Body piercing, urban legends, and sorority girls

I made good on my intentions to stay off my couch today. I got my hair colored and cut (aka "tamed the nurse Afro"), had lunch at my favorite falafel place while reading an adolescent vampire book, and then trotted down the block, to get a piercing (a conch, for the curious...just a bit of bling). Because, you know. I wanted one.

I bopped into the store and flung my ID across the counter just as two firefighter/medics came in announcing they had to check the fire code AND as a girl wobbled out of the piercing room with the "I will faint now," look. I asked the medics, "Did you come for her?" Because I was confused. The three of us peered at the girl reeling around and did a mental rock-paper-scissors. I was closest, so I did the "grab under the armpits while person falls" catch and put her on the couch.

The medics went to check the fire extingishers (which were in fine order, I'm assuming), no one having, after all, asked them there for their medical services.

Here is what I don't understand. The piercer shot out with glucose tablets and started stuffing them in this girl's mouth. Why do they do this? Is there something magical about body piercing that causes blood sugar issues? Because to me it looks like your average vasovagal response.

The girl looked like she was going to barf up the tablet, so I said, "Lie down on the couch and put your feet up on the back." She felt better a few seconds later. So someone explain to me, what's up with the glucose tablets? Is it like a tradition or something? Or is there any physiological reason for it?

Then her friend turned green and wobbled for a repeat performance after her own piercing.

Then they both got queasy just seeing through the curtain when I had my ear done. I checked in the mirror, jumped up, and strode out. They were like, "OMG, lemme see!" Then they got queasy.

Apparently those two are nonstarters for body piercing! Holy cow.

I know. It's not that great of a story, but for your average afternoon out it was a LITTLE funny. My friend kept texting "is your ear done yet?" And I had to say, "No, these two little girls are still lying around being fanned!"

I've had better times in my life

I've had WORSE times as well. In fact, my outside life is just fine, with some little relatively unimportant exceptions that, of course, I blow up in to hideous disasters in my head. Inside, it is challenging to be me lately.

I'm basically able to do nothing but the absolute bare minimum to keep things going, and even that is getting debatable (how bad SHOULD my yard get before I drag out to mow it?). I prefer to sleep. All the time. I have done ridiculous things like spend all morning just trying to get out of bed; it's as if being anxious for so long has finally sucked every morsel of energy from me. I seriously spent 4 hours just trying to get up and take a shower. I finally got it done, but that was about it for the day.

It can't be totally the case that I am inept, however. I am able to go to work and take care of the animals, wash the dishes, do laundry, and so on. In fact I'm DELIGHTED to go to work most of the time because I don't have to decide what to do with myself. Someone will tell me. "Go triage" or "assume care of those three patients" or whatever. And I'm good at my job, and it normally prevents me from being afraid of anything because I'm in an EMERGENCY DEPARTMENT. Emergencies are expected there, and we can fix most of them, and emergencies that actually occur are far easier to handle that the ones between my ears than never materialize (the two times I've had anxiety/cardiac issues at work, I was taking a break!).

The bad times are when I am home with unfilled time. I have plenty I COULD DO. I could plant flowers or work out or finish an article or work on a book or find another freelance job (typical example of my head's machinery: I am pissed off at losing a gig I didn't want to begin with). I could read a book. I took go take pictures. But usually I don't do any of that because it's too exhausting. I have given myself mental gold stars for stuff like "I took a shower!" So I'm probably not going to coordinate a photo walk.

"What," some have asked, "are you depressed about?" I don't know. I don't even know that I am depressed. I know it looks like depression. I also know that anxiety looks an awful lot like depression if it goes on long enough, which mine has. Decades of nearly daily terror apparently catch up with a person. If you ask me what I'm SCARED of, I can readily name 50 things that I am worried about all at the same time. But now that I have actually put enough stress on my heart that it's cracking under the pressure, I am frozen to the bed or couch with panic that if I move at all the racing pulse will begin, and that, I hate above all.

If I never have to have a panic attack so horrible that I wake up on the floor in a slick sweat, nauseated, with a pounding heart? I will feel like the richest person on earth. Until then I'm apparently fashioning a lonely agoraphobic life for myself, unintentionally.

I have a feeling this is the kind of mental habit that gets quickly difficult to reverse, so I'm making myself do one thing a day. Overachiever, huh. But that's more than NOTHING each day. Today, I'm going to have my hair done AND see my therapist. Two things! For some reason, he seems to feel that we need to talk.

I started to write a "sorry I'm not posting" post until I remembered those annoy me. Don't clutter my feeds with that shit. Post if you want or don't if you don't, I mean, there's plenty of other stuff out there to read. But I wrote it anyway because when I read stuff like this, I think, "Thank GOD other people feel this way."

No, really, I don't need any credit!

I don't mind. REALLY.

I'm the lowly nurse in there sweating in a totally untenable position to hold down the patient fighting against a procedure. I'm the one filling up linen bags with sheets wet with diarrhea and vomit and swilling patients down so they feel clean and nice, and all that after starting an IV in a finger because that's all they had and "my God, I didn't even feel that, you're a genius!"

I'm the one holding a child's hand while she screams with fear and pain and somehow managing to convince her that this next pain is necessary...an IV, moving a broken bone for an x-ray, grating bone against bone for a splint.

I'm the one endlessly reassuring patients and parents and sons and daughters, explaining again what that was the doctor just said. Explaining I'm sorry, he is going to die soon, is what the doctor said. It's me, at the bedside, holding wrinkled old hands and smooth bloody young ones while the pulse flickers and fades.

And I'm the one who thought ahead and got those blood cultures and a chest x-ray on the hypoxic febrile patient who was really here for hip pain after a fall, because gee, that fall was a result of that bad pneumonia.

I really don't mind when, after all that, everyone in the room says, "Thank you so much, doctor!"

I don't mind at all.

More rules for life

I was bowled over by the awesomeness of the Bloggess's rules for life (here). So I posted them on Facebook. My BFF the FOD (Fairy of Doom) reminded me that we ALREADY have rules for life, so I felt I should add to the "rules for life" circulating today. Here are ours:

1. Keep your head on the right side of the oven door [meaning "correct"].
2. Interpersonal violence of any kind is unacceptable.
3. Anyone with 10 or more televisions is, by definition, unfuckable (NB: the count is understood to include little mobile TVs that some people have in their mini-vans).
4. If you don't know what it is, don't put it in your mouth.
5. Never piss off a rhinoceros.
6. Unstaple your underwear from your pants, and move on.

In the interest of full disclosure, rule 6 came long after the other 5 and was inspired by an incident at work (mine, not hers)---but I probably didn't have to tell you that. Each rule is based on a real-life experience.

Think of all the trouble you could save yourself if only you followed these rules!

Body modification in nurses: take another stab at it

I had dinner with a friend who is pierced and tattooed and sits in front of computers all day. "I'm surprised," she said, "that they let you have all that. Don't they harbor bacteria?"

For those who don't know, I have currently the (above neck) piercings: nostril, septum, bilateral lobes stretched to 0 gauge, rook, tongue, labret, and forward helix. But at work I tone all that down to the ear piercings, nostril, and lip. Sometimes not even the nostril. And I wear micro gems in both anyway. In my lobes I almost always wear solid plugs that look like normal earrings. I usually leave the tongue bar in for purposes mentioned below, but I'm one of those closed-mouth talkers where it's not that noticeable and I can leave it out for up to a week with no issues if needed. After that I have to jaaaaam it back in. Anyway.

Before I address the bacteria issue, I should mention that most objections against bod-mods in nurses are that patients will be bothered by it. I know it's got to be heavily regional and so on, but my experience is solidly the opposite. So many people have piercings and tattoos that it's accepted by nearly everyone around here. I say "nearly" but have never had anyone have a negative reaction. On the contrary, the number of times people have complimented me on a piercing or tattoo is so high I wouldn't even know it. And the elderly LOVE them some facial piercings. The argument that they'll be offended is bunkum and twaddle. "I love your sparkly lip!" I've heard dozens of times. "That's so cute." I even cared for a 70-year old with 7 piercings in one ear!

And for peds, people borrow me for my tongue. Many a toddler is swayed by "if you stick out your tongue, I'll stick out mine, and I have a big EARRING in there!" They love that. Curiosity nearly always wins. It's far better than holding them down and wrestling a tongue blade down their throats while they scream. Instead they laugh. "Shiny!"

Perception aside, let's talk about...perception. Do body piercings harbor bacteria? No doubt. A cursory search on PubMed revealed no studies. But research DOES show that rings, fingernail polish, and long nails harbor bacteria, yet these things are allowed. So I pose the question: is it an infection issue or a perception issue here? People are used to lobe piercings and giant studded wedding rings and laquered nails, the last two of which are known to harbor bacteria.

Is it just what we're used to? Because I'm not seing any evidence that body piercing is unhygienic.

Pierced people are incredibly consciencious about hygiene because we don't want nasty infected piercings. My face is probably cleaner than most people's because I clean it a lot. And I don't rub it on patients. Bacteria-infested wedding rings, tolerated in all hospitals, DO touch patients. So do long fingernails (also tolerated). So do bracelets and watches. I shudder to think about what bracelets get dragged through. I mean, literally, I shudder.

But people are USED to bracelets and wedding rings. As for ear piercings, why are lobe piercings OK but not cartilage piercings? I have two holes in each ear. Should the location matter? Why?

If it's a matter of pure fashion sense, I'm going to call foul. I don't like big hairsprayed hair, I don't like bangles, and I think heavy makeup looks trashy. But a coworker can legitimately come to work looking like a New Orleans whore whereas I might be censured for having a sparkle in my lip and one in my nostril, despite my hair being clean and pulled back, my face scrubbed, and my hands clean and nails clean and short.

I think we just need to PONDER this a little bit. I'm not suggesting that big swastikas tattoed on your face are all right, but this issue is only going to get more prevalent.

Newspaper picks up that battery occurs

My local paper published this ("Lawrence man, 53, punched by stranger on Massachusetts Street"). THIS IS NOT NEWS.

Almost every night at least one person checks in and says, "I was on Mass Street just drinking a beer and minding my own business when some dude came up and just HIT me!"

Sometimes it's two dudes. But no one EVER knows who hit them. One coworker says, "If I feel like a good ass whuppin, I just go downtown, drink beer, and mind my own business."

So, this happened

I walk these animals on a Y-leash, as shown below (note also that Banjo, the fawn, now looks small compared with the swaggering beast next door).

They both wear Halti collars because otherwise Banjo pulls me on my face. Annie doesn't like hers. Today she randomly decided to try rubbing her snout on the sidewalk to scrape it off, but Banjo forged ahead, and the nature of the leash pulled her forward while she had her snout tucked under. So, she went ass over head and did a little summersault in the road. She sprang right back up on her paws and trotted along, leaving me gaping and thinking, "Did that just happen?" It did. 

Unrelated: ANNIE ATE ANOTHER TAG OFF BANJO'S COLLAR. WTAF. 

Your legs ARE NOT BROKEN

I know my peeves are random. Today's peeve is brought to you by "why do you suddenly lose the ability to do stuff you do at home when you get to the ER?"

It doesn't HAVE to be the ER. I remember being a CNA on the floor and an RN in the ICU and people would want to be moved and have stuff handed to them when it turned out they lived AT HOME. They could do that stuff just fine. They just want someone else to do it. Anyone who doubts that the human psyche idles on "lazy" should work in healthcare.

The ER is a little different. A patient's family member got very upset with me because I refused to lift his mother from wheelchair to bed (after also refusing to lift her out of the car). My immediate explanation was, "Your mother weighs twice what I do. How exactly should I do that?" Which sounds a little snippy, but already I had been told to run out and lift this lady out of the car when it turned out she lived at home and drove herself around, and she was able to get out of the car by herself just fine. So no, they just felt that if you're sick, you should not even have to exert the effort to get out of the car. I pull plenty of people out of cars, but I'm not going to risk my back if it isn't needed.

A tangent: this argument shocks and angers patients as well. I'll have someone in a wheelchair who outweighs me by 100 pounds or more and say, "Wait here. I need to get help to transfer you." A family member will say, "I do it myself at home." I usually say, "Great! But I'm not willing to risk my back, so I'm going to go get some help." They usually look all thunderstormy. Like I should totally be willing to make that transfer A CAREER LAST. Like I should not even mention my insistence on personal safety.

Even stranger are the many patients who ask for bedpans, Foleys, and bedside commodes when they are completely able to walk to the bathroom. I would need to be anesthetized before using any of those. But I'm not confused by the American obesity epidemic: literally, people are so lazy they don't want to walk to the bathroom. They don't want to walk ANYWHERE. They want to be lifted and transported and have stuff handed to them.

That can't be healthy. I don't believe in this kind of coddling. No one gets well lying around in bed, and no one should give up abilities they still have. People who really need to be pulled out of cars and get Foleys and be fed? Would LOVE to have the option.

So, my patient satisfaction scores are probably really bad. "You can do that yourself. You're able to reach it," I'll say, when a patient uses the call light to ask me to come pick up their water and hold it to their parched, thirsting lips. The water I've placed on a table right next to their bedside.

But...WHY? The people who want a lot of extra attention and help are never the sick patients. Those people are all, "naw, man, I got this." And I'm like, "yeah no, I'll be doing this for you."

And another thing: people don't realize we have security cameras. Yeah. We do. So when I'm triaging, I can WATCH the people who jump out of the cars and walk just fine up to the entrance and then start swooning and limping after composing themselves. "I ain't been able to walk for 2 days, lord, the pain is just so bad." "Really? I saw you walked in just fine. Are you better now, then?" [Anger at mean unsympathetic nurse.]

These things are peeves, but they're also legit medical issues. You need to use the capacity you have. Nurses need to consider our health. I figure there's a finite number of times I have in life to lift people up, and I'm not wasting one on someone who just WANTS me to. And patients don't need to lose what functionality they have, and we need to know if they're making stuff up.

And another thing

For 15 years or so, I have checked my e-mail first thing when I wake up. Every day. NEARLY every day, something in my e-mail pisses me off. Therefore, within 10 minutes after I wake up, I am mad, almost every day of my life.

Why do I do this? Lives never depend on the expediency with which I check my e-mail.

I am feeling like a real idiot today. That definition of insanity, doing the same thing and expecting different results? The more I think about it, the more things I do fit it.

Ridiculous. I'm turning off all e-mail notifications except from my VIP list, which contains only 3 names. And maybe I'll get really crazy and wait until my SECOND up of coffee to check my e-mail, because really, when I say "I'm going to check my e-mail," it equates to "I'm going to get really upset now!" Who rushes to do that?

The way you spend your days

The way you spend your days is the way you spend your life.

I heard that some time ago and thought, fuck. I just thought of it again, and this time I'm paying attention. Because so far I've been awake for an hour and 15 minutes and am so angry I feel certain my blood pressure is high and I feel like storming around and eating junk food before work. Because THAT will totally injure the person who "made me mad." (I know people can't "make me mad" any more than they can "make me happy," but I'm not so good at that whole "Lookee me controlling my emotions regardless of external circumstances!")

Yeah, no, someone MADE ME MAD.

People make me mad a lot. Situations make me upset. Blah blah blah. And I let it DESTROY me. I spent the last 15 minutes writing down what I want in life, and then I realized you would never know it from looking at what I do. I wrote things like "lose weight" and "run 3 miles again," for example, but I eat junk and rarely leave the house with running shoes on.

I pretty much spend my days asleep and then working or reading or watching TV until I can go back to bed. That's how I spend my days. That's how I spend my life. Asleep or getting through a span of time. I endure my life, if you look at it objectively.

No likey. I'm going to start spending my days differently. So that I'll be spending my life differently, and it won't HAVE to be endured. It'll be lived.

App reviews: using an iPad as an external display

I wasted some money on Mini Display because some people I usually respect said it was a good buy. It is a terrible buy. Don't buy it!

First, why would I (or anyone) want such a thing? It lets you use an iPad as an external monitor. That's useful to me because I like really little computers and also often have a need to see two things at once: a reference list while I'm writing something, say, or a list of acronyms for an article I'm writing. Sometimes I just like to have music running on the iPad next to me (on its Book Arc) so I can see what's playing. I pay for Spotify, so I could just run it on the iPad, but you get the idea. You could also let Twiter scroll on the iPad or whatever.

I bought Mini Display with some misgivings, including its $12.99 price, but it's from the makers of Screens, so I figured it was probably badass. It also had some features like being Retina ready and being universal that I thought might be useful or nice.

It lags to the point it's not usable. If you touch the iPad with your finger or use the mouse, either way, be prepared to wait a few seconds for anything to happen. It works, I suppose, because the desktop appears on it. The creators are getting a lot of mileage out of how easy it is to make it work.

After quickly becoming disgusted with it, I remembered doing this before, a long time ago. I dug through the really large list of iOS apps I've purchased over the years and came up with DisplayPad, which is cheap ($2.99) and works better. I wish I hadn't wasted money on Mini Display, but perhaps the spoils will allow the developers to make it fabulous and then I'll be glad I have it.

They both work the same way. You download a companion app to your Mac and open the app on the iPad and pick to connect them. They're both childishly simple and this part works fine. You adjust the displays just as you would with any external monitor.

DisplayPad doesn't lag at all. It isn't a Retina, pretty display, but you can pick to change the display quality with both apps. Changing it with Mini Display makes no difference in lag. Leaving it on defaults with DisplayPad makes it incredibly handy. Both allow you to flip the iPad all around and they adjust the screen to appear upright, but Mini Display left me with a plain blue screen that didn't recover a couple of times.

If you've never thought of using your iPad as an external display, give it a think. It's a good idea for certain things if, you know, you don't already HAVE an extra display. And save your money. Use DisplayPad.

I work weekend nights on purpose: here's why

I tell people my schedule (generally every Friday, Saturday, and Sunday night from 7pm to 7am), and they look sorry for me and assume I must be new and subjected to this horrible schedule. In fact I have seniority and could work any nights I wanted. I do this on purpose:

• Most of my friends are busy with their families on weekends, and I have time then to see them during the week when they aren't; I don't have a spouse, children, or even a significant other, so I literally do what I want when I want to

• I make the maximum possible hourly wage by working weekend nights

• I wouldn't have anything else to do anyway different from what I'd do on week nights. I'm too old to be out partying on Fridays and Saturdays (now I take care of those who do)

• It frees me up to freelance during the regular work week; currently I have two freelance writing gigs and one editing gig

• Because I work every single weekend, I incur the goodwill of my coworkers and they work with me if I need to switch

The beauty of nursing is flexibility. This puzzle piece fits me well. I mean, holy crap. During my entire working life except for like one year, I've been able to fit my work around my life instead of the other way around. First I freelanced full-time for a decade, and now I have a career where they need people 24 hours a day 7 days a week. I just have to find 36 of those hours to show up and be a nurse, and then I'm done. It's actually pretty cool.

Useful Mac tidbits for lazy geeks

I've been lying around for a few days with some crud. Nothing exciting. I was pretty sure I was dying from the Avian flu, but I haven't died yet. I listened to a lot of podcasts, and so I ended up spending a lot of money on new apps and a lot of time and making them do cool stuff. Mac Power Users specifically costs me money almost every time I listen to it.

I used to use my iPad for nearly everything, but I find the Mini is less suited for productivity and I have a 13-inch MacBook Air I'm using much more than I ever used my MacBook Pro. I love the Mini, don't get me wrong. I can't bear to be separated from it for long. But the Air is like a regular-sized iPad with a keyboard and more power, plus I've been doing some freelance work that requires a lot of complicated text manipulation involving Word and macros. I've decided that Airs are the ultimate in awesomeness.

Anyway, the point is, I didn't buy Mac apps for a long time because I used my iPad so much, but now I am. Here are some goodies I love lately:

• BusyCal: This is discounted until April 30, so if you're at all interested, pay attention. I like this app because

  • It integrates Reminders, including carrying undone ones forward automatically
  • It lets you tag both Reminders and events and save them as smart searches much like iTunes, which is very handy for me because I can tag everything to do with my hospital job, freelance editing job, and various writing gigs as "Work" and see at a glance what stuff I need to be doing to make money
  • You can put cool graphics and sticky notes in it. They jack up your calendar view on iOS so I got tired of this fairly quickly, but it was fun at first

• Alfred 2: This is for keyboard aficionados. I hate using my mouse. This app with the optional Powerpack cuts way down on my need to. Even without the Powerpack it's extremely useful, but with it you can totally geek out. You can e-mail people, open files, move files, and launch apps, but that's just the beginning. Yesterday I created a custom search so that when I have an article name on my clipboard, I can type "opt-space" (to launch Alfred) and then type "pm cmd-V" and Safari searches PubMed for the thing I pasted. This saves, like, MICROSECONDS, people.

• TextExpander: Again: save on effort. Cast aside the idea that this app simply expands your address and e-mail signatures, because it's gone way past that. It now has all kinds of tricky little bits of code you can put in your snippets. It's fun to make your own, but other people have done a lot of work, so you can snag their snippets.

  • David Sparks, who literally wrote the book on Markdown, has snippets on his site for download. They're for stuff other than Markdown, but as a devotee of Markdown, I actually get warm fuzzies from these snippets.
  • And then there's Brett Terpstra, who wrote...everything, I mean I have a nerd crush on the guy, who has snippets that work on iOS, handily, because not all of the fancy bits of code work on iOS.

• Hazel: Hazel allows deep and ongoing laziness and also effortless organization. Like Bartleby the Scrivener, I believe that the easiest way is always the best way, so I bought Hazel a long time ago. She's come a long way. Stuff Hazel does for me:

  • Trashes the screenshots that litter my desktop after a day
  • Files all my bills automatically into Dropbox folder by utility and year (after I scan them with my ScanSnap and use TextExpander snippets to name them by my own convention in like a nanosecond)
  • Trashes any duplicate file on my desktop
  • Opens my mail downloads folder when it gets more than 20 things clogging it up so I can clean it out manually

That's a good start. I didn't buy all this stuff at once or I'd be broke. Some stuff I bought a long time ago and just found uses for recently, but having done so, I find it REALLY USEFUL. So there you are: a list for the lazy.

How to add keyboard shortcuts to duplicate Mac submenus

I'm posting this because I just spent an hour trying to find out how to do it, and most sources say you can't. I don't like using my mouse. I especially don't like using it when I'm performing e-mail triage. That's one reason I liked the Gmail Web interface. So I went on a mission to transform Mail.app into a Gmail experience (I prefer to use Mail.app for reasons that are not really interesting), and mainly I just want to have keyboard shortcuts to file messages. The built-in command-1, -2, -3 ones for favorite mailboxes work fine for viewing, but mousing to either drag the message to a folder or go to Message --> Move to --> Thefolder was pissing me off. Because I AM NOT A PATIENT PERSON.

The issue was that, although it's pretty easy to add a keyboard shortcut to menu items (see here for an example out of dozens of tutorials), Mail.app has a few submenus with the same name (such as in both "Move to" and "Copy to"). Normally you can just type the exact menu item and it works; you don't have to fool with whether it's nested. But in this case, telling System Preferences the menu item name is useless because it exists under several options.

So, how to specify submenus to assign shortcuts?

You use "->" to do it. I know. It seems obvious once you see it. But you have no idea how many sources said you can't do it at all or just don't address it.

YOU'RE WELCOME.

Screenshot of my Keyboard System Preferences pane with the first two nested shortcuts set up. Works perfectly. 

Work conversations, part X

I tried to think of some way to report this that didn't sound terrible, but I can't, which is kind of why it's funny. Recall that not too long ago I went into SVT in the triage bay, and my tech freaked out completely because although he's a pretty seasoned EMT who is not alarmist, it's apparently different when it's the nurse collapsing. I get that. Yet I am still getting good mileage out of tormenting him about it, because I can.

So early this morning, I said, "Why does your mom [a day shifter] always say 'OH GOD, this is going to be bad' when she sees me coming to triage?" Because obviously people think the worst of me at all times in my head.

Him: "It's just the cardiac thing. I've never had a nurse go down on me before." Then he kept talking.

I said, "Did you just say 'I've never had a nurse go down on me before?'"

He said, "Yes I did. I was trying to just keep talking and hope you wouldn't notice, but now you've mentioned it AND IT WILL NEVER GO AWAY."

Then I laughed for like an hour. The poor guy was brick red. "I can't even LOOK at you," he said. Then I told his mom on him when she came to work.

Snicker.

Rough day at the office

I reblogged this on Tumblr and am reblogging it again I guess. NOT EVERYONE READS MY TUMBLR. I just love this photo. It so totally expresses how I feel when people who aren't in medicine have a hard day at work. I know it's all relative, and I had hard days at work when I was sitting on my butt full-time in front of a computer too, but holy crap. Those days when you feel totally whipped and someone still DIED...those are hard.

Why do fevers make me laugh?

I'm sick today. It's been a decent interval, for me. If I could buy an immune system, I would. Anyway, I took an unrecommended amount of Motrin and got out of bed to drink some tea and pitifully read my RSS feeds, which are filled with news of the bird flu, so I'm pretty sure I've got the Avian flu and will shortly be dead, and I want to leave the world with some important questions to occupy itself with.

1. Why do high fevers make me laugh? It's a 50/50 chance when I have a high fever (and I get high fevers, for an adult, like 103, pretty regularly when I'm sick) that I will feel warm and happy and giggly. It's almost like a drug, THEORETICALLY.

2. Do spicky, garlicky things really help when you're sick, and if so, why? I have a special "knock your socks off" spicy garlic noodle recipe which I religiously make and consume with copious amounts of OJ and water when I'm ill. Even though I stay sick, I'm somehow convinced it's helping.

3. Does it really make that much of a damn difference to be under blankets when you have a fever? I mean is it a difference between a fever of 99 vs 102 or of 101.1 vs 101.4? Because I feel mean taking blankets away from febrile patients, and I personally put every blanket in the house over myself when I have a fever. Fevers are miserable when you're chilled. I'd like to know the data, here.

I had some more, but now I am super hungry for my garlic noodles and OJ and then I'll probably go back to bed, where I fully intend to unapologetically crank up my electric blanket even though it's 70 degrees outside.

Cleaning out the junk

I'm done with my 30-day challenge, which I failed out and out. Except I learned the value of progress and gradual improvements in the course of my failure, so maybe it was a success. That's getting confusing.

The point is, I have been doing things reeeeeeeally gradually. It's turning into a metaphor for personal development, but the gradual things I'm doing are, like, cleaning my house.

Although Martha doesn't live here, I'm not a total slob. I regularly wash my dishes, do laundry, and pick up clutter. I sweep all the time because the puppies shed like crazy. I dust...rarely, because in an hour the puppies bring like the whole back yard in with them. Despite this non-total-slob-bery, my house is pretty dirty. I had rented it to two tenants while I was off getting married and divorced, and they weren't terrible, but they didn't give it much TLC either.

I want it clean. Deep-down clean. And the idea is totally daunting. So, I've been doing Something Odious for 15 minutes every day. I figure eventually the whole house will have been super-duper cleaned, and I bought it 10 years ago, so, you know, once a decade whether it needs it or not.

Currently? I'm in the kitchen. The linoleum has dirt ground into it. It resists mops and toxic chemicals, so I have to actually put hot water and dish soap in a bucket, get down on my knees, and use a scrub brush, like the old days. Then rinse and dry.

THIS IS EXHAUSTING. I would have made a terrible housewife or maid or anything domestic. I scrubbed about a quarter of my kitchen today and it took 30 minutes and my arms were about to fall off and I was thoroughly tired of the whole thing. But I was past my 15-minute limit so I quit. See the difference?

Some people might be bothered by having a now markedly filthy kitchen, in contrast, but not I. No. Because tomorrow I'll do another quarter, and shortly the whole floor will look fabulous. Meanwhile, I look at it metaphorically. If I can clean a house one dark corner at a time, surely I can do that with my insides too. And not be bothered by the lack of instant success.

The reason nurses yell all the time

I finally figured out why we're always getting e-mails about how we're too loud. We ARE. Nurses yell at everyone all the time. It's not because we're mad; it's because so many of our patients are hard of hearing. We just get used to talking loudly.

Common scenario:

Me: Are you having any pain?

Pt: What?

Me: ARE YOU HAVING PAIN?

Pt: Argh! You don't have to yell!

And once I had a lady who was nearly deaf as a post. I wasn't talking much louder, if at all, than usual, but her friend kept telling me not to YELL at her. I said, "I'm not yelling at her. It's actually just how I talk, but she can't hear me." I think the lady also had macular degeneration or something so we couldn't write back and forth, but whatever it was she couldn't see very well. "She reads lips," said the friend. "Stop yelling at her." What?

I thought "vagina" made a comeback

But this teacher is in trouble for saying the word!

The students are already even given the option to opt out of the horror of having to hear a term that designates a female organ.

I thought vagina was kind of trendy. All the funny stand-up folks and bloggers pepper their best material with it. Which was a horrible sentence (never pepper anything with vagina!).

Also: can teachers say "penis"? I'm just curious.

This is all theoretical for me anyway, because I work in the medical field, so I'm totally safe from ever hearing either word. To my patients, their genitals are

• Hoo-hahs
• Cootchies
• Hootchies
• Baloney curtains
• "Things"
• "Down there"
• Cooters
• "Where I go to the bathroom"
• Equipment (this one always makes me picture one of those giant home gym assemblies)

I could go on. But it CAN be worse when they try to be technical. I once got a triage slip that read "sore gentles."