Where Artists Go in Old Age

Mr. Fuzzy Beard was picked up by the police for public masturbation.  Given the choice between jail and the hospital for psychiatric evaluation, Mr. FB chose the latter and sat comfortably, staring at everyone and everything with large, disconcerting eyes.  During the course of his stay, he received a sandwich and was very much pleased with it, temporarily distracted... until he saw me walk by.

"Hey, hey, are you *ethnicity 1 or *ethnicity2?"
"*Ethnicity 1, how did you know?"
"My wife, she's a painter, you know. She teaches painting to two little girls who look just like you."
Because all of us look the same, I know. "Oh, acrylic or oil?"
"Oil. You know, I'm an artist too.  Give me paper and a pencil. I'll draw a portrait of you."
"Really?
"Yeah, you'll have to give me $10 for it, though." I humored him and brought him a clipboard, a few sheets of paper and a pencil.
"Mr. FB, it looks like you're still eating."
"Yeah, I guess I am. You can draw a picture of me until I'm done. I bet you're better at it than I am."
"Why do you say that?"
"I can just tell that about you."

I smiled and asked his sitter if she minded me sticking around. "Nah, anything to keep him happy and quiet."
So I made a rough sketch of him.  It was a good likeness- if you can imagine a Harry Potter-world "mad wizard", Mr. FB would be it.  He had long hair around his balding pate and a full beard. His fingernails were dirty and he had a necklace of beads made from rolling up pieces of magazine.  His features were fine, however, and in some alternate universe would have looked scholarly provided his twitch tic and crazy eyes didn't betray him.

"Well, well, let me see it! You're taking an awfully long time, aren't you?"
"Good art takes time."
"What, you think Picasso more than a few minutes?"
"Absolutely sir, here, what do you think?"
"Ahh, that's wonderful.  See, I would give you $10 for this. Don't I look like a professor?" He smiled beatifically.

I should have included the dab of mayonnaise left on his beard, but otherwise, the likeness was real. I would take a picture of my drawing and show you, but wouldn't that be a HIPAA violation?

Later, he drew a picture of his sitter. From his picture, one can clearly see that he has been majorly influenced by Picasso. His sitter was less than pleased.

S

Hurricane Aftermath

Walking through the "hurricane" just two blocks to the hospital was an odd experience yesterday. The day was beginning to brighten through the clouds and wind whipped around me gently. Leaves and branches were scattered about the street and the first cars were beginning to make an appearance on the roads. In front of the hospital, a battered little tree had split in half, but it was removed by the end of my shift.

It was oddly quiet, strangely silent. I normally associate the area in front of the hospital with lots of activity- from the researchers, physicians, students gathered around the little tables and benches, the food carts and their billowing fragrant smoke clouds, to the constant battle between pedestrian and motor vehicle in the crosswalk. All of that was gone. I was the sole, silent figure walking on the rustling, deserted street.

The normally busy employee entrance was closed and I made my way through the main entrance guarded by one lone security guard. Inside the hospital, life was also suspended. Valhalla, or the "section above", was unfortunately still being used to quarter my night-shift co-workers who had to work again the following night, so I was assigned elsewhere. In my new section, I arrived to see we had 6 providers/doctors for only 6 patients! Where normally our census boasted at least 80-90 patients at any given time in the ER, we had less than thirty in house, some of which were already discharged to go home. With each new EMS arrival, we would ask- how is it outside? Not bad, they would reply- the sun is coming out.

Sure enough, our patients started arriving. After staying 24 hours indoors, they flooded our gates, eager, angry, anxious. My first patient that came in during this rush was a young man and his hood rat friend, who sassed us from the moment she walked in. She would not elucidate her relation with him, whether familial, fraternal, or professional, but proceeded to try to speak for him, demanding amenities such as blankets, pillows, and food. He apparently arrived because he 'asked someone for a cigarette and when he smoked it, felt high." Good riddance when we kicked both of them out after determining no foul play.

We had, oddly enough, several very amply padded patients come in by ambulance. Their chief complaints were: firstly because they had lost power, secondly because they were alone and scared and thirdly because they wanted us to refill their at-home oxygen tanks. It took a lot of staff-power to move and shift them about, as they barely fit into our 700lb capacity bariatric stretchers. After whatever action we had to perform, whether it was holding legs open for a foley catheter for a UTI or moving them up from sliding too much in the stretcher or even just moving them to our stretcher, four of us would be breathless and incredulous. I will refrain from repeating some of the names I heard referring to these poor immobile folks. But wow, what are the chances we would get three of them within the same hour?

I had a very sweet old lady who then came in, for bleeding gums. If I should live to be 95 and my only problems were bleeding gums from a tooth extraction and deafness in one ear, I should be a very happy little old lady, grinning every day ear to ear with the bloody gauze in my mouth. My sweet LOL was totally with it and even chastised the nurse for pulling her clothes off unnecessarily- it's just a tooth, for goodness sake! She reprimanded. As I was helping her get up and dressed, she commented to me, it's so much harder to manage the motions of dressing with somebody else, isn't it? I gently squeezed her foot into her brown loafers and pulled her pants up for her and thought about what she said. How many babies, children, invalids, and elderly people must have passed through her life that she must have cared for. I pushed her in her wheelchair to the waiting room to await her daughter's car so she wouldn't have to sit in the draft.

More and more patients started coming in- and our tube system was down, again. I made 4 courier trips to the blood lab... on my return, the team leader nurse pulled me aside apologetically and said, "I'm sorry S, you have to sit." Soon, I had the prattling pretender (again) on my hands and passed the evening in more or less of a stupor, listening to him gab.

What a night! Our manager was wonderful through it all and had stayed the overnight shift, didn't sleep, then continued to work until the end of my shift. He ordered pizza and soda (white birch beer is delicious with pizza!) for us as a morale booster for coming in during the hurricane. Free food is the best morale booster there could be. <3 Our hero!

S

Wormy or Crazy?

Through the 8 hours I spent with her, Ms. Wormy was a hot mess.

She had fallen after fainting and couldn't bear any light to touch her eyes. I put a rolled towel over her eyes, much to her relief, and began taking her clothing off to put her on the monitor. My gloved hands were orange after touching her. I realized with a jolt that it was her heavy dose of spray-tan.

She recounted the story of how she fell, then calmly interjected "I know it sounds crazy, but I have worms under my skin." She showed us the pockmarks from where they 'broke out of her skin'. They came out in a ball from her reproductive tract, and when she stuck a (gloved, she added) finger up her anus, she found them there too.

She told us about how she would cover her legs with paper towels at night, then find puncture marks in her skin where the worms would break out during the night. They looked like fingernail picking pockmarks, but I just watched the spectacle of her trying to convince the doctors about her worm problem.

In order to get urine, we had to walk her to the bathroom so she could use a straight stick catheter- apparently, this is how she always urinated.

A nurse commented that Ms. Wormy was the kind of crazy that should be locked behind padded walls. I wasn't sure- but I sure wanted to see the worms she was talking about!

Ms. Wormy wore dentures at an age most women still can have children. She was a near impossible stick, but I got her labs using our smallest gauge needle. She showed us her ileostomy, pulling it tight so we could see all the fibrous material floating about. They were worms, she insisted, I pass thousands of them a day. She pulled my hand to feel the coarse roughness under her skin where "worms were nesting."

How did such a young woman end up with so many problems? I didn't know, but I kept stopping by her room to listen to her terror about the worms infesting her body.

When I left 8 hours later, nobody had lifted a finger to examine her for these worms she kept talking about coming out of her nether regions. Was I the only one who fell for some sort of joke? She seemed too genuinely scared to be making it all up...

Nevertheless, I took an extra hot shower when I got home. All her talk of worms made me scrub harder than usual... you know, in case the crazy was catching.

S

Edit: Later, I looked up some symptoms. She might be a meth addict- it would explain the anxiety, itching under the skin, and dentures... but I don't know. So strange.

Dalliances with Drunks

Mr. Slick began his ER hallway drunk-tank adventure as an explorer. He sailed through the halls, through uncharted wildernesses of unused stretchers and linen closets, stopping man and beast alike to chat and build local street cred. He sensed the triage nurses were inattentive and slow and he knew the system like the back of his hand. Eventually, he was caught by the native security guards and escorted back to his bed without being tied down. He tried to talk me out of his involuntary stay on his stretcher, but it was to no avail. Grumbling, he covered himself with a sheet and passed out for a few hours. His BAC was .380.

Mr. Scumbag then wheeled in with a BAC of .327. He refused to admit he drank anything and proceeded to ask directly for a sandwich as soon as he was settled on the stretcher. He also needed a glass of water and needed to go to the bathroom, too. Despite these needs, the floor was "too dirty to walk on" for him. Eventually someone fetched him a sandwich. He didn't eat a bite before he asked me to throw it out, "not to be a scumbag or anything." Winking at me, he kept making a come-hither sign, saying "hey, hey, pssst, come'ere." The first time, I did go near him and all he said was, "you're gorgeous." Uh, thanks. "Wait, come back, come'ere." He looked conspiratorial- "whatever you have to say to me, you can just say it out loud." "Tsk... no, really, come here, it's important." "You know you're into me." Half an hour later, he gave up, "you don't want to talk to me because you know I'm a scumbag." I did take him to the bathroom and suddenly, he put me in a bear-hug. Feeling his arm around my throat was not a good feeling, so I called security and he tried to laugh it off. He was escorted back to his stretcher and warned. He soon became bored and woke up Mr. Slick.

They became great buddies, feeding off each other. Mr. Slick knew our system well from coming in all the time and taught Mr. Scumbag what "AMA" means- against medical advice. This prompted a chorus of "I want to sign out AMA! I want to sign out AMA!" Of course, as I explained calmly, this was impossible considering they were intoxicated and therefore incompetent to make that decision. Then, Mr. Slick pulled out a cellphone, which was not allowed. I told the nurse, who totally undermined me by saying "I don't care if they have it if it makes them calmer." Way to go for standing up for your co-workers and workplace morale. Mr. Scumbag snatched the cell phone and tried to use it, too, to no avail. Our radiology department was next door and the leaded walls blocked out signal. Mr. Scumbag declared my explanation as "a crock of ****", and Mr. Slick became convinced the hospital was full of voodoo that blocked cellphone signals instead. "Hey, I'll give you $100 if you go get Burger King for me," Mr. Slick offered me. I laughed at him and turned to help the nurse with Mr. Scumbag.

A nurse tried to take vital signs on Mr. Scumbag. The cuff kept popping off. His arms weren't that big and I watched him to see why- he was flexing as the meter read and being a general d-bag. He started bragging "You can't take my blood pressure because they're DIESEL," posing for all to see. The nurse gave up. Soon, Mr. Scumbag realized nobody was watching him flex and he got bored, declaring "I just wanna go home and get laid."

Mr. Slick shook his head, deciding he did not like his new friend. That was when Mr. Slick's neighbor, Mr. Goldfish, wheeled in. Mr. Goldfish was looking for his phone, which was in his pocket the whole time. Security took it out and put it in the bag under his stretcher because he was not allowed a phone. He had some sort of short-term memory loss- he didn't remember anything that happened about 10 seconds before. So he kept asking for his phone. Pleading for it. Pleading for us to find it. So he could call our hospital. He did not stop and mournfully wailed for it, even crying large tears out of both eyes. Why are you crying, Mr. Goldfish? My mother died! he wailed. He continued crying inconsolably. He refused to breathalyze for about half an hour despite our most insistent nurse drilling at him. Finally, I asked him- when did your mother die? 20 years ago. Geez, the way he was crying, one would have thought it was yesterday. Soon, Mr. Goldfish was put in 2-point restraints because he kept flailing and refusing to sit back. When he was taken out of restraints, based on a verbal agreement that he'd behave, 30 seconds later, he had to be put back in. He didn't register there ever was any sort of agreement. Completely incapable of normal cognition, my hours with him wailing and asking for his phone really grated on my nerves.

"This is a sobering experience," observed Mr. Slick. "I wanna go get laid," interjected Mr. Scumbag. "WHERE IS MY PHONE? CAN I HAVE MY PHONE?" asked Mr. Goldfish.

8 Hours later, the noise level was still the same and I was beat. Drunk tank tech is done for the day. Time to go for a long run.

S

There's a Little OCD in All of Us

"Um... Um, nurse... I think I'm going to try again."

Mr. Antsy Pantsy looked so forlorn, disheveled, with worry etched in every line of his face.

"S, are you busy? Can you walk this gentleman to the bathroom?" the nurse asked.

"Sure, why couldn't he go before, just so I know?" I asked, looking over at the twitchy man.

Mr. Pantsy: "Um, excuse me. Did you want me to go in the cup? Because I just... can't. I can't. I can't. It's hard. I think the bottom of the cup touched the sink... do you think that makes a difference? It got dirty! It's too small. I just can't. Just can't."

S.(to the nurse, a knowing look): "Well, sir, how about this urinal? Do you think it would work better?"

Mr. Pantsy: "Well, I don't know. I don't think I can go. It is too much pressure."

S: "No pressure at all, sir, if you'll just walk with me..."

Mr. Pantsy: "I can't. I can't. You know, I don't think I can do this..." Nurse gives me an exasperated look. I try again, by walking forward. Mr. Pantsy follows reluctantly.

Mr. Pantsy: "I feel dizzy."

"Do you want me to hold your hand?" I grasped his cold little hand. He was shaking. "Your fingers are cold!"

Mr. Pantsy: "They're always cold. I don't know if I want to go back to the home."

S: "Why not?"

Mr. Pantsy: "Last night, the temperature wasn't set right. It was too hot. I kept thinking about it all night. I couldn't sleep much. I mean I did, but it wasn't good. I want my temperature to be lower. Oh God, I can't do this."

S: "Ok, sir, this is the bathroom, the urinal is right here."

Mr. Pantsy: "Can you put that right there? No, just there. Ok. I really can't do this. This is so stressful. I can't, I just can't."

S: "Please try, Mr. Pantsy, it would be really great if we could get a sample for the lab."

Another tech walks by, shuts the door, yells through it, "Just do it!", then says to me "I've had him before. He's always like this. In a few minutes, you'll hear a knock on the door and he'll say he can't do it. He can't help it, and it's sad, but it's a pain in the neck to deal with."

After standing outside the door for about 15 minutes, I got worried and knocked on the door. Are you ok in there??

"Yes, almost done. Can you come in?"

"Sure"

Mr. Pantsy was standing by the sink, staring at it.

"Mr. Pantsy, what's wrong?"

"I don't like water that's too hot or cold. My hands are always cold."
I turned on the tap and felt the water. It was cool. "What do you think, Mr. Pantsy?"

"It's cold! I want it lukewarm."

I turned the tap a little warmer. "How's that?"

"A little colder."

Third time was the charm. He began washing his hands. Looking fretfully at the soap dispenser, he gingerly pushed the button and a small dollop of soap went into his hand. He examined it closely and held it up to me, "is this enough?"

"I think it's just right, Mr. Pantsy"

"No, it is too much! Too much!" He began scrubbing his hands over and over. "I can't get it off!"

(about four minutes later, still watching him scrub) "I think you've washed all of it off."

"No, no! I haven't. It's still on my hands!"

"Sometimes, when your hands are clean, they feel slippery in the water..."

Finally, he turned the tap off and stared at the paper towel dispenser. "I don't want to touch it."

I moved the lever so he could take a towel and he ripped it out in a very ritualized way. "Did I do it right?? I have OCD, you know. By the way, I need two more towels." I obliged and pulled the lever again, twice.

"You did it just fine, Mr. Pantsy. Let's go and I will send this sample out to the lab."

"Wait," he looked down at his pants where some water had splashed, "I got soap on my pants!! Oh noooo."

"I think that's just water, Mr. Pantsy."
"No, I think it's soap! What do I do now? Oh God, I need to take them off and scrub them."

"That's really just water, Mr. Pantsy, I watched you splash it there."

"How could it be water? It's soap! I need to wash it off!"
"Mr. Pantsy, really, it's going to be ok. The water will dry and you won't see it."

He considered this and walked toward me, beckoning him out of the bathroom.

"Wait. I don't think my hands are clean. I'm going to wash them again."

And he rushed back to the sink and we repeated the ritual. He tried to wash his hands a third time, but he very reluctantly let me talk him out of it. I would have indulged him, judging how upset he got, but I had other patients to see!

Mr. Pantsy managed to get a sandwich and a ginger ale during the course of the night. The sitter who was watching him needed to go on a dinner break, so I sat with Mr. Pantsy for almost an hour. During the course of eating, he rubbed the bottom of the can of ginger ale. "I have to check for spikes every time I drink it," he explained. When he set his ginger ale down, three drops sprayed on him. It was barely noticeable to us, but a horrifying experience for him.

"I need a towel right now."

"For those three drops, Mr. Pantsy?"

"I need a wet towel! I need to clean this off!"

"Mr. Pantsy, I'm sitting with 3 people, I can't leave this area."

Another tech walked by at this moment and wet a towel for him.

"It's warm!!!" wailed Mr. Pantsy, startling the other tech, who mumbled something about ungratefulness and did not come back. "Can you get me a towel with cold water?? I can't use this. Take it away from me."

"Sorry, Mr. Pantsy, I really can't leave this area..." I said. "Maybe if you waited a few minutes, the towel will get cold..."

Mr. Pantsy looked crestfallen. He placed the towel gingerly next to him and burst into loud sobs.

"Mr. Pantsy, don't cry... Look, the doctor is coming to talk to you."

Mr. Pantsy was becoming increasingly agitated and began to pace around the hospital floor, ignoring any entreaties to sit down unless it was a specific, barked order with a sharp tone. He was miserable- so much so that the doctor ordered a tranquilizer cocktail to calm him down. With his discharge papers in hand, Mr. Pantsy declared he couldn't do anything with the paper and wanted me to take it from him because he couldn't read it without his glasses. He didn't like the idea that he could carry it back with him or put it in his pocket. He kept trying to hand it to me, so I instructed him to put it down next to him (and the towel). He couldn't help himself, though, and kept picking it up to try to read, then hand off to a person walking by.

Disturbingly, I understood him. I felt terrible for him, because I feel like I have been in the same paralysis and looped thinking at times. An hour after he was discharged, I saw him in the ambulance bay again.

"You're joking," I said to the ambulance drivers.

"Nope," they replied. He's back.

Thankfully, it was the end of my shift.

S

Jailbreak Week: What Else Did You Put Up There?

I knew it was too good to be true. It has only been a week since I've been in the drunk tank; I've been stationed there several times since, but people have been nice enough to take that shift from me, knowing my particular dislike for being there all the time.

Alas, last night, I wasn't to be spared.

It happens to be jailbreak week, for whatever reason. Police are patrolling our halls instead of the streets, keeping an eye on those in custody. When prisoners flip out and give themselves health issues, they can come to the hospital to be 'coddled and catered to', as one cop put it.

My first few hours were in the drunk tank, which was converted to psychiatric patient overflow. For some reason, they are pouring in this week (and it's not a full moon yet). One of my patients put me on edge; she had been there before, violent, verbally abusive, manipulative. Luckily (for me) or unluckily (for her), whatever drugs she had taken were making her delirious and nonsensical. She couldn't keep her concentration long enough to make any real demands or implement any plans.

Then, I took my dinner break, was yelled at by charge nurse for doing so, since she needed me to sit. Were you on dinner break? Yes. Did you tell anybody? I wasn't assigned on the sheet, so no. I've been looking 45 minutes for you. That's absolutely incorrect- I took 30 minutes. 45, she insisted. Ok, well, where should I be sitting? She chided me some more, then sent me to the obgyn room. (Nurse power trips are so sad to watch. Don't bully techs!) Lucky I took my break; I wouldn't have gotten one if she found me a minute sooner.

My lady Tina was in custody. I was instructed to never take my eyes off her and to take any wires or cords away from her. She had apparently tried to hang herself in our ambulance bay. Tina, upon seeing me, demanded a sandwich. I said, I need to ask the doctor. Oh no, I can't wait, just get me one since I've already had one! It's ok! The other tech came in and gave her a sandwich. I looked in the trash pail, she had already eaten at least one. She snarfed it down in less than 2 minutes.

She then settled under her blanket and proceeded to masturbate. The blanket was thin, she was naked under it (for fear she'd hang herself on a hospital gown with laces), and the stretcher was moving. When I walked over, she stopped, then after a few seconds, started again.

Great. Now I feel like a pervert.

The OB-GYN resident came in and needed me to stay there to do a pelvic exam. The drunk, non-English speaking trauma patient I was also watching had to be watched by someone else as I stayed in that horrific room.

"So how many partners do you have?"

She shrugged. "I don't even know"

"20? 30? 50??" as she shook her head.
"More?" She nodded.

"Ok... any history of STD's?" She didn't answer.

"So what else did you put up there?"

Tina had taken a whole box of tissues and stuffed them one-by-one into her birth canal. The resident took a large speculum and some speculum tongs and fished out the foul, blackened plugs. Upon irrigating the area with water, all of it splashed out onto the sheets and the floor.

"Whoops, looks like I made a mess," he exclaimed and hurriedly left the room, never to return. With the help of a nurse, I cleaned the room of the water from Tina's netherparts and returned to sit down. "I want a sandwich! Can I please have a sandwich? I'm so HUNGRY. They don't feed me in there!"

"Tina, you've had 2."

"One," she corrected me. I rolled my eyes.

She kept pleading, nonstop, and at this point, I was really annoyed. After a few hours of this kind of slow abuse, it really adds up!

I asked the volunteer to go fetch a lunchbox, which she also scarfed down in less than 5 minutes.

She then proceeded to her after-meal exercise, which is to say, the sheets started moving again and the stretcher started shakin'.

Edit: Mind you, one of her hands was cuffed to the stretcher, so she only had use of one for eating... and other purposes...

The resident came in to give her discharge instructions and an antibiotic. They were set to go, but the officer needed hospital-jail paperwork, so we asked the resident, and again, and thrice. An hour later, I left my sitting duty (against my credo) to ask one more time, to see the doctor chatting with others. He dismissed me in an annoyed way and said, I'll get to it in a minute when I'm not busy. His minute just to print out a sheet of paper was 3 hours of time- mine, the officer's, and the patient's, who was still enjoying herself this whole time.

These are the nights that will make me burn out. I don't think it's ego- I'm not averse to working hard or under people- it's just that one can only stand for so much mental abuse such as sitting without repercussions.

S