Who will care for the caregivers?

It's been a week.  A week since our collective souls were shattered.  Seven days, almost to the minute.  None of us will ever be the same.  Children.  Teachers.  Educators.  Lost forever.  My heart still breaks.

Since then, our country has been debating.  Arguing gun control.  Should guns be allowed?  What purpose does an assault rifle serve in the average suburban home?  Is the second amendment still relevant?  We've also been talking about mental health.  Do we do enough for those among us with mental illness?  How can we prevent another atrocity from occurring?

All of those questions are good.  I enjoy the conversation.  But what I want to bring up is the health of those that responded that day.  The police officers.  The firefighters.  The paramedics.  They saw death and devastation that day that no one should ever have to see.

Yes, it's what they do.  "They're trained for it," you say.  But no amount of training could ever prepare someone to see twenty children whose lives have been snuffed.  To see the bodies of the educators who gave their lives to save the children entrusted to their care.  I'm sure they did a critical incident debriefing.  But here's the problem.  It's not enough.

First responders are, by definition, the ones who are on the front lines.  On a daily basis, they're out there, seeing blood and guts, literally, observing human drama at its most raw.  And they're expected to.  No one questions whether or not they're capable.  Sure, they're trained.  But how do you train the emotions not to respond?  No amount of training can stop the nightmares.  The panic attacks.  The memories.

One physician lost fourteen patients that day.  He is devastated, wondering how he's going to comfort the families left behind without losing his composure.  Doctors all over the world are offering advice.  Some say "Stay strong."  Others say "Cry with them."  It underscores the fact that first responders and physicians aren't immune to the questions that arise from incidents like Newtown.  They're not always sure how to react.  They act on instinct, on training, at the scene.  But what about when they go home to their own families?  They're strong when they pull the bodies from the wreckage, but that strength all to often fades into silent, hidden tears.

I have gone to visitations, to funerals, of the patients whose lives I've briefly touched.  I've cried when I've learned that the baby I pulled back from the brink has passed on.  I've spent sleepless nights, wondering what else I could have done.

I know I'm not alone.

When you think of, pray for, those whose lives were taken, remember those that tried to save them.  If you see a police officer, a firefighter, a nurse, or a paramedic, thank them for their service.  It may not be much, but every little bit helps.

Goodbye, Bianca

Last week was a rough one.  We had to put our 16-year-old cat, Bianca, to sleep.  She pre-dated my husband, my profession, and my writing life.  Needless to say, I felt very close to her.  Only problem?  She wasn’t very close to me.  She was a hisser, a scratcher, and an occasional biter.  I still loved her, but when the time came to euthanize her, I doubted myself and wondered if I was doing it for convenience.

I know it wasn’t about convenience.  She couldn’t jump, couldn’t climb, and was drinking water out of the shower because she was too weak to hold her head up over the edge of the water bowl.  She was too tired to hiss when the kids picked her up, too weak to protest when placed in someone’s lap.  If I didn’t know my cat, I’d say she had become a lap cat in her old age.  But when she yowled at night, in pain, I knew the time had arrived.

            The girls took it hard.  I did, too.  Even the husband shed a tear.  (Don’t tell him I told you.)  I worked that weekend, and several co-workers asked how I was holding up.  The conversation, being held in an ER, soon turned to humans, and how some people wished euthanasia would be made legal for their human loved ones.

            Person after person told of a family member with terminal lung cancer.  With Alzheimer’s so severe that the person didn’t remember to eat and needed a feeding tube.  With congestive heart failure requiring oxygen and intravenous medications just to keep the person from drowning in his own fluids.  Some wished that they could help them on the final journey.  Others felt it was morally wrong.  Conversation became heated.

            Medicine in America is different than medicine in other countries.  Death is seen as a disease, a condition to be avoided, a failure.  In other places, death is part of life.  It’s not something to be feared.  Doctors aren’t sued when it occurs.  Money is spent to make sure death is honorable, honest, and free from pain.

            When I took the Hippocratic Oath, I swore to First Do No Harm.  While I don’t think euthanasia is the right answer, I do think we need to spend more time making death something that is free from pain.  Something that is part of the journey, not an end to be feared.  Palliative Care is such an important field that does good work.  I just wish we used it more.

            When my own father passed, some in my family criticized that we didn’t send him to the hospital.  It’s true.  We didn’t.  We didn’t put him on antibiotics.  We didn’t put him on intravenous fluids.  Instead, we gathered around his bedside, lit a candle, and reminisced about the man who was leaving us.  He wouldn’t have wanted it any other way.

I've been a baaaaad, baaaad blogger

...And boy, do I feel sheepish.  (Sorry, recent pun wars with my brother-in-law have left me making puns where no puns should dare to tread.)

My crazy year, you ask?  It just keeps getting crazier.  The new job I took this summer?  Quit.  The old job I quit?  Back in.  I'm staying home during the week with the kids, working in the ER on weekends, and writing like a fiend.  And I'm loving every minute of it.

I just finished NaNoWriMo as a winner.  I wrote 50,596 words in thirty days.  Crazy, but true.  I have no idea if they make sense or not, but I like where the story is going, and I can't wait to finish it (which will probably take me another 20,000 words).  Then I'll dive in, edit the heck out of it, and start submitting.  Unless, of course, I've got an agent by then.  Here's hoping.

My question on my last blog post went unanswered by myself for months.  Sorry about that.  But it's kind of a moot point right now, since the words are flowing out my fingertips.  And I'm loving that, too.  It feels good.  Sometimes I have a tough time forcing myself to write, but NaNoWriMo showed me that I can do it.  I wrote every day except one (sick kid kept me from getting to the computer-- really didn't want to get vomit on my keyboard), and there were days I didn't feel like writing, but I did it anyway.  I'm finding that this writing thing is really important to me.  I hope someday to say I'm a published author.  But even if I'm not published, I can truly say I enjoy the journey.

After months of writing, form rejections, and dashed hopes, it's a powerful thing to believe that writing just to write is OK, too.  Crazy, no?

Writing: easy peasy or blood, sweat and tears?

Talk about a wild year thus far.  My old job went belly-up, I had to find a new job (which has yet to start), and I've been writing two works in progress. *Whew* I've come up with some great ideas for a couple of novels, and slowly but surely I'm pecking away at them. These aren't coming out as easily as CODE did, and I'm not sure why.

What about you, dedicated writer? Do you find that the words just flow from your fingertips? Or is it a struggle to get those sentences out on the page? Are some works easier than others? Why do you think that is?

I'll share my thoughts in a day or two. Until then, let me know what you think.

A public service announcement

Well, it's that time of year again. RSV is here. Influenza is here. And in a cruel trick of microbiologic proportions, there's a gastrointestinal bug here that is absolutely vicious. At one point yesterday, 7 of my eight patients were puking. It wasn't pretty. And one patient needed three bags of IV fluids, just to be hydrated enough to pee. THREE. That's dehydrated, folks.

So here's a friendly reminder to wash your hands. Wash them every time you think about it. Carry hand sanitizer with you. Use it. And make sure to moisturize your hands, too. You don't want bugs crawling into the cracks that inevitably form when you wash your hands within an inch of their lives.

Here's to a healthy and happy 2012!