So many kind words.  As Josh Groban sings, “They raise me up.”  Thank you.

Status:  9.0/10.  A better day, but Lisa is off to work, so I miss my support structure.  She’ll come over afterwards – look forward to even a few minutes with her.  Trying to get some rest in preparation for another lumbar puncture tomorrow.  Do not look forward to these things.  I sleep with a knit watch cap, and it’s surprising how much heat you lose through your head.   But be careful of that oft-misunderstood “90% of your heat loss is through your uncovered head.”  When you are out in the cold all bundled up, the only heat loss occurs where you aren’t covered up, so yes 90% of the “loss” is from your head, but most folks interpret this as losing 90% of your ”body” heat through your head.   You’d have to have a really big head!

Events: Received two more units of blood, in an attempt to get my hematocrit up to 30% and please the now rounding attending.  Awakened this morning about 5 AM, by a loud and noisy nurse who said, “GOOD MORNING, TIME FOR YOUR VITAL SIGNS!”  Now, does anyone like being awakened from a dead sleep as if a fire alarm went off?  On top of that, instead of weighing me in the bed (it has an electronic weighing function that already has the tare weight of the bed and blankets in it) they made we get out of bed in the dark and stand up on a large portable scale they move from room to room.

  All you want is a whispered, “Sorry to wake you, we’ll just take some quick vitals on you.”  You stick out your sleepy arm, open up your muted mouth, and 30 seconds later go back to healing sleep.

 Comments:  I asked to see the floor care manager (head nurse) to see what we could do about it.  She explained that their ward here on 5A (as opposed to my previous 5C) thought the scale was more accurate.  I said fine, but if that were determined to indeed be the best practice why wasn’t that carried out throughout the hospital or at least on the same floor.  She couldn’t answer that one, but offered a compromise.  Would I be amenable to getting my weight checked at night before going to sleep?  You betcha.  Unless I’m sneaking out to the Popeye’s Fried Chicken I see right outside my window, it’s unlikely my weight is going to change from 11 PM to 5 AM.  Gina, the care manager, is a dedicated nurse with 28 years experience, cares deeply about patients, and is exasperated at times of how they are treated.  We had a long talk about the good old days when patients were more than numbers on a chart.

   People keep bringing up these long forgotten escapades.  Long-time friend Marsha Wilson emailed me about an incident at Vanderbilt when I was an intern.  Vanderbilt hospital had a cafeteria that served housestaff and patient families, but closed after lunch, and after noon on Friday did not open up until Monday morning.  That meant that those of us who had to work overnight and weekends ate out of vending machines – Snickers bars, Cheetos, and cold soybean burgers you could heat in the microwave (we tried microwaving Cheetos, but you really don’t want to know).

  I, as always, complained as far up the ladder as I could go to get some hot meals, but to no avail.  So, as a child of the 60s, and believing we had a 1st Amendment right to “petition the government for a redress of grievances,” I decided to stage a strike.  A 4th year med student (who shared a rented house with me and 3 other interns/residents) created the two-person Housestaff and Medical Student Coalition.  We declared May 1 to be Brown Bag Day at Vanderbilt.  We posted signs, stood at the entrance and reminded our brethren not eat a hot lunch, and encouraged patient family members to join us.

  I don’t know how much hot food went uneaten, but it got the issue noticed.  Thereafter meals were served 7 days a week.  The Hospital Administrator wanting apparently to make it a Pyrrhic victory came up to me and said, “You used to have 10 bad meals a week, now you have 21.  Are you happy?”  He was fired shortly thereafter.  Can’t tell you why.

 Tomorrow may be a little traumatic.  My L4-L5 intervertebral space is getting a little sore from all the poking, but I’ll think of all of you, and that will get me through.

 Love to you all,



12 Responses to “”

  1. Rick Davidson Says:

    Ah yes. The Vandy cafeteria. So many of us appreciated you making that fine mystery meat available all week. Most of us were too busy to even go to the cafeteria much of the time during the week, but the nurses would provide us with those little tiny cups of ice cream and Jello. It’s amazing we all weren’t megaloblastic for three years. Listen, you take care of that interspace….you’ll need it for pilates. Just pull those knees up to your chest and root for an attending…or a third-year fellow.

  2. joel steinberg Says:

    I was taught in my SCUBA classes that 50% of your heat loss underwater is through the scalp. Which is why one almost always wears a neoprene hood when diving–even in sub-tropical waters. Otherwise one can become quickly hypothermic. The scalp has a very rich blood supply (which is why scalp lacerations can bleed so profusely–witness William Holden dying from a scalp laceration incurred when he cut himself while falling-down-drunk) and can radiate off a great deal of heat. Also why neurosurgeons take special care to close the galea and sew up the scalp tightly to tamponade the numerous bleeders. I totally agree that when one is imprisoned on call in the hospital that decent hot meals should be provided. Everyone who has gone through an internship and residency will surely concur. Be thankful you are not a female. Bald men are a dime a dozen. But Margaret just spent $400 for a mid-range wig; otherwise she looks “like a big egg-shaped head with ears that stick out.” (her words). Your blog continues to entertain and inspire us. Joel and Margaret

  3. Ashby Says:

    Good Lord Almighty! To be awakened at 5 am with the words, “Time to take your vital signs.” You have got te get out of there as soon as you can. Have made progress with some horses for the gang. Just have to figure out which ones are up for the ride so that we can spring you. May have to ask Suttle and Slaten to fashion a papoose. You know we can’t afford to lose a $400 hand cart.

  4. Judi Golding-Baker Says:

    OMG! Thank the Lord you speak up…I love that “child of the sixties” spirit…keep it up and keep speaking up!

    I hope you get some healing rest tonight and get through the day tomorrow as best you can. I’m sending you positive thoughts.

    With much love

  5. wendy Says:

    B- If I remember correctly..L4-L5 was operated on many a year ago…there should be a lot of space where that disc used to be..shouldn’t be a problem… Just Kidding…

    I’ve been know to organize as well.. mine were as successful, but maybe not as momentous… At Camp Miramichee I organized a mid nite Johnnie Run… and if I remember correctly the camp reported back to Mom that I was a strong leader – and could be effective if steered into a more positive direction.

    guess we’re more related than we thought..

  6. Donna Hill Howes Says:

    We laugh and cry right along with you!
    And so many, many of your devoted fans would love to donate a unit of blood in your honor, if we could just get you to sign that form giving us permission to do so….hint, hint….
    Sending all positive energy for a day that speeds by for you….
    And of course, love, good friend.

  7. Judie Davidson Says:

    Gina sounds like a special person. Why can’t they use a different interspace for the lumbar puncture and give the L4-L5 a rest? Oh…Rick goes to pilates every day (yea, right).

  8. MOM Says:

    Let them use Hank’s or my space, those are the the only ones of us that haven’t been used. Merrills & Terrys twice and Wendy once and you, too many times. More of my love than usual today, don’t hurt!

  9. Margot Says:

    Bruce –
    Sounds like you need a Noisy Nurse award – or just throw a Depends at the loudest ones. Keep up that 60’s spirit and rebel against them and any poor choice of drugs and cold middle of the night scales and against whatever strikes your fancy! We will support your revolution – send flowers, peace signs and even troops of grey haired hippies if we need to (it’s kind of amazing to think how many of those are still around). I just got a big shipment of “flower power” misic for mother’s day – would you like to borrow it?
    What is your opinion of Benadryl for kids? We’ve all done it before a plane ride and now I only give it at night – but should we drop it all together?
    I loved seeing that your blog is being covered in medical media reviews -I hope they give awards for the best blog – hands down it’s yours!
    I hope this day goes well. No pain – and if there is – yell! Don’t hold back! David and I are thinking of you all the time and wishing you strength.
    With Love from all the Budins

  10. Eileen Breslin Says:

    Dear Bruce,
    Well, you forced me to pull out good ole’Florence Nightingale 1859 Notes on Nursing…back to basics… You may want to share with your favorite nurse…She said “Never allow a patient to be wakened intentionally or accidentally is a sine qua non of all good nursing “; and All hurry and bustle is particularly painful to the sick”; Do keep them on their toes and speak up that fighting spirit. We are all here cheering you on and wishing the very best for you and your family. love, Eileen & Bill

  11. Julie Hill Says:

    Bruce – I learn something everyday from your writing. I think a TPC blog may be next on your list of assignments. We are thinking of you each day. I will keep the prayers coming your way.

    Take good care,

  12. Greta Says:

    Greetings Bruce! Hope the LP wasn’t too tramatic today and you’re able to sleep well tonight. Our thoughts and prayers are with you, Lisa, Rachel & Ethan constantly. We love you! Greta & Michael

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