Room 1: The First Patient I Ever Lost

8765547_cb84ee4533_zI’m no stranger to patient death. If you’re going to be a nurse (or anyone in the medical field for that matter), it’s something you will deal with routinely. This post is in reference to a patient who suffered a critical event while under my direct supervision and did not survive, about five years ago. I was a rookie who had seen death a hundred times under the care of another person, but I’d never personally lost a patient.

Mr. Z was a drunk. He was a frequent flyer. He would use the money he should have been spending on his seizure medications to buy booze. Then he would get wasted, have violent seizures, and his wife would bring him to the ER. He would come up swinging, too, fists throwing out wild haymakers at all of us after the seizures subsided. We’d have to restrain him. Then he’d come to his senses and apologize profusely. This happened once every few weeks.

In my mind, I can still see his wife, always casually strolling through the ER to the waiting room as we began treating him. She’d be carrying a small suitcase and a blanket, preparing for another few nights in the hospital.

On one such occasion, Mr. Z was abnormally lethargic. He didn’t do his usual Mike Tyson routine after his seizure. Dr. Y ordered a CT scan of his head. I approached Room 1 to transport him to the radiology department. He was asleep when I entered. His blood pressure was a little low, but his pulse and respirations were normal.

The radiology tech accompanied me, and we wheeled him down the hall on the stretcher; the whole trip took less than five minutes. I kept track of his heart rate and respirations throughout. He remained stable. We slid him onto the examination table.

And just like that, he stopped breathing. I quickly checked for a pulse. Nothing. We quickly slid him back onto the ER stretcher, where I began CPR. I ordered the CT tech to call back to the ER and prepare for a Code Blue (patient not breathing). She made the call and steered the stretcher back to the ER with me perched on the side, doing compressions the whole way.

My team were at the ready as we wheeled Mr. Z back to Room 1 and went swiftly to work. Despite our best efforts, within fifteen minutes, it became obvious he wasn’t going to make it. Dr. Y announced the time of death. It all had happened so fast. I was dumbfounded.

Dr. Y, a seasoned veteran of medicine, cast a glance across the room and immediately sensed my struggle to process what had just happened. She marched toward me with purpose, grasped me firmly by the shoulders, looked into my eyes, and stated,

“It’s not your fault.”

I looked cluelessly into her eyes.

“It’s not. Your. Fault.” She repeated again.

I wept.

“Tripp. It’s not. Your. Fault.” She was insistent this time, firm.

I nodded. I stepped outside, pulled myself together and finished out the shift. I’ve often pondered why I was so upset, and over the years it has become apparent to me. We treat human beings, without question, without prejudice, without judgment. Whatever your race, your gender, your sexuality, your background, we will treat you.

As an emergency nurse, whenever I feel myself compartmentalizing inefficiently, feeling burned out, exhibiting jaded behavior, getting frustrated, I reflect back on Mr. Z in Room 1, and I am reminded that human beings are human beings. A life is a life. And a life lost before its time is a tragedy. Period.

To my dear fellow nurses this 2017 Nurses Week, you sometimes carry the weight of the world on your shoulders. You are a special breed. You see more disturbing images in a typical week than most people will see in a lifetime. You are loved, you are adored, and you are a vital part of the transformation of this world. Take time to accept the gratitude and appreciation that is declared to you, for you are all rockstars.

Cheers.

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When The Shit Goes Down

https://www.flickr.com/photos/dave-a-roni/9139212242/in/photolist-eVARoS-ekxtuc-9PH5uo-9sQ8XQ-2332AC-9aVVgC-vh7gy-388qZD-7yDxrs-eZqzEk-L52ad-5CZAJk-q8PpT4-5DCLMf-9aSV6X-vgZua-8N7pZC-5Dytu2-fsce-4xa8u9-5CZApB-5H4Pqp-5H4RXi-pL5BGS-7WL2xF-5H97Jo-3oXGi1-5BBbJS-5BB7E7-5BwXE4-5CZAzZ-5BATtj-5BAXzm-5BwJKF-5BwMLa-5CZAW6-LRd5E-fscg-9nWac-99rVL-6DM5Cn-g85jGT-8EcC1Z-3oTbez-8GhZPR-8Gm9Sw-4PKiiK-f6ZQXT-7X7TCX-8LSqF3  This is an aside that loosely relates to About A Breakup, Part 3 of 5: The Atom Bomb. The shit has gone down a lot in my own life this year, and it coincidentally appears to be happening in the lives of several of my closest friends and students as of late. If you get nothing else from this post, get this: Every time the shit has gone down in my life, and I mean EVERY time, in the thick of it, I decided that life would never get any better, and I should just get used to the mediocrity, trapped and doomed to days of despair and anguish. And yet, here I am.

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Have a look back at your life. It has happened to everyone who has ever breathed air on this planet. You lose your job; you’re struck by a devastating illness; you’re flung headlong into a dramatic breakup or divorce; somebody close to you dies unexpectedly; you holy piss off the wrong person or people; you put $10k of the kids’ college fund on Roulette red and go broke; you have a falling out with a family member; you have an “FML” moment and drink your bodyweight in Tequila and get hospitalized for alcohol poisoning; you have an alternate “FML” moment and sleep with a few random strangers and next thing you know you’re being treated for some syphi-gono-herpes super bug; and so on, and so on, and the shit absolutely, undeniably, unquestionably . . . goes down. In my personal experience, it’s usually one small- to medium-sized incident in a string of incidents that finally pushes you over the edge, and has you going all Jerry Maguire, flagrantly leaving his corporate job in the famous meltdown scene.

In my own life, the shit has gone down many, many times; so many, in fact, that I’d be hard pressed to remember them all. There was that one time in Nashville in 2003 when I had FINALLY gotten a decent band together, and we were making gig plans, when our daughter Em was born several weeks early; our house was over an hour commute from the hospital where Em had to stay in ICU for weeks; then on the day we finally got to take her home, an ambulance backed into our sole means of transportation, ripping the rear door from the hinges, rendering us without transportation for days while it was repaired; we racked up an astronomical hospital bill and had to sell the new house we’d bought two months prior; finally, my demo had been rejected for the 159th time by yet another label, and in a fit of rage, I drop kicked every last one of my remaining 1000 CD debuts’ barcoded asses into the neighborhood dumpster as the neighbors chowed down on popcorn and wine and enjoyed that evening’s entertainment.

THAT’S OKAY!!! IT’S JUST OUR ONLY FUCKING CAR!!!!!! -Postpartum Catherine (Em’s mom) to the mortified EMS guy, profusely apologizing for clipping our car.

Or the time in 2009: fresh divorce; enter nursing school a month later; flunk pharmacology; wait a year until pharm is offered again whilst getting a night shift job in the ER to pay bills; spend the next nine months working 7:00p to 7:00a, going straight to class and/or clinical after work from 8:00a – 2:00p, sleeping from 2:30p-6:30p, and going back to the ER for another shift; forced to sell my favorite truck because I can’t transport my kids in it when I have them for visitation; buy a piece of shit sedan that starts to fall apart during the first week of ownership; find out my kids are moving to California; get one call a day from collectors threatening to garnish my wages for old hospital bills; final meltdown happened after graduation. See “A Prelude.”

It’ll affect my credit score? (Maniacally) HAHAHAHAHAHAHAHAHAHA!!! Lady, I’m pretty sure about two years ago my score dipped below zero! You want to settle this medical bill?! Well take a number! -Me on mental breakdown day to a collector

My friends, I’ve coached a whole bunch of people during their “Shit Goes Down” times. Here’s what I’ve learned from my experiences and theirs:

  • I have never experienced a transformation without first experiencing a meltdown. The greater the meltdown, the greater the transformation. One of the greatest transformations of my entire life was a direct result of being chipped away, bit by bit, little by little, until I finally caved and hit rock bottom. And from rock bottom, I could offer no resistance to complete reformation. When you find yourself looking up to see the bottom, the doorway to transformation is right there. We are too often so overwhelmed by the pain and hardship that we cannot see the doorway. See if you can briefly let go of your perception and consider that you are on the verge of something amazing. 
  • We human beings become very attached to our problems. We identify with them. We think our problems make us unique (sidenote: they don’t). We will go to great lengths to prove to ourselves (and many times to show those around us) how much harder our lives are than anyone else’s. I’ve done this many times in my own life, and I’ve seen it many times in others. Observe the conversations you hear on a daily basis. I find it interesting that most human beings would rather argue about who has the worst problems,  the most bills, the most hardship, than whose life is the most vivacious and empowering.  Consider that you may have some degree of pride in being able to survive all that you’re weathering, and that you may be afraid that taking actions to pull yourself out of the rut may strip you of your identity. 
  • Emotional pain is familiar territory for just about everyone. And we LOVE familiarity. We are terrified of the unknown, terrified of stepping outside of our comfort zones, even if there was a great chance that it would lead to complete liberation. Hell, I would go so far as to say even if liberation was GUARANTEED, we’d hesitate if it meant stepping outside of our comfort zones. Consider that any attempt to create change in your life will come with some degree of discomfort. You must be brave enough to try something new, or has your old way of approaching life been invigorating for you? As dear friend and mentor Donna once told me:

Look at the emotional pain scale, with 0 being complete freedom and 10 being absolute misery. We human beings will live for years with a nagging 4 or 5 out of 10 because it’s familiar, rather than take an action that may BRIEFLY cause 10 out of 10 pain, even though that action has the potential to get us to a 0, complete freedom.

Finally, a word about perception. Shortly after my breakup with Alex, I was hanging out with some friends.

One of the guys said, “I heard you’re having some trouble with the woman.”

“Yeah,” I replied with my usual melancholy. “We broke up.”

“Congratulations,” he said.

It shocked me a little. Up until that point, everyone I’d told had showered me with empathetic phrases and angst-filled words of support. Not that I fully agreed with my friend’s way of thinking, but it momentarily jolted me from the perception to which I was so tightly clinging.

Change your way of thinking, my friends. Consider that things are not always as they appear. A new perception will breed new actions, which will breed new results.

To vitality, my friends.