all of the accounts, but we need them filled out so he can approve trades as well.

Thank you,
Tia

6. To RBC 10/8 after receiving no response nor any paperwork

John, James, et al,

I was writing about the paperwork that was, I thought, going to be sent out again.  We have yet to receive anything, nor any further correspondence regarding the matter.  Is the paperwork on its way to us? 

If the paperwork has not been sent out, I think we will look elsewhere for assistance with our investments.  Unfortunately, due to our previous history with Ameriprise, we are not inclined to move forward with this many missteps at the outset.

Regards,

Bryan and Tia Kauffman

7. From RBC on 10/8

Tia,

Responding to your email, below, with the exception of the fee mis-statement, our sense is that we've performed as promised. Here's a brief timeline of what's gone on from our perspective:

9-20-13 James called Brian, who confirmed he received the email with the client worksheets and would get the information back to James when he had a chance.

9-24-13 The account forms were completed, in James' absence, buy a backup client associate in our office based on Brian's information and mailed to your address of record.

10-1-13 The forms included an erroneous fee, of which you informed us; I told you the fee would be corrected.  James sent forms giving the spouse Trading Authority for all accounts and left a voice message for you telling her the forms were mailed and if you had any questions to please call James. the next we heard from you was your email of yesterday.

The paperwork sent to you - again with the exception of the fee amount (which was changed immediately when you brought it to our attention) - is exactly as Brian originally filled out in longhand and returned to us. Yet, you say in your email of October 1, below, that "there are several errors".

Frankly, we're a bit perplexed at what is your obvious frustration. As far as I can see, "this many mis-steps" is limited to an immediately-corrected fee error in the original documents returned to you and Brian for signature. None of us have been able to identify the other, "several errors" you mention in your e-mail of October 1.

Tom, James, and I take client service very seriously and endeavor to provide all clients a level of service and response that will, at the very least, meet their expectations; in practice, we think that most feel we exceed those expectations. We regret that you, quite clearly, don't feel the same way. Any of us are available to discuss this further and would be pleased to call you if you'll let us know a convenient time.

Obviously, it's your call on where to go from here.

sincerely,

John

8.  My response 10/9

John,

On October the 1st, Tia emailed a request to you and to James requesting all the original paperwork be re-sent to us with corrected fee information.  My inquiry was largely related to whether or not this has been addressed and new paperwork sent out.  If this has not occurred, we can conclude our business and move on.  If it has been sent out, as we had requested, we can move forward once it arrives.  We have received the other paperwork James sent out on the 1st, but not the paperwork we requested. 

Regards,

Bryan Kauffman

9. Response (evasion) from RBC 10/9

Brian,

I've left a message on your cell for you to call...suffice it to say, we're confused.

John

10. Tia re-forwards the original email detailing our request.

11. Response from RBC 10/9

Tia,

I would really  appreciate either you giving me a call, or letting me know a convenient time I could call you to discuss what's going on here in person.

thank you,

John

12.  At this point, we give up and let them know we won't be working with them. 

So, in summation, this is all about a packet of paperwork they sent us that had the wrong charge information.  They offered to "either send new paperwork, or you can scratch out the 1.5% and replace with 1.25% on the form."  We requested new paperwork and, evidently, this proved mystifying.

Also, don't let the backdoor hit ya on the way out.  We don't knowingly invest with fools.  

Investments & tat pic

I feel like I am pretty well informed about investing money.  I know the difference between a stock and a bond (FYI: the difference is owning a piece of a company and loaning money), and how bond prices correlate with interest rates (inverse).  I understand, roughly, what the words, large cap, mega cap, small cap and mid cap mean.  I know what a mutual fund is vs. an EFT.  I even have a good handle on compounding interest.  So, why is it that I feel utterly lost when I start reading about managing it without an advisor?

I think the big problem is time.  I am never inclined to act terribly quickly until I am ready...and then I just go!  But, I like to read, research, and feel comfortable with my decision before making it.  This, unfortunately, does not always lead to the best decisions, but I like to believe it leads to more of them than not.  So, when looking into investing, I want a deeper understanding of what I am doing.  Only the market is so complex that it is hard to grasp it's intricacies.  I think that is why so many people, even financial advisors, just use mutual funds.  They dont really have to do or know much other than look at fund performance and understand the mixes inside those funds and try to match them to their investor profiles (or in many cases, just suggest proprietary funds that offer a better financial renumeration for themselves). 

The facts are pretty straightforward, though short term volatile.

1. The longer you are in it for (the longer you have until retirement) the more you should be in the stock market.  Historically, you will find no better return rate.  However, you must be willing to look away when the market tumbles and not panic.  Panic here is the enemy.  If you sell when it is falling and buy when it is rising, you will lose money.  But, it takes a certain kind of intestinal fortitude to buy when everyone else is selling.  I guess you should just think of it like a sale.  "Microsoft is 25% off today!" 

2.  Savings and CDs are a security blanket and nothing more.  They are akin to a raft with a slow leak.  You may make it to the shore, but your raft will be in bad shape.  With the average inflation being over 2.2% over the last decade (http://inflationdata.com/Inflation/Inflation/DecadeInflation.asp) and the average interest rate on savings being less than half that (most less than 25% of that number) you are losing purchasing power.  This is something I know and have a hard time letting go of. 

3.  Investing in precious metals like gold is a fools game (http://www.nber.org/papers/w18759), which is why the real money is in buying it under value (CASH4GOLD) and selling it at market price.  This model of buying for less than something is worth and then selling for what it is actually worth will, of course, work with EVERYTHING.   

4. Your own home is generally not a great overall investment, though it is better than savings:

The ultra-long-term reality is that, according to data from Robert Shiller, the real (inflation-adjusted) return on house prices has been just about 0%, albeit punctuated by some sharp booms and busts along the way. While many have built significant long-term equity in their homes, it has been less about real investing returns and more about the simple result of investing with leverage in something that appreciates at the rate of inflation, and having a mortgage obligation as a form of "forced savings." In addition, living in a personal residence saves the cost of paying rent elsewhere, and that shelter-as-return can ultimately enhance wealth…with the caveat that it must be balanced against the impact of paying mortgage interest (as paying more in mortgage interest than you would have paid in rent can actually result in less wealth, not more).  It should really be viewed as an asset, not an investment for the reasons listed above and the lack of 'liquidity' it offers. 

So, how should you invest your money?  Hell if I know.  Just know that no one else really does either (or at least not the people who will be sharing it with investment magazines, tv shows, or your personal advisor).  The people who have a pretty strong idea are already wealthy and probably gathering even more wealth as we speak.  The rest of us are just trying to guess correctly.  And the major word I hear over and over again is diversification.  Put your acorns in many tiny holes and hope that some of them survive the winter.  In the meantime, strongly consider hollowing out a mattress and filling it with cash, start a successful (though short lived, highly dangerous, and ultimately leads to the destruction of your family) meth empire, or give it to someone who most convincingly feigns to understands any of this but is, for a small fee, somehow willing to share this information with you.  But ultimately, just feel damn lucky you have to consider it all in the first place vs. living in a situation where you are far more focused on the base of the pyramid in Maslow's heirarchy of needs.

Oh yeah, and here is my tattoo:

Ink Master

I know a lot of people eschew television.  I am sure the reasons are varied.  For us, it is the combination of a lack of time to watch it, a lack of interest in watching very many shows, and the prohibitive cost considering the other 2 factors.  If it were, say, $20/month, I am sure we would still have cable and not just use an antenna.  Honestly, I bought the Roku thinking we would use that, and I rarely do.  Thankfully, the cost of the Roku and the cost of the antenna were negated by just one month of not having cable. 

My point, and I do have one, is that in spite of the fact that we watch little TV (wasting our down time on the internet instead), I see some positive effects of it.  Now, I want to be clear, there is a lot of crap on TV that I cannot imagine has any positive effects.  If you glean any life lessons from Keeping up with the Kardashians or The Real Housewives of (insert city here) or find anything redeeming in the Bad Girls Club or Toddlers in Tiaras you let me know.   But, sometimes we just want to be entertained (hello football).  Sometimes, however, it can change how you view things.  

Case in point: food.  I have learned more about food from TV than almost anything else save eating.  I know far more about preparing, cooking, and presentation (not that I have mastered any of the 3) from shows like Top Chef and No Reservations.  From the latter and from Andrew Zimmern, I have learned to try (and I succeed far more often than not) foods outside of my comfort zone.  From this, I have learned to like a much broader variety and am always clamoring for something new and different.  This palate expansion has also expanded (to a lesser degree, but still significantly) Tia’s palate.  I may not like all the things I have tried, but I have tried them because they have been demystified on TV. 

So, in a roundabout way, I can credit (blame?), TV for my new tattoo.  I have long found them interesting, but the idea of walking into a shop and trying to pick an artist or a design was frankly intimidating.  Plus, the actual tattoo itself seemed like it would be painful and bloody.  Ultimately, it was neither (well, barely both actually).  The show, Ink Masters, led me from conceptualization to realization.  It demystified the process in the same way as the cooking shows did.  It gave me some ideas on what to look for in an artist, how to pick a shop, and what the process would be like.  It alleviated my fears.  

So, this past Sunday (nigh 2 days ago) I found myself in a chair with someone jabbing an ungodly amount of small needles into my arm.  It felt less like needles going into your arm and more like they were scraping across it.  The tattoo gun is so rapid that, after the first few seconds, you don’t notice it much more than a tingling sensation with rare blips of minor pain.  Following the tattoo, it feels raw…..almost sunburned (and still feels that way, though less, today).  Evidently over the coming weeks it will dry and peel and then, it will just be there.  For now, it is just a strange site.  It’s as though I expect it to wash off one day in the shower.   But, I am very pleased with the result. Now the next question is, will I want another?

Pic to come once it heals up.    

Random thing to remember on a shitty day: A patient of mine’s sister called yesterday to ‘see I was working today, because they were going to cancel otherwise’ as they ‘had a tough experience the last time in.’ This same patient had already transferred clinics due to difficulty accessing her veins.  I had the good fortune of being successful on my first try.  I am evidently the only one who has had this success.  So, with much trepidation, she came in for her medication and I was able to get her again on my first attempt.  After which she said, ‘I hope they are paying you what you are worth’ and wanted to be certain I would be there on her next apt.  Her sister hugged me and thanked me.  It feels good to have that positive feedback.  God knows if I will make it 3 for 3 the next time though!