Angels in Scrubs

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Physicians taught me how to treat diseases. Nurses taught me how to care for people.

It’s no secret that I feel more of a kinship to nurses than I ever felt to physicians. I was an orderly working eight-hour shifts with nurses long before I went to medical school. I saw what the nurses did, how hard they worked, and how the orders physicians gave, with little thought to implementation, affected them directly. They also treated me as part of a team, not as cheap labor to be abused and berated.

During my internship I quickly learned that nurses can make a physician’s life easy or a living hell. I threw myself on the mercy of the head nurse at the beginning of my ICU rotation and she guided me, suggesting drug dosages, ventilator settings and letting me know when to call for help.

Obstetric nurses taught me about the natural progression of labor: when a woman entered active labor, when she was in transition, when to intervene, and when to leave well enough alone. (Thanks, Marj B!). One threatened to teach me about labor: “We’ll shove a bowling ball up your butt and then tell you not to push.”

Clinic nurses taught me to treat Medicaid patients with kindness, respect and a little tough love. They also taught me I could not solve everyone’s problems.

Once in practice I realized I couldn’t do my job without nurses. They spent an eight or twelve hour shift with a labor patient while I was in the office or tending to someone else. Sometimes they would stay past shift change if the woman was close to delivery. They started IVs, ran Pitocin, magnesium sulfate, antibiotics, and blood. They comforted a woman while she got a spinal or an epidural anesthetic. And they were the first to resuscitate a baby in trouble.

Nurses watched over my patients after surgery, while they recovered from serious illnesses, and while they slept. One seasoned med/surg nurse told me what drug to order for a little old lady whose daily cocktail was a lot more than “mostly ice;” she went into “D.T.s (acute alcohol withdrawal, the night after her surgery.

Nurses are not afraid of anyone, including physicians, who sometimes do really stupid things. Chocolate and contrition goes a long way towards appeasing them. Not pissing them off in the first place goes even further.

Physicians live by “every man for himself,” with, until fairly recently, an emphasis on “man.” Nurses support each other, and physicians who stand up for them. They don’t have massive egos (for the most part); they just have to deal with those egos every day.

Nurses will cry with you after you’ve delivered a dead baby, or when someone with a terminal illness finally loses the battle. They’re eternally grateful when you have the foresight to buy everyone lunch because the day is going to hell and they will never make it to the cafeteria.

So Happy Nurses’ Week to all the nurses of various species I’ve known: registered nurses, licensed practical nurses, advanced practice nurses, nurse practitioners, certified registered nurse anesthetists, and my favorite, certified nurse midwives and L&D nurses.

 

The Thunderbird

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The 1950s and 1960s were the heydays of America’s love affair with the open road. Gasoline was cheap–20¢ to 30¢ a gallon—and flying was expensive, so during summer vacations many families hit the road in search of adventure or just a break from tedium. They would need a place to stay if they weren’t camping or dragging a trailer, which opened up an opportunity for roadside sleeping accommodations.

There were a few major hotel chains: Holiday Inn with their enormous green, yellow and orange signs; Howard Johnson’s, which added lodging to many of their numerous restaurants in the 1950s, and the Phoenix, Arizona-based Ramada Inn, which opened its first motel in Flagstaff. But many vacationers stayed in small mom-and-pop establishments along highways and near small towns. They were initially known as “motor lodges,” “motor inns,” “motor courts,” or “motor hotels,” which was eventually shortened to “Mo-Tel.” Out West they had romantic-sounding regional names like Aztec, Apache, Desert-Aire, El Sol, Ghost Ranch, Monterey Court, Sun God and Thunderbird. One could park right outside the room and haul everything inside without having to climb stairs or wait for an elevator. They were relatively Spartan compared to now but it was adequate and exciting.

We never took extended family vacations when I was growing up because we didn’t have much money. I lived in Arizona; I finally saw the Grand Canyon 30 years after I’d left the state. And going to Disneyland was completely out of the question. I didn’t miss anything, though. I made it to Disneyland in 1989 during a business trip and was surprised at how small it really was compared to Disney World.

Sometimes, instead of trekking back to Bisbee after visiting friends, we’d stay overnight, or a couple of days, at the Thunderbird Motel in Tucson, on a strip of four-lane highway known as “The Miracle Mile.” We usually got Room 25, one of the few with two double beds. It had real air-conditioning unlike the ubiquitous evaporative “swamp coolers” found in most desert homes. The beds were made with white linens stretched so tight and smooth you could bounce a quarter off them. I’d never used a shower before staying there. And I remember that crisp, clean smell that welcomed us when we walked in, untainted by cooking, wet animals or old beer farts.

The swimming pool was the best part: bow-tie shaped; going from two feet at one end and eight feet at the other end where the diving board sat, and surrounded by tasteful desert foliage. I’d change into my bathing suit as fast as I could and run out the sliding glass door. I can still remember jumping feet first into the water and the abrupt change in sound from outside noise to that other-worldly SCHWOOOOOP as the water closed in around my ears. There was an underwater light at the shallow end; I’d swim up to it, sometimes with my eyes closed because it was so bright.

I don’t ever recall my mother or step-father sitting poolside to make sure I didn’t drown. Maybe they watched from the room or listened for a distress call. Maybe they trusted me not to do anything stupid. Or maybe they just weren’t as paranoid as parents have become.

The Interstate Highway System marked the beginning of the end for the roadside motel. I-10 bypassed the Miracle Mile and by the mid-1970s it had become a haven for prostitutes, drug dealers and gangs. Many of the landmarks were demolished and in 1987 the Miracle Mile returned to its old name, Oracle Road. The golden era had come to an end.

Time heals some wounds. The Thunderbird has found new life as a men’s residential recovery center for Teen Challenge Arizona, an honorable use of an old building. The nearby Monterey Court now houses galleries, specialty shops, a café and an outdoor venue for live performances. The Ghost Ranch Lodge is on the National Register of Historic Places and was converted to senior housing.

I spend a lot of time in hotels, but none of them compare to the thrill I got staying at the Thunderbird. T

Bright Lights, Small City

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I spent most of my childhood in Bisbee, Arizona, a small mining town tucked into the Mule Mountains 90 miles southeast of Tucson. Many people made a decent living working in the mines; some, like my father, lost their lives there. The mines closed in the mid-1970s and the miners have been replaced by hippie artist types. One can get a bumper sticker: “Bisbee, AZ. It’s Like Mayberry on Acid.”

Living in Bisbee wasn’t bad at all. We had a Safeway grocery store, a movie theater and a Dairy Queen—all hallmarks of civilization. But every so often we’d trek two hours north and west to “the big city” of Tucson to buy groceries a little cheaper or to shop for stuff at Sears. Highway 80 took us out of town, through Tombstone, St. David and Benson until it dead-ended at Interstate 10. From there we drove the modern, four-lane into Tucson.

Sometimes we’d spend the day with one of two families we knew. Barbara and Art lived in South Tucson. There was a sign propped up against the wall in Art’s garage—a cartoon worm with a bow tie, top hat and a big smile saying, “Howdy, Folks!” My sister and I would play with their three daughters, Troy, Debbie and Laura, while the adults did whatever adults do when kids aren’t bugging the crap out them. One evening, when we were getting ready to leave, I put my fingers in the wrong place and the back door closed around them. It hurt like hell and prompted a trip to Tucson Medical Center’s ER, where an x-ray showed nothing broken.

Woody and Dolores lived farther east, near the intersection of East 22nd and Wilmot Road, where the Oxford Plaza was built in 1960, making it the second largest shopping center in Tucson. The backyards of all the houses were enclosed in 6ft cinder-block walls that opened to an alley running by a drainage ditch, known as a “wash.” Pantano Wash, a couple of miles away, is a much larger canal, usually dry as a bone until monsoon season, when sudden thunderstorms beget raging torrents carrying all sorts of debris and the occasional car driven by some dumb-ass who didn’t think the water was that deep or powerful.

Their older son, Jim was in high school and starting to become rebellious. He had a poster of Frank Zappa sitting on a toilet on the wall of his bedroom, the infamous Phi Zappa Krappa. Richard was closer in age to me, so we hung out together, playing in the back yard or prowling the neighborhood. My sister usually wasn’t included but I’m sure she was around since my mother would not have left her home alone.

Arizona doesn’t observe Daylight Savings Time, so even in the summer it’s dark by about 7:00-7:30pm. When it was time to leave we’d pile into the back seat of our Chevy for the long trip home. I’d usually look out the window until we turned off the Interstate at Benson. There was a long house outside of town that, when the lights shone through the full-length windows looked a lot like the Wright brothers’ first airplane.

There was a lot of nothing along desert highways back then and even less traffic. Sierra Vista was a small speck of light 35 miles away—not the massive beacon it has become. I’d lay down on the back seat and listen to the soft rumble of tires on the road, interrupted only by the headlight dimmer, a small cylindrical switch in the floor near the driver’s left foot. Ka-Click. The lights would dim for an approaching car. Ka-Click. The high-beams came back on as the other car passed by. Punctuation in the ongoing conversation between the car and the asphalt that continued until we were back home.

Growing Old: A Warning

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You’re young and you pray to God it will never happen to you. Like Pete Townsend, you think “hope I die before I get old.” Well, it’s not likely, but it isn’t all that bad. How you look at things changes as you get older.

  • You can blame being a cranky son-of-a-bitch on getting old when, really, you’ve always been a cranky son-of-a-bitch.
  • You lose all your filters and just don’t give a shit what anyone thinks. Except for your wife. You will always care about what she thinks because she is far more likely than your offspring to pick your nursing home. Be careful before you bite that hand.
  • You will finally understand that age and treachery will always overcome youth and skill and you won’t hesitate to use the latter, judiciously, of course.
  • That waitress may have bodacious ta-tas and a fine ass that make your loins stir, but she’s got Jell-O between her ears and your loins will soon be napping. Yes, she can ride you all night, but will she ride in the ambulance with you when you have a heart attack? Or will she be willing to wipe your ass when you are too old and feeble to do it yourself. The woman you’ve been married to for fifty years will do it without thinking.
  • Good sex is based on quality, not quantity, but a good night’s sleep trumps any sex every time.
  • You turned into your father when you asked your kids, “What is that crap you’re listening to?” But the music your kids and grandkids listen to really is. Whining coffee house singers pale next to Jagger, Plant, Daltry and Bowie. Aretha Franklin, Gladys Knight, Diana Ross and Grace Slick would eat alive those breathy waifs who sing as if they have chronic lung disease. So would Frank, Dino, Tony, Mel, Nat, Bobby, Sarah, Carmen, Ella and a whole bunch of guys and gals you thought you were too cool for when you were a teenager.
  • You suffer from CRS (Can’t Remember Shit) Syndrome because your brain is a sink with a broken garbage disposal. It’s filled with mostly useless crap that crowds out important stuff like: Why did I come into this room? Where’s my cell phone? Occasionally, flipping the switch stirs the garbage long enough for answers to filters through.
  • You will tell younger people stories they’ve heard several times before, even though you swore you would never do that when you got old.
  • You proudly tell everyone about your colonoscopy and think anyone who’s afraid to get one is a pussy. You really liked your colonoscopy, mostly because they gave you really great drugs and you can’t remember any of it. Kinda like living through the late ‘60s.
  • Everything has been aching for so long that you don’t notice anymore. You have little patience for people under 40 whining about a cold or a stubbed toe and growl, “Suck it up!”
  • You will look back on your youth with amazement and shame, pondering how stupid you were to think you knew everything. You’ll have far more questions than answers and discover the answers are far more elusive.

When you’re young you think you have all the time in the world. Make the most of it because the ticking gets faster and louder. You hit 35; you’ve got a mortgage, a family, and a mountain of debt. Then you blink a couple of times and find yourself on the downside of fifty, sitting on the couch watching TV, wondering what the hell happened to the last 20 years, and thinking, “Golden years,” my ass!

Less is More …More or Less

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NOTE: I left my writers group over creative differences. They demanded “more emotion” in my writing, but when I gave them the following, they didn’t like it. Be careful what you wish for.

In 1992 John Grey told us “Men are from Mars, Women are from Venus.” This revelation did not surprise any man— most of them didn’t read the book in the first place—but it was a shock to most women. Yes, men and women are different but despite the latter’s fervent wishes to the contrary, we men are fairly simple creatures who don’t require endless analysis to understand.

Men learn quickly that women are mysterious, complex creatures but not much else. We know they have boobs. We know they possess that Holy Grail “down there,” our bumbling quest for which is eternal. And we know that saying the wrong thing however innocent will get us into a shitload of trouble. We also like to piss them off sometimes by doing something they expressly told us NOT to do, because it’s fun in an adolescent way. But we’ve reconciled never understanding the female psyche and moved on.

Women find men to be exasperating, lacking in self-awareness, and devoid of that most-coveted but rare attribute, “emotion.” That’s not entirely true. We understand and express a few emotions—anger, humor, sarcasm, lust, and the overwhelming joy that comes from vicariously crushing your buddy’s dreams in sudden-death overtime.

We bury our feelings in alcohol, drugs, work and manly pursuits like football, hunting and Call of Duty until ulcers or a heart attack grant us a reprieve from our stoicism. We don’t run naked through the forest howling at the moon, join drum circles, or pour our hearts out in embarrassing songs like “Sometimes When We Touch,” the sound of which still makes me cringe.

Men don’t want to get in touch with their inner child; we’d rather have had the opportunity to yank the little bastard out to warn him about the shit he’s gonna face in life. We do not want to wallow in, nor publicly express, the soul-searing pain most of us have experienced during our lives, having learned a long time ago that doing so invites the rebuke, “That sounds like a personal problem to me.” Or, as a woman I knew in college told me, “Nobody likes a downer,” a gut punch that said in no uncertain terms, “You’re on your own.”

In the 1980s, women said they wanted men to be like Alan Alda, comfortable with emotional intimacy. Not true! Women really wanted men who acknowledged women’s emotions, not men with their own matching set of emotional luggage. “How can you take care of me when you are sad/depressed/angry/scared/hopeless?” So, in order to successfully navigate the minefields of personal relationships, our innermost feelings stayed buried, taken out occasionally in front of a therapist for a hundred bucks an hour, or with a bartender for far less.

I spent the first forty-some years of my life wearing my emotions like a badge of desperation, an emotional train wreck. I look back on those times with a great deal of shame and humiliation. I may not live there anymore, but I remember the address. And the phone number.

All that changed when the pain of my affliction outweighed the stigma of acknowledging it and I sought absolution through Prozac, leveling out the highs and lows. I abandoned New Age music’s comforting vulnerability for jazz’s impenetrable complexity. I bade farewell to Bogie and Bergman, embracing the likes of Stallone and Stone. Disengaging from my emotional side made coping easier. I saved my soul but lost a part of me, for better or worse.

Writing may be therapeutic for many—in the past it has helped me—but I’ve achieved a balance I’m reluctant to disturb. I am neither Henry David Thoreau nor Nicholas Sparks. I do not want to “lead (a life) of quiet desperation and go to the grave with the song still in (me).” I don’t want to resurrect demons previously banished or go back to the edge of the abyss. Mostly I don’t want the existential vulnerability of my previous life. I’ll walk down old paths carefully, breaching some walls while leaving others undisturbed, but in my own good time.

Yes, men and women are different. We have feelings but we’d rather die than admit it, so please stop asking us. Our inner child will thank you.