Monday, March 23, 2009

I've Been "Olivized"

I'm sure that many of you, dear readers, have realized that since the death of my beloved Opal, a new life has come to join us here at the Manor...

I must admit that's it's been tough trying to blog since Olive found me. I've forgotten what it's like having a puppy in the house and my brain has flipped into some kind of "Mommy mode". Life is now a matter of moving from one distraction to another. In the time it has taken me to write these few sentences, I've had to leave my laptop and tend to puppy mischief three times. That's added up to about 90 minutes away from the computer.

Now the 90 minutes isn't all about misdirecting Olive from mischief. It also involves playtime, walk time, nuzzles, kisses and gazing upon her lovingly as she falls asleep in my arms. Yeah, I've fallen hard for this one... and as someone who's been pretty much living life from one death to another, this is one distraction I sorely need.

Sunday, March 15, 2009

Hospice Hitwoman and the C.Y.A.: Part 2

(This is the second part of a two-part Adventure. To access the first part of the story, please click here.)

This has gone beyond the pale. I take a look at Mrs. C. and Marcy. They look almost frozen in time; mouths slightly open, eyes unblinking. I can't tell if they're in shock over Bob's outburst or anxiously awaiting my answer:

"Bob, I'm not killing anyone for you. I'm not a murderer."

I can't help it. I'm taking this personally and it's pissing me off. What in the name of God makes him think that I'm capable of murder?

Is it because I look like this?

Bob's demeanor changes instantly... His anger and desperation have crumbled into nervous back-peddling. He's said far too much and he knows it:

"Oh God, no really. I didn't mean that... it's just that we're... we can't..."

Oh God, I think I really want to leave this house right now..."Okay, let's just put an end to this subject", I say. "You know that Raymond's time is coming very soon and that I've told you that he appears to be comfortable. Please just try to stay as calm as possible for Ray and just give me a call if he passes on."

Returning to the quiet of my car, I decide to call my supervisor and "cover my ass". I tell Kathy as much as I can remember about this disturbing visit and then head for home. I don't get very far at all. Less than twenty minutes has passed before the answering service tells me that Mr. C. has died. I turn the car around and head back. Crap...

It's like a different house. The place is buzzing with friends and neighbors and the grieving family is happily soaking up all the attention. This is good. I'm able to keep the family informed and then fade into the background. After the funeral home leaves, I say goodbye to Mrs. C., update my supervisor and continue with the rest of my shift.

The next day...

I get report before the start of shift from my supervisor. Just before I hang up the phone, Kathy says, "Oh, by the way, there was a complaint from Mr. C's family today."

"Really? What was wrong?"

"They said that a hospice nurse never showed up at the house when they called last night", answers Kathy with a little chuckle.

Wow, wow, wow... See? It does pay to CYA.

Tuesday, March 10, 2009

An Ethics Lesson with 'Druwing on Drawing'

I've often felt that our ethics is not keeping up with our technology (medical or otherwise). However, that's not really true. The moral code that we need with regard to technology has been there all along. It's just that unfortunately, we're so seduced by all the bells, whistles and shiny buttons that we just don't want to put the "toys" down.

In this short, disturbing sketch from Adult Swim's, Tim and Eric Awesome Show Great Job!, Bob Druwing gives us a lesson on "just because you have it, doesn't mean you should use it".

Watch more Tim and Eric Awesome Show Great Job! videos on AOL Video

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Saturday, March 7, 2009

The Art of Making Popcorn

Everything you need to know about microwave po...Image by via Flickr

by Insurance Guru

There's an entire generation out there that believes popcorn comes from the microwave. As long as you have the right side up and hit the "popcorn" button on your microwave, a tasty treat is just seconds away.

My dad was a popcorn connoisseur when I was growing up in the '60's. He was always after the perfect combination of chilled popcorn kernels, oil temperature, pan size and the Zen of being one with the kernels. We experimented with Jiffy Pop and all the latest corn poppers that came out one by one. Did you know there was an early version of a microwave popper that used water instead of oil? An absolutely sub-par product came out of that contraption.

Sad to admit, but I've lost the art of making popcorn from the stove. In the spirit of "Economic Hunkering Down" I bought a Stir Crazy Corn Popper. Now I can control the amount of oil, salt and butter in my tasty snack and there's a warm, fuzzy memory in every bite.

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Wednesday, March 4, 2009

Palliative Care Grand Rounds: Vol. 1, Issue 2

Presenting PCGRrrr!

There are so many wonderful writers with thoughts to share and tales to tell that are relevant to the fields of hospice and palliative care. Here are some of my favorites for this month's PCGR. I hope that you'll visit these talented bloggers often. (Oh, and little Olive will be helping out a bit here, too!)

Drew Rosielle MD, of Pallimed, gives us an emotional full plate with his post Not Safe For Work. Here, he's found a great podcast by Mike Destafano who does a wonderful job telling the story about events leading up to the death of his girlfriend from AIDS. Drew also includes a video from The Onion entitled,
"Courageous Man Refuses to Believe He Has Cancer". It's very funny and also gives you that weird little feeling of unease. You know, like 'I don't think I should be looking at this, but I must' kind of thing.

I pretty much use Twitter to let readers know that I haven't died between posts, but Christian Sinclair MD, of Pallimed, has really put it to good use. I had no idea it could be so versatile! If you want to know how Twitter can help you and how to get started, Christian's post, Twitter For Hospice & Palliative Medicine, is a must read!

Paul Levy of Running A Hospital is also a "Twitterer". His post, Twitter Etiquette, also discusses aspects of this micro-blogging service and his mysterious, new-found popularity.

I think I just 'twittered' in the hallway.

An excerpt from Hours-to-days, a poem by Risa Denenberg of Risa's Pieces:

"They need knowledge of a kind
not previously imagined. They want
to know when. And how to wait. What to say.
Things the doctor forgot to explain."

In another post by Risa, Unfinished Business, a story is told that brings to life a term commonly used and heard in hospice and palliative care.

ONCRN returns to work after having her baby. She commemorates this event with her wonderful, so busy, yet so tired, poem back.

Amber Wollesen MD, of Pallimed: Arts & Humanities, takes a moment from her hectic day to ponder a family's "thank you" card, herself and Robert Frost in Stopping to Appreciate the Roses with Robert Frost.

Jessica Knapp of The Good Death contemplates how readily we use death metaphors in Death as a Metaphor for a Cluttered Life. Jessica also gives us a laugh with That's What a Hospital Is For.

Speaking of which... shrimplate knows what a hospital is for. The nurses (duh!). Read this nurses's take on the matter in Songs About Buildings But Not Food. Another great story from shrimplate is How Doctors Decide Whether a Patient is Sedated From Opiate Overmedication or Just Plain Dying.

Gail Rae Hudson of The Mom & Me Journals dot Net wants to explore the dying process from the "dyees" point-of-view. Much easier said than done. In her post Finally! My Kind of Snow, Gail skillfully tells of her search for answers and performs an in-depth comparison of information gleaned from The Tibetan Book of Living and Dying with her own mother's recent death.

Never one to pull punches, Leo Levy at DNR/DNI gives us a two-part story that is a "DNI" conundrum and then some. For a great read, check out Nursing on the High Wire (Part One) and Part Two. Leo also teaches us the value of putting forth a little extra effort in patient communication with Quadriplegic For Life.

Another great lesson in the value of good communication comes from Bruce Campbell MD in his post The Pre-op Visit. Read and see how "jumping to the end" can alleviate so much anxiety for the patient.

Marachne, a hospice/palliative nurse and doctoral student, takes us into her classroom as she and her students discuss a case study... but it's so much more than that. Please read this wonderful post, Expectations and Filters.

Hospice Guy gives good advice and some surprising insight into Continuous Care Issues. He really opened my eyes to this seldom discussed aspect of hospice care.

David Tribble MD, of Alive Hospice Blog touches on a phenomenon that's rather near and dear to me. His post, Visits From the Dearly Departed: Hallucinations or Sacred Encounters?, treats this subject with the respect that it deserves.

Pressure ulcers are unfortunately, an all too common problem among the dying. Angela Morrow RN, at, stresses the importance of pressure ulcer prevention and knowing the risk factors. Her post, Dying with a Pressure Ulcer, serves as an important resource for all caregivers.

Fresh Widow gives us a chuckle with her "inventiveness" in her post Introducing My New (FREE) Product! The Widow Card!. Also... a memory of missing pain meds for her dying husband inspires this post, Two and a Half Years, Dozens of Anniversaries.

I find myself at a loss for words when trying to describe this blog... In October 2007, this family physician's then three-year-old son was diagnosed with a cancerous brain tumor. On February 26th of this year, little Henry died. Please spend time with Dr. Smak.

Thaddeus Mason Pope of Medical Futility has a great post, The Pope Confuses Me - The "New Eugenics".
In this article, Mr. Pope cleverly reveals an inconsistency in the Pope's (no relation, I presume) logic regarding the mind and body.

Along the same line of thought, Maurice Bernstein MD of Bioethics Discussion Blog, reviews the sad case of Eluana Englaro. This Italian case brings back many memories of our own Terry Schiavo. Dr. Bernstein's Suffering, the Unconscious and the Application of Dignity: What is the Science, What are the Ethics? boldly examines this frustrating conflict.

Let us not forget those who died in the bushfires in Victoria, Australia. Hospice and Caregiving Blog pays homage to the victims and discusses the effects of public tragedy in Mourning a Public Tragedy in Australia.

Let us also not forget all the wildlife that lost their lives in this horrible fire... Peter McCartney RN of NSW, Australia gives us this "moment of awwww" in his post Sam the Koala. As Peter so nicely states, "These clips may not seem earth shattering but for us Australians Sam shines as a representative of the millions of animals, birdlife and reptiles lost in these fires..."

Many thanks to all our readers and contributors! Next month's PCGR will be held Wednesday, April 1st at The Good Death.

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