"There is a powerful contemporary Christianism that admires Dives (Latin for rich man) and emulates him, and regards Lazarus as burdensome and reprehensible. Indeed, the supposed Christian revival of today has given something very like unlimited moral authority to money, though Jesus did say (and I think a literal interpretation is appropriate here if anywhere), "Woe to you who are rich!" (Luke 6:24). If this seems radical, dangerous, unfair, un-American, then those who make such criticisms should at least have the candor to acknowledge that their quarrel is with Jesus."
by Marilynne Robinson
from The Best American Essays, 2007 Edition, Page 219
Friday, August 15, 2008
Monday, August 11, 2008
The Gap (Part 2 of Looking At Workplace Psychological Abuse)
(For those who expected Part 2 to be entitled "Tell Everyone!" stay tuned, it's coming.
Part one was entered on this blog on April 11).
Most large businesses and corporations today have written statements spelling out rules or standards that employees are expected to follow. These standards go by a variety of names. There is often a "Mission Statement" and a "Basic Conditions of Employment." In addition there may be "Standards of Conduct," "Customer Service Standards," Principles of Conduct," or maybe the word "philosophy" is used in the title of a statement. Frequently these statements deal with ethical guidelines, or how employees are expected to behave. These documents may govern or provide guidance for actions and speech by employees in their interactions with each other, or with customers. They are written for a variety of reasons, including attracting customers and employees, preventing conflict, and especially protecting upper level management from legal action for problems that may occur.
Over the last few decades workplaces in the United States have experienced some troubling changes. While the salaries of CEOs and other top executives have skyrocketed, wages and benefits of the average worker have gone in the other direction. The average family with two full time wage earners today actually has less discretionary income than a family with one breadwinner a generation ago (Mark Ames in "Going Postal" Page 101). In one year, 1999, the average CEO salary increased by 37% while the average worker salary increased by only 2.7% (Ames, Page 91). Health insurance, pension plans, and vacation time are also diminishing, and in some places, disappearing altogether. Lay-offs, downsizing, and outsourcing has made employment for many Americans very unstable. This contrasts sharply with the trend in most other industrialized countries. Other industrialized nations have universal health insurance for their citizens. Minimum annual paid vacation in France is five weeks, and most western European countries are, in many ways, much more pro-family than the US. One example is that they offer new parents longer maternity and paternity leave, usually with a significant percentage of their pay. The average American works 350 more hours each year than the average European.
In spite of this trend of decreasing compensation and support for workers in the US, the written statements and standards of companies are more impressive than ever. Many corporations have written policies and standards governing the interaction of employees that sound almost New Testament Biblical in their stated concern for the employee. Unfortunately those are only written statements. In reality there is a massive gap between what is written and the actual behavior of management toward employees. My own experience is a powerful example of this gap.
From 1976 until 2006 I was employed as a respiratory therapist at Saint Alphonsus Regional Medical Center (SARMC) in Boise, Idaho. Saint Alphonsus is part of the Trinity Health system headquartered in Novi, Michigan with facilities in seven states. Trinity Health is the fourth largest Catholic Health system in the United States. For the last 28 of those 30 years I was a shift supervisor providing job assignments, and communicating changes in physician orders and many other responsibilities, usually for two to eight people per shift, as well as caring for respiratory patients myself, often in the Emergency Department.
Let me point out that I think the average person who goes to Saint Alphonsus probably gets excellent care. But that care comes from the employees who directly care for the patients. The vast majority of those employees are committed, dedicated, hard-working people who sincerely care about their patients and often go above and beyond the call of duty to provide timely and appropriate care, and they usually do it without necessarily expecting anything in return, often not even charging for overtime if they miss lunch or stay over to complete their care. In the thirty years I worked there I did that thousands of times, just out of commitment to the cause, to the place, and to my job, and I know many others have done the same. But with management, especially upper level management, the story is somewhat different.
In January of 2004 I became the target of a workplace "bully," an adult version of the school yard bully that many of us had to deal with in grade school, junior high, or high school. This psychologically abusive co-worker began to target me with chronic misbehavior that included among many other things, withholding information I needed to do my job and refusing to communicate with me. Refusing to communicate with a co-worker in a hospital setting endangers patients, since clear, succinct communication between health care workers is necessary to provide timely and appropriate care. In so doing she intentionally created and maintained a hostile, high-stress work environment.
To keep this entry as short as possible I will simply add the following three facts about this ordeal. First: Her "bullying" continued for over two and half years until I was forced to resign because I was seriously injured and becoming disabled by the chronic abuse. Second: She adamantly refused to participate in any kind of resolution process to try to resolve the problem. I offered to participate in any kind of process involving either direct or indirect communication including the use of a professional mediator, but she refused to participate and continued to behave in an abusive manner toward me, jeopardizing patient care and causing serious injury. Third: Management intentionally gave her permission to refuse to participate in any resolution process. At no time did any member of management require her to discontinue the abuse, or change her injury-causing behavior toward me. Therefore nothing was done to address the problem or to provide me with a safe working environment, relative to the occupation.
The problem should have been very easy to resolve. The bully was violating multiple "Customer Service Standards" every shift we worked together. These standards include encouraging employees to discuss problems with co-workers before reporting them to management and instructing employees to listen to anyone who wants to talk to them. The "standards" include strong statements such as "treat each person the way you want to be treated," and treat each person as if he/she is the most important person in the facility." Anyone who acts as a bully is violating numerous Customer Service Standards as well as the Basic Conditions of Employment.
Trinity Health has their own Standards of Conduct with equally clear and positive emphasis on respect, kindness and also requiring honest and clear communication. However for the purpose of this entry I want to look at just a small portion of the 20 plus pages of the Standards of Conduct which you can find at http://www.trinity-health.org/ under "Organizational Integrity."
This section is on Page 13 and entitled "What Should I Expect from Trinity Health?"
It includes the following statements.
...you should also expect Trinity Health to:
1. Treat you with honesty, dignity, fairness, and respect.
2. Provide you with a meaningful work experience.
3. Provide you a safe and supportive work environment free for harassment, intimidation, or
violence
4. Provide a respectful work environment that allows you to freely ask questions, seek
clarification when needed, and raise issues and concerns in good faith without fear of
harassment or retaliation
5. Have your requests for information, input, or assistance responded to in a timely manner.
(I added the numbers for easier reference)
Sounds great, doesn't it? Reading that list would give any employee a sense of security, hope, and optimism about working for Trinity Health, right? Now read what happened to me and you will recognize the significant gap that exist between these promises and the actual practice of management at Trinity Health.
I was the target of a bully for over two and a half years. By the time I left I was partially disabled by the chronic psychological abuse. Although I'm no longer dealing with any disability I still have to cope with the effects of PTSD over four and a half years later. The bully jeopardized patient care every shift we worked together. Her intentionally malicious behavior toward me started abruptly when she found out that I did not share her religious and political beliefs. A year after the problem began I was diagnosed with Post Traumatic Stress Disorder (PTSD) as a result of the work abuse. The diagnosis of PTSD was made by Saint Alphonsus, as occurring on the job at Saint Alphonsus, and I have that in writing from Saint Alphonsus. There was never any question about the cause of the PTSD injury.
I reported the patient endangering behavior of the co-worker and the discrimination against me to management numerous times. Nothing was done to address those problems. I reported the PTSD injury to management more than two dozen times over a period of approximately two years. The respiratory care department manager specifically told me, both verbally and in writing, that my injuries were "petty," even though PTSD is a potentially life threatening and disabling injury, as any veteran of Vietnam or Iraq can confirm.
The CEO and the chairperson of the Bioethics Committee never responded to my reports of being abused and injured, this in spite of the fact that the Bioethics Committee chairperson was a surgeon whose patient I had been at least three times in the past!
All three managers from department, human resources, and senior management ordered me to not talk about the injury with co-workers, even though telling others what happened to me is an excellent way to raise awareness and thereby help prevent others from also being injured.
A vice-president told me to just let the abuse "pass over me;" whatever that means.
The employee relations manager was especially toxic in his behavior toward me. I met with him three times to try to discuss this problem, and the injury, but he refused to listen to my side of the story even before I met with him the first time! He conducted two investigations, both clearly manipulated to obtain pre-determined results. He promised me a written report of the first investigation, then refused to provide it even though I requested it several times. He promised me a meeting with the department manager to discuss the results of the first investigation. It was never scheduled. He promised me I wouldn't have to work with the abusive co-worker anymore. The promise was broken in two months. In July of 2005 he even threatened to fire me for reporting the PTSD injury to him! In the third meeting with him on October 4, 2005, red-faced and bellowing at me across the table in a tiny office, he ordered me to lie about the PTSD injury if anyone asked, and threatened to fire me if I reported any more problems with the abusive co-worker to either him or the department manager, or if I discussed the PTSD injury with anyone in the department.
Those traumatic experiences with the employee relations manager demonstrate a few facts about Saint Alphonsus and also Trinity Health. One: at that point not just the co-worker, but management also was engaging in the abuse and aggravating the PTSD injury. Two: denial is a chief tool of St. Alphonsus and Trinity Health when it comes to dealing with problems management does not want to address. Three: this experience also demonstrates that Saint Alphonsus is a "punitive authoritarian system," that is a system of management in which one or more people in management actually derive pleasure and satisfaction out of hurting those in the hierarchy below them.
From my experience that's the reality of how Saint Alphonsus Regional Medical Center and Trinity Health responds when problems occur in the workplace. The statements above are the promise and the ideal, but there is a massive chasm or gap between the promises in the written statements and the actual reality that one experiences in the workplace. The gap is so large that, in reality, there is no connection between the two. From my experience there was no sincere attempt made by anyone in department or upper level management to address the abuse I was targeted with, and provide me with a safe working environment. The statements and the entire Standards of Conduct are just a public relations stunt to attract employees and customers. I know of others who've been treated the same way at Saint Alphonsus including people who were fired for reporting unethical and patient endangering behavior by a physician, for being injured on the job, and also terminated for having to be on bedrest due to a difficult pregnancy. Firing someone for those reasons may not be illegal, but it is injury-causing behavior and should not be a part of any Christian organization, or the part of any responsible health care business. It also violates their own standards. Even before I reported the abuse and the PTSD injury to the employee relations manager, another employee warned me that I would be retaliated against, simply for reporting the problem. That's exactly what happened. I also reported the problem and the PTSD injury to a vice-president at Trinity Health and received no assistance, not even a response for months.
I was abused and injured on the job at Saint Alphonsus and it occurred with the knowledge, approval, and participation of upper-level management, including senior management.
The problem of management at Saint Alphonsus and Trinity Health not only allowing employees to psychologically abuse and injure their co-workers, but actually participating in the abuse and adding to the injury is every bit as serious a problem for the Catholic Church as the pedophile priest problem. Texts on bullying and psychological abuse in the workplace document that the emotional harm done when one is the target of a workplace bully as I was, can be just as severe as the emotional harm done when someone is raped, tortured as a prisoner of war, or shot at repeatedly in a war zone.
Let's look at # 5 above for a minute. That's the statement that promises "a timely" response to requests for assistance. I first reported the PTSD injury to management the first week of January, 2005. It's now more than three years and eight months since and I have yet to receive a written or verbal response from any member of management addressing the PTSD injury. See what I mean by a "gap. " Or perhaps they just have a different definition of "timely."
Leonard Nolt
Thursday, August 7, 2008
The Exit (Fiction)
Room 518 was nearly dark. The only colors visible were on the monitor. It hung over the still form on the bed with instant vital sign information, even if Doug Hale didn't want to know. The green line was the heart rate sprinting along at 150, blue, the breathing pace, also too fast at 40. The red blood pressure line was faltering, as was the purple line recording the oxygen levels. For several minutes both had teetered on the bottom edge of normal. If we could just average them together, thought Doug, they could all be normal.
On the wall beyond the foot of the bed hung a large round clock over a small gold-plated crucifix. The space above the head of the bed was filled with the business end of IV poles from which hung the soft plastic containers dripping fluids into his dad. Also suspended there was the monitor.
Doug's father, Holland, was attached to the monitor. He lay on the bed between the shiny side rails, his chest rising slowly with each breath, and then collasping toward his spine as if the effort to fill his lungs was exhausting. The colored lines on the monitor continued their rhythmic dance across the screen as Doug stared with bloodshot eyes. A few minutes ago his father had returned to Room 518 after three hours of abdominal surgery and an hour in the recovery room.
"I removed the necrotic section of his bowel," the surgeon, Dr. Ash said, running his fingers through his curly black hair and glancing briefly toward the door. "He should do okay." His voice hesitated a moment, then added, "But he is seventy-five."
He looked at Doug as if expecting a response. Then the operator's calm, clear voice came out of the ceiling, "Dr. Ash, call three-eight-seven-one stat." The surgeon quickly walked out the door and to the nearest phone.
For the next couple hours Doug sat by his dad's bed. Again he propped his head against the wall and dozed. Morning sunlight began to brighten the room. Every fifteen minutes the nurse came and checked his father's vital signs. She wore blue surgical schrubs even though she had introduced herself as an intensive care nurse. The black capital letters on the white tag spelled out the name, COURTNEY. She stared intently at the monitor for a few seconds, then wrote something on a sheet attached to the clipboard she carried. Then she took a small hand-held plastic instrument with a funnel-shaped end, stuck the small end gently into Holland's left ear for a few seconds, removed it, glanced at the digital readout, wrote on the clipboard again, and left as quickly as she had arrived.
Holland stirred in his bed. His respiratory rate quickened and his eyelids flutered. One eye opened briefly. Doug leaned toward his father's ear.
"Dad, it's me, Doug. How are you?'
After a pause, his father's head nodded slightly, then his eyes opened. "I'm hurting, " His voice came out hoarse and weak. "Can you get that nurse to give me some more morphine?"
"Is it bad?" Doug asked.
"Like sandpaper on the eyeball," his father said.
Doug slipped out of his chair and walked to the nurse station where Courtney was talking on the phone.
"Did you tell him that?" Doug heard her assk and then he voice trailed off as she saw him approaching. Putting her hand over the mouthpiece, she asked, "Can I held you?"
"My father would like more pain medication." Doug said.
She glanced at her watch. "I'll be right there," she said, then turned back to the phone.
Doug returned to the room and Holland opened his eyes. "Did you find her?" he asked.
Doug nodded. His father looked relieved and closed his eyes. Doug slipped his left hand through the side rail and gripped his father's hand for a moment. He felt a weak squeeze in return and saw a brief smile come to Holland's face.
A minute later Courtney walked into the room, a loaded syringe and needle in her hand. After a brief glance at the monitor, she located the inlet port on the intravenous line, wiped it off with an alcohol swab, and with two fingers, kinked the line above the port. Then she inserted the needle into the port and slowly emptied the syringe. After increasing the flow from the bottle to send the narcotic to its destination, she reset the drip to just keep the line open. Then she placed the used syringe and needle in a red container with the warning label, SHARPS, attached to the wall, and left the room.
Soon Holland rested easier and appeared to be in a deep sleep. Doug suddenly realized that he was hungry. He hadn't eaten anything in more than a day. He rose from his chair, glanced out the window at the parking lot where fresh sunlight glared from the shiny polish of a hundred cars, checked to make sure his father was still sleeping, and then left the room.
He walked down the hall toward the elevators. The place was busy. Dietary aides carried trays from food carts to the patients. A large muscular man with a ponytail was carefully stacking perfectly folded towels in a linen closet. Doug had to squeeze past four nurses standing in a circle intently discussing some information on a patient's chart. He didn't see Dr. Ash or Courtney anywhere.
He pushed the elevator button for the second floor cafeteria and got off when it stopped. It took a few seconds before he realized his mistake and tried to get back on the elevator, but the door had squeezed shut and it was gone. This was a patient floor also, not the cafeteria. He looked down the hall and saw, at the far end, the bright exit sign indicating a flight of stairs.
That'll be quicker than waiting for the elevator again, he thought, and started toward the sign. Halfway down the hall he saw a thin man approaching. The man was wearing only a pair of loose white shorts. Doug's pace slowed as the thin man got nearer. His hairless skin was pale and ghostly, but shiny, almost translucent, as if lit from inside. Doug thought for a minute that he could almost see the outline of the man's skeleton through his skin. He had a yellow band around one wrist and a purple one around the other. His step was hesitant, but determined, like one who should use a cane, but refused to. Doug started to nod in greeting, but noticed that the man had a faraway look in his eyes, as if focused on some distant goal.
Doug reached the exit, glanced back to take one more look at the thin man, but he was nowhere to be seen. Doug paused a minute searching with his eyes, but the hall was as empty as if no one had ever been there. Doug opened the exit door and went down the barren concrete steps.
On the second floor he checked the vending machines in the snack bar for breakfast. The only thing they contained was some overpriced yogurt of questionable age. On a wide shelf between the sandwich and snack machine sat a ruined microwave. The door was open. Someone had turned it on with metal inside, and the melted plastic hung in blobs from the top of the interior like stalactites in a cave.
Doug left the snack bar and entered the cafeteria, but his appetite had disappeared. He bought two granola bars and a cartoon of milk and ate, sitting alone at a table in the corner of the cafeteria. In the ceiling over his head was a speaker and from it came the saccharine music heard in hospitals, frequently interrupted by the measured cadence of the operators's voice calling for doctors, nurses, or therapists.
Doug returned to his dad's room. deliberately retracing his steps through the same stairs and hall, but did not see the thin man again. In Room 518, a small woman dressed completely in white from her shoes to the large bow in her coal black hair, and holding a small silver tray in her hand, had arrived to draw blood. Doug watched closely as the sun shining in the window reflected above the silver side rails like a rectangular halo suspended above the sleeping form of Doug's father. The woman circled the bed, breaking the sun's rays, and placed her tray on the narrow bedside table. After turning off the monitor's alarms. she took two small needleless syringes from the tray in her gloved hands and withdrew the plungers on both. She attached one to a port on a tube inserted in an artery in Holland's left arm. Then she attached the other syringe to another port on the same line, turned a stopcock, and filled one syringe, then adjusted another stopcock, and filled the other. She moved the second syringe from the line, capped it, and briefly rotated it in her hand. The she pushed the blood in the other syringe back into the line, flushed it with fluid from the IV bottle, and turned the stopcock again before removing the syringe and discarding it.
As she left, Holland slowly opened his eyes and whispered in a husky voice, "What did she want?"
"Some of your blood," Doug said.
"Vampires," Holland said.
"Feeling any better, Dad?"
Holland nodded. Then he motioned for his son to come closer. Doug leaned over the rail.
"I'm not going to make it out of here," he said.
"Nonsense," Doug said. "Even you said you were feeling better."
"I am, but that's not it, " Holland said, "I just know."
He paused a moment to catch his breath. The red line on the monitor jerked upward into the path of the green one. The screen switched to a row of white numbers and a square red light began to blink. An alarm shrilled out a series of four high-pitched beeps, then became silent as Holland relaxed, and the screen changed again to the rows of colored lines, realigned to their normal paths.
"My keys are in the bag," Holland said, and gestered toward a brown leather pouch lying on the broad windowsill.
"What keys?" Doug asked.
"To the ranch house," Holland said. "There's a chest under the bunk bed with some things in it for you."
"You'll be back there in a couple days, " Doug said. "You'll need those keys."
Holland shook his head.
"Just remember what I told you," he said.
A volunteer walked into the room. She was an elderly woman wearing a pink dress. Her gray hair was curled tightly close to her scalp. She smiled at Doug without speaking, handed him an envelope and continued on to the next room. Doug glanced at the envelope, started to speak to his dad, but noticed that Holland seemed to have fallen asleep. He tore the envelope open. In side was a get-well card. On the cover was a crude caricature of a frazzled nurse trying to give a shot to a patient who was lying in bed with traction attached to each arm and leg. Doug barely noticed the verse which said something intended to be funny about nurses, shots, and hospitals. The card was signed, Bobby.
Holland stirred and opened his eyes.
"Hey Dad, you got a card, " Bobby said, He held the card up for his father to see. "It's from Bobby."
"Who?" Holland asked.
"Bobby," Doug repeated.
"Who's Bobby?" Holland asked.
"How would I know?" Doug asked. "The card's addressed to you, not to me. Do you want to see it now?"
Holland closed his eyes. Soon his breathing relaxed and he was sound asleep. Doug sat in the chair and rested. On the wall at the foot of the bed the second hand of the clock silently clicked from second to second quivering each time it stopped, as if nervous about the future, before moving on. Doug noticed that sometimes it took six jerks of the hand to cover five seconds on the dial and other times only five.
He glanced out the window. A cherry red pickup truck was pulling into the parking lot five floors below. It came to a stop between two of the diagonal white parking lines. A man, woman, and a small girl got out of the truck. The man was carrying something. He bent over and made a series of up and down movements with his arms and back. Next to him a flat object inflated into a large yellow beach ball. He handed the ball to the girl, then loped an arm around the shoulder of the woman and, without looking back, they walked to the edge of the parking lot and laid on the grass under a small tree.
The girl bounced and chased the ball around the parking lot. At one point the ball ricocheted between two parked cars, and then bounced into the path of a black van accerating as it headed for the exit of the parking lot. For a second Doug thought the girl would run into the van, and opened his mouth to cry a warning even though there was no way anyone on the parking lot could hear him. But the girl halted just in time and stood still as the ball careened up from the van's fender, its shadow passing over her, and then bounced off the roof of a parked car before rolling across the lot. The van stopped, and Doug saw a person step partly out the door, make some wild gestures with an arm, then retreat into the van, disappearing behind the tinted glass, and the van sped off. Under the tree the man and woman lay still.
What kind of people, thought Doug, would let a small child play on a busy hospital parking lot? Exhausted from watching the scene below, he turned from the window and sat in the chair, resting his head against the wall again until he fell asleep.
He slept for a couple hours, dreamed of food, and woke up realizing that he was hungry again.
Holland was still asleep. Doug dropped the card and envelope from Bobby in the trash can as he walked out the door. He took the same route to the cafeteria. A physical therapist who though he was lost, pointed to a more direct way. Doug thanked her and without changing directions, kept going.
He bought a full meal of broiled halibut with rice and cooked broccoli and finished it off with a couple chocolate chip cookies. While drinking lemonade, he overheard snatches of conversation from a table of hospital employees nearby.
"Did you see that one's x-ray?"
"I gave him enough to make his bones soft, but the doctor still wanted him more relaxed."
The sounds of he conversation were interrupted as a food aide slowly pushed a cart of empty trays through the room.
"He's circling the drain," said one.
"Not long for this world," said another.
Another employee approached the table and the conversaton turned to words of greeting. Over the intercom the calm voice of the operator came, "Code Blue, ICU, Code Blue, ICU." Two people from the table nearly left in a hurry, their trays abandoned, food uneaten.
Doug finished his meal and left the cafeteria. As he approached Room 518 he saw a couple nurses run into the room. A third pushed a large cart into the room. A tall breaded man dressed in wrinkled green scrubs with a black stethscope around his neck dashed by. A nurse recognized Doug and walked quickly toward him.
"Your father's taken a turn of for the worse. He quit breathing," she said.
She tried to direct him into a small lounge nearby , but Doug brushed past her and walked to the glass door of the room. The room was full of people. One nurse was trying to start an IV in Holland's arm. Another was injecting something into another IV. A respiratory therapist at the head of Holland's bed was helping him breathe with a large blue bag attached to a mask covering his mouth and nose. Another nurse was standing on a stool and pushing on Holland's bare chest, moving up and down in quick jerks, his fingers interlaced on Holland's sternum. The nurse's hairy arms quivered each time he compressed the chest. Still another was writing on a clipboard.
Doug was startled at the color of Holland's skin.. HIs father's usual dark tan had a yellow tint to it. The door to the room was closed so Doug couldn't hear anything. The bearded man walked to the head of the bed, picked up a metal object with a hinged curved arm, opened Holland's mouth, and slipped the curved part into it, then another person handed him a plastic tube which he inserted into the opened mouth and anchored it with tape.
For a few seconds everyone stopped and stared at the monitor which displayed a few shallow wavy lines, then they continued the resuscitation effort. Doug became aware of someone's hand on his shoulder. It was Courtney.
"Would you like a chair so you could sit down?" she asked.
He nodded, still staring into Room 518.
A few minutes later Dr. Ash walked past Doug and into the room. He consulted with the bearded man, listened to Holland's lungs, peered into his eyes with a small falshlight, and looked over a piece of paper containing a heart tracing. Then he motioned for everyone to stop. The green line on the monitor undulated irregularly across the screen and then settled slowly into a straight line. The bearded man shook his head and shrugged his shoulders.
For a long time Doug sat and stared into theroom. After arrangements were made and the body removed by the mortician, Doug picked up the brown pouch and a small opaque plastic bag containing Holland's things and walked slowly to the parking lot. It was beginning to get dark and two stars had appeared. The crescent moon curved toward the silhouette of a mountain range in the west. Doug unlocked his VW bus, got in, and sat there with his head on the padded steering wheel for several minutes. Then he turned the motor on, and steered out of the parking lot to I-40. The familiar whine of the acclerating engine increased in volume. He fingered the keys in the pouch and then took the next exit toward the ranch house.
(previously published in slightly different form by
Boise State University in the 1997 cold-drill)
Doug glanced out the window toward the parking lot and noticed his gray '78 VW bus parked in a corner under a street light. Then, exhausted from the long drive here, he sat down in a chair near the foot of his father's bed and dozed with his head against the flat hard wall. He wore the same jeans, sweatshirt, and new running shoes he had on when he left home over 24 hours before.
On the wall beyond the foot of the bed hung a large round clock over a small gold-plated crucifix. The space above the head of the bed was filled with the business end of IV poles from which hung the soft plastic containers dripping fluids into his dad. Also suspended there was the monitor.
Doug's father, Holland, was attached to the monitor. He lay on the bed between the shiny side rails, his chest rising slowly with each breath, and then collasping toward his spine as if the effort to fill his lungs was exhausting. The colored lines on the monitor continued their rhythmic dance across the screen as Doug stared with bloodshot eyes. A few minutes ago his father had returned to Room 518 after three hours of abdominal surgery and an hour in the recovery room.
"I removed the necrotic section of his bowel," the surgeon, Dr. Ash said, running his fingers through his curly black hair and glancing briefly toward the door. "He should do okay." His voice hesitated a moment, then added, "But he is seventy-five."
He looked at Doug as if expecting a response. Then the operator's calm, clear voice came out of the ceiling, "Dr. Ash, call three-eight-seven-one stat." The surgeon quickly walked out the door and to the nearest phone.
For the next couple hours Doug sat by his dad's bed. Again he propped his head against the wall and dozed. Morning sunlight began to brighten the room. Every fifteen minutes the nurse came and checked his father's vital signs. She wore blue surgical schrubs even though she had introduced herself as an intensive care nurse. The black capital letters on the white tag spelled out the name, COURTNEY. She stared intently at the monitor for a few seconds, then wrote something on a sheet attached to the clipboard she carried. Then she took a small hand-held plastic instrument with a funnel-shaped end, stuck the small end gently into Holland's left ear for a few seconds, removed it, glanced at the digital readout, wrote on the clipboard again, and left as quickly as she had arrived.
Holland stirred in his bed. His respiratory rate quickened and his eyelids flutered. One eye opened briefly. Doug leaned toward his father's ear.
"Dad, it's me, Doug. How are you?'
After a pause, his father's head nodded slightly, then his eyes opened. "I'm hurting, " His voice came out hoarse and weak. "Can you get that nurse to give me some more morphine?"
"Is it bad?" Doug asked.
"Like sandpaper on the eyeball," his father said.
Doug slipped out of his chair and walked to the nurse station where Courtney was talking on the phone.
"Did you tell him that?" Doug heard her assk and then he voice trailed off as she saw him approaching. Putting her hand over the mouthpiece, she asked, "Can I held you?"
"My father would like more pain medication." Doug said.
She glanced at her watch. "I'll be right there," she said, then turned back to the phone.
Doug returned to the room and Holland opened his eyes. "Did you find her?" he asked.
Doug nodded. His father looked relieved and closed his eyes. Doug slipped his left hand through the side rail and gripped his father's hand for a moment. He felt a weak squeeze in return and saw a brief smile come to Holland's face.
A minute later Courtney walked into the room, a loaded syringe and needle in her hand. After a brief glance at the monitor, she located the inlet port on the intravenous line, wiped it off with an alcohol swab, and with two fingers, kinked the line above the port. Then she inserted the needle into the port and slowly emptied the syringe. After increasing the flow from the bottle to send the narcotic to its destination, she reset the drip to just keep the line open. Then she placed the used syringe and needle in a red container with the warning label, SHARPS, attached to the wall, and left the room.
Soon Holland rested easier and appeared to be in a deep sleep. Doug suddenly realized that he was hungry. He hadn't eaten anything in more than a day. He rose from his chair, glanced out the window at the parking lot where fresh sunlight glared from the shiny polish of a hundred cars, checked to make sure his father was still sleeping, and then left the room.
He walked down the hall toward the elevators. The place was busy. Dietary aides carried trays from food carts to the patients. A large muscular man with a ponytail was carefully stacking perfectly folded towels in a linen closet. Doug had to squeeze past four nurses standing in a circle intently discussing some information on a patient's chart. He didn't see Dr. Ash or Courtney anywhere.
He pushed the elevator button for the second floor cafeteria and got off when it stopped. It took a few seconds before he realized his mistake and tried to get back on the elevator, but the door had squeezed shut and it was gone. This was a patient floor also, not the cafeteria. He looked down the hall and saw, at the far end, the bright exit sign indicating a flight of stairs.
That'll be quicker than waiting for the elevator again, he thought, and started toward the sign. Halfway down the hall he saw a thin man approaching. The man was wearing only a pair of loose white shorts. Doug's pace slowed as the thin man got nearer. His hairless skin was pale and ghostly, but shiny, almost translucent, as if lit from inside. Doug thought for a minute that he could almost see the outline of the man's skeleton through his skin. He had a yellow band around one wrist and a purple one around the other. His step was hesitant, but determined, like one who should use a cane, but refused to. Doug started to nod in greeting, but noticed that the man had a faraway look in his eyes, as if focused on some distant goal.
Doug reached the exit, glanced back to take one more look at the thin man, but he was nowhere to be seen. Doug paused a minute searching with his eyes, but the hall was as empty as if no one had ever been there. Doug opened the exit door and went down the barren concrete steps.
On the second floor he checked the vending machines in the snack bar for breakfast. The only thing they contained was some overpriced yogurt of questionable age. On a wide shelf between the sandwich and snack machine sat a ruined microwave. The door was open. Someone had turned it on with metal inside, and the melted plastic hung in blobs from the top of the interior like stalactites in a cave.
Doug left the snack bar and entered the cafeteria, but his appetite had disappeared. He bought two granola bars and a cartoon of milk and ate, sitting alone at a table in the corner of the cafeteria. In the ceiling over his head was a speaker and from it came the saccharine music heard in hospitals, frequently interrupted by the measured cadence of the operators's voice calling for doctors, nurses, or therapists.
Doug returned to his dad's room. deliberately retracing his steps through the same stairs and hall, but did not see the thin man again. In Room 518, a small woman dressed completely in white from her shoes to the large bow in her coal black hair, and holding a small silver tray in her hand, had arrived to draw blood. Doug watched closely as the sun shining in the window reflected above the silver side rails like a rectangular halo suspended above the sleeping form of Doug's father. The woman circled the bed, breaking the sun's rays, and placed her tray on the narrow bedside table. After turning off the monitor's alarms. she took two small needleless syringes from the tray in her gloved hands and withdrew the plungers on both. She attached one to a port on a tube inserted in an artery in Holland's left arm. Then she attached the other syringe to another port on the same line, turned a stopcock, and filled one syringe, then adjusted another stopcock, and filled the other. She moved the second syringe from the line, capped it, and briefly rotated it in her hand. The she pushed the blood in the other syringe back into the line, flushed it with fluid from the IV bottle, and turned the stopcock again before removing the syringe and discarding it.
As she left, Holland slowly opened his eyes and whispered in a husky voice, "What did she want?"
"Some of your blood," Doug said.
"Vampires," Holland said.
"Feeling any better, Dad?"
Holland nodded. Then he motioned for his son to come closer. Doug leaned over the rail.
"I'm not going to make it out of here," he said.
"Nonsense," Doug said. "Even you said you were feeling better."
"I am, but that's not it, " Holland said, "I just know."
He paused a moment to catch his breath. The red line on the monitor jerked upward into the path of the green one. The screen switched to a row of white numbers and a square red light began to blink. An alarm shrilled out a series of four high-pitched beeps, then became silent as Holland relaxed, and the screen changed again to the rows of colored lines, realigned to their normal paths.
"My keys are in the bag," Holland said, and gestered toward a brown leather pouch lying on the broad windowsill.
"What keys?" Doug asked.
"To the ranch house," Holland said. "There's a chest under the bunk bed with some things in it for you."
"You'll be back there in a couple days, " Doug said. "You'll need those keys."
Holland shook his head.
"Just remember what I told you," he said.
A volunteer walked into the room. She was an elderly woman wearing a pink dress. Her gray hair was curled tightly close to her scalp. She smiled at Doug without speaking, handed him an envelope and continued on to the next room. Doug glanced at the envelope, started to speak to his dad, but noticed that Holland seemed to have fallen asleep. He tore the envelope open. In side was a get-well card. On the cover was a crude caricature of a frazzled nurse trying to give a shot to a patient who was lying in bed with traction attached to each arm and leg. Doug barely noticed the verse which said something intended to be funny about nurses, shots, and hospitals. The card was signed, Bobby.
Holland stirred and opened his eyes.
"Hey Dad, you got a card, " Bobby said, He held the card up for his father to see. "It's from Bobby."
"Who?" Holland asked.
"Bobby," Doug repeated.
"Who's Bobby?" Holland asked.
"How would I know?" Doug asked. "The card's addressed to you, not to me. Do you want to see it now?"
Holland closed his eyes. Soon his breathing relaxed and he was sound asleep. Doug sat in the chair and rested. On the wall at the foot of the bed the second hand of the clock silently clicked from second to second quivering each time it stopped, as if nervous about the future, before moving on. Doug noticed that sometimes it took six jerks of the hand to cover five seconds on the dial and other times only five.
He glanced out the window. A cherry red pickup truck was pulling into the parking lot five floors below. It came to a stop between two of the diagonal white parking lines. A man, woman, and a small girl got out of the truck. The man was carrying something. He bent over and made a series of up and down movements with his arms and back. Next to him a flat object inflated into a large yellow beach ball. He handed the ball to the girl, then loped an arm around the shoulder of the woman and, without looking back, they walked to the edge of the parking lot and laid on the grass under a small tree.
The girl bounced and chased the ball around the parking lot. At one point the ball ricocheted between two parked cars, and then bounced into the path of a black van accerating as it headed for the exit of the parking lot. For a second Doug thought the girl would run into the van, and opened his mouth to cry a warning even though there was no way anyone on the parking lot could hear him. But the girl halted just in time and stood still as the ball careened up from the van's fender, its shadow passing over her, and then bounced off the roof of a parked car before rolling across the lot. The van stopped, and Doug saw a person step partly out the door, make some wild gestures with an arm, then retreat into the van, disappearing behind the tinted glass, and the van sped off. Under the tree the man and woman lay still.
What kind of people, thought Doug, would let a small child play on a busy hospital parking lot? Exhausted from watching the scene below, he turned from the window and sat in the chair, resting his head against the wall again until he fell asleep.
He slept for a couple hours, dreamed of food, and woke up realizing that he was hungry again.
Holland was still asleep. Doug dropped the card and envelope from Bobby in the trash can as he walked out the door. He took the same route to the cafeteria. A physical therapist who though he was lost, pointed to a more direct way. Doug thanked her and without changing directions, kept going.
He bought a full meal of broiled halibut with rice and cooked broccoli and finished it off with a couple chocolate chip cookies. While drinking lemonade, he overheard snatches of conversation from a table of hospital employees nearby.
"Did you see that one's x-ray?"
"I gave him enough to make his bones soft, but the doctor still wanted him more relaxed."
The sounds of he conversation were interrupted as a food aide slowly pushed a cart of empty trays through the room.
"He's circling the drain," said one.
"Not long for this world," said another.
Another employee approached the table and the conversaton turned to words of greeting. Over the intercom the calm voice of the operator came, "Code Blue, ICU, Code Blue, ICU." Two people from the table nearly left in a hurry, their trays abandoned, food uneaten.
Doug finished his meal and left the cafeteria. As he approached Room 518 he saw a couple nurses run into the room. A third pushed a large cart into the room. A tall breaded man dressed in wrinkled green scrubs with a black stethscope around his neck dashed by. A nurse recognized Doug and walked quickly toward him.
"Your father's taken a turn of for the worse. He quit breathing," she said.
She tried to direct him into a small lounge nearby , but Doug brushed past her and walked to the glass door of the room. The room was full of people. One nurse was trying to start an IV in Holland's arm. Another was injecting something into another IV. A respiratory therapist at the head of Holland's bed was helping him breathe with a large blue bag attached to a mask covering his mouth and nose. Another nurse was standing on a stool and pushing on Holland's bare chest, moving up and down in quick jerks, his fingers interlaced on Holland's sternum. The nurse's hairy arms quivered each time he compressed the chest. Still another was writing on a clipboard.
Doug was startled at the color of Holland's skin.. HIs father's usual dark tan had a yellow tint to it. The door to the room was closed so Doug couldn't hear anything. The bearded man walked to the head of the bed, picked up a metal object with a hinged curved arm, opened Holland's mouth, and slipped the curved part into it, then another person handed him a plastic tube which he inserted into the opened mouth and anchored it with tape.
For a few seconds everyone stopped and stared at the monitor which displayed a few shallow wavy lines, then they continued the resuscitation effort. Doug became aware of someone's hand on his shoulder. It was Courtney.
"Would you like a chair so you could sit down?" she asked.
He nodded, still staring into Room 518.
A few minutes later Dr. Ash walked past Doug and into the room. He consulted with the bearded man, listened to Holland's lungs, peered into his eyes with a small falshlight, and looked over a piece of paper containing a heart tracing. Then he motioned for everyone to stop. The green line on the monitor undulated irregularly across the screen and then settled slowly into a straight line. The bearded man shook his head and shrugged his shoulders.
For a long time Doug sat and stared into theroom. After arrangements were made and the body removed by the mortician, Doug picked up the brown pouch and a small opaque plastic bag containing Holland's things and walked slowly to the parking lot. It was beginning to get dark and two stars had appeared. The crescent moon curved toward the silhouette of a mountain range in the west. Doug unlocked his VW bus, got in, and sat there with his head on the padded steering wheel for several minutes. Then he turned the motor on, and steered out of the parking lot to I-40. The familiar whine of the acclerating engine increased in volume. He fingered the keys in the pouch and then took the next exit toward the ranch house.
(previously published in slightly different form by
Boise State University in the 1997 cold-drill)
Monday, August 4, 2008
Signs
Anyone who has spent much time looking at this blog knows that I have an ongoing interest in signs. I often find myself photographing signs, or messages in public, not just signs, but messages on t-shirts, billboards, walls, road surfaces, bumper stickers, etc. I'm especially interested in messages or signs that are unusual, humerous, contradictory, strange, creative, original, threatening, or innane. Recently I deviated somewhat from the usual content of my blog to include pictures of important events of family or friends such as weddings. Now I will probably go back to including information and interest from outside family and friends. That will include poetry, one short story coming up soon, articles on issues that interest me such as the environment, more on psychological abuse in the workplace, and more "signs."
Signs or public messages in our sociey and culture are ubiquitous. They say something about the kind of people we are. The value of some signs is in the directions and instructions they provide. This would include traffic signs. Others such as billboards and realtor signs exist to generate income for someone. But what about personal, political or other messages, brief statements about what someone believes or thinks, or who they are? I'm thinking of the message on the back of the shirt of the young man on crutches that I included on this blog shortly after I started it about a year ago. The message says, "Never judge a man until you walk a mile on his crutches." It was taken in Texas' Palo Duro Canyon many year ago. When ever I see the picture I think of him and wonder what his life was/is like. The front side of his shirt had the message, "Quad Power" on it. I wonder where he is today.
I think the abundance of signs and public messages in our culture may indicate that we are optimistic, or at least hopeful. We believe that someone, perhaps many people, care enough to want to read our message, even it it's in small print on a rear bumper sticker that cannot be read by anyone in a moving vehicle without dangerous tailgating. On the other hand perhaps some people don't really care if anyone sees it or not; they just have a need to express themselves. This would include those who decorate their bedrooms with posters, etc. Of course many of these are teenagers wanting their parents, siblings, friends, and other relatives to know who they really are. Perhaps if I had done that when I was a teenager there would have been more understanding between my parents and I, since it seems as if there was not much communication.
An abundance of signs is one of the characteristics of our culture. Signs can be an eyesore, a littering of the air around us. Too much exposure to messages from strangers can result in sensory overload, and then we may miss an important sign installed for our safety. Past attempts to beautify America included an emphasis on getting rid of billboards. Signs can be an indication of our addiction to consumerism, to getting "things." Many people will see little or no value in photographing signs. However signs come and go and therefore are a part of our history, a part of our lives and our culture. They inhabit our past, present, and will also be a part of our future. I'll probably keep photographing them, and adding them to this blog.
Signs or public messages in our sociey and culture are ubiquitous. They say something about the kind of people we are. The value of some signs is in the directions and instructions they provide. This would include traffic signs. Others such as billboards and realtor signs exist to generate income for someone. But what about personal, political or other messages, brief statements about what someone believes or thinks, or who they are? I'm thinking of the message on the back of the shirt of the young man on crutches that I included on this blog shortly after I started it about a year ago. The message says, "Never judge a man until you walk a mile on his crutches." It was taken in Texas' Palo Duro Canyon many year ago. When ever I see the picture I think of him and wonder what his life was/is like. The front side of his shirt had the message, "Quad Power" on it. I wonder where he is today.
I think the abundance of signs and public messages in our culture may indicate that we are optimistic, or at least hopeful. We believe that someone, perhaps many people, care enough to want to read our message, even it it's in small print on a rear bumper sticker that cannot be read by anyone in a moving vehicle without dangerous tailgating. On the other hand perhaps some people don't really care if anyone sees it or not; they just have a need to express themselves. This would include those who decorate their bedrooms with posters, etc. Of course many of these are teenagers wanting their parents, siblings, friends, and other relatives to know who they really are. Perhaps if I had done that when I was a teenager there would have been more understanding between my parents and I, since it seems as if there was not much communication.
An abundance of signs is one of the characteristics of our culture. Signs can be an eyesore, a littering of the air around us. Too much exposure to messages from strangers can result in sensory overload, and then we may miss an important sign installed for our safety. Past attempts to beautify America included an emphasis on getting rid of billboards. Signs can be an indication of our addiction to consumerism, to getting "things." Many people will see little or no value in photographing signs. However signs come and go and therefore are a part of our history, a part of our lives and our culture. They inhabit our past, present, and will also be a part of our future. I'll probably keep photographing them, and adding them to this blog.
Sunday, August 3, 2008
Saturday, August 2, 2008
Friday, August 1, 2008
"But forgiveness allows us to actually let go of the pain in the memory, and if we let go of the pain in the memory, we can have the memory but it does not control us, and I think it's the fact that when memory controls us, we are then the puppets of the past."
Alexendra Asseily (From the film "The Power of Forgiveness")
Alexendra Asseily (From the film "The Power of Forgiveness")
Thursday, July 31, 2008
Some Interesting Quotes
"Liberalism is not a fixed set of doctrines, but a temper,
a public spirit of openness and generosity."
Forrester Church
"Liberalism is trust of the people tempered by prudence;
Conservatism is distrust of the people tempered by fear."
William Gladstone
"Liberalism, above all, means emancipation--
emancipation from one's fears, his inadequancies,
from prejudice, from discrimination...from poverty."
Hubert Humphrey
"Liberals support the idea that individuals are more important
than corporations, that as long as there are welfare programs for
corporations there should be welfare programs for individuals."
Jan Carroll
"What passes for radical left-wing opinion in America today would
fit comfortably into the platform of any center-right party in Europe."
Phil Freeman
"The liberal soul shall be made fat: and he that watereth shall be
watered also himself."
Proverbs 11:25
from "The Best Liberal Quotes Ever"
Pages 129-132
a public spirit of openness and generosity."
Forrester Church
"Liberalism is trust of the people tempered by prudence;
Conservatism is distrust of the people tempered by fear."
William Gladstone
"Liberalism, above all, means emancipation--
emancipation from one's fears, his inadequancies,
from prejudice, from discrimination...from poverty."
Hubert Humphrey
"Liberals support the idea that individuals are more important
than corporations, that as long as there are welfare programs for
corporations there should be welfare programs for individuals."
Jan Carroll
"What passes for radical left-wing opinion in America today would
fit comfortably into the platform of any center-right party in Europe."
Phil Freeman
"The liberal soul shall be made fat: and he that watereth shall be
watered also himself."
Proverbs 11:25
from "The Best Liberal Quotes Ever"
Pages 129-132
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