Archive for March, 2007

Two stories

Two stories.

One. I’m walking into work and meet my consultant on his way in. I ask if he’d had a quiet night on call and as I said it his phone rang. Quiet up till now I suppose. So there’s a patient in the GP hospital 30 mins flight north who’s not too well and could the helicopter come and pick them up. And so that becomes my job for the morning. I grab the trolley with all the gear, enough to run an ICU in the middle of nowhere, and go to the hangar.

In Wairoa (referred to as the wild west of Hawke’s Bay) there’s a poor wee 62 year old Maori lady with not enough breath to utter a word and so sweaty and cold she feels like death. She’s now confused and wanting to stand up and sit down and then stand up again. Not a good option in a helicopter. I fill her with drugs for half an hour and if anything she’s worse. For once it’s probably not my fault.

I ring my boss and tell him the only way I’m getting her back is paralyzed and ventilated. I feel I ought to tell him cause I’ve never done this on my own before, and if I’m gonna kill someone then I’d prefer he knew.

And so I open the mini-icu in a bag and get my bits and pieces together. Now what I’m proposing to do is give an anaesthetic, play the role of the gas man. Now usually this is in a nice controlled environment with lots of flashy screens showing nice normal numbers. I have a portable monitor that would give me most of this. If it wasn’t for the fact that her blood pressure is so low that the only pulse I can feel is in her neck so I know her blood pressure’s not good. And that the probe for measuring oxygen content doesn’t work cause her fingers are so cold and the only number it gave us was 78% and I really hoped that wasn’t right.

The idea is to give her some sleepy stuff and then some stuff to paralyze every muscle in her body (apart from her heart – which is kind of stuffed already) so I can put a tube down her throat into her lungs and breathe for her.

So that’s straight forward enough, the nurse gives the drugs (half the big syringe, all the little syringe…) and she stops breathing. And the tube goes in easy enough and I squeeze the bag and her chest goes up and down. I feel the pulse in her neck and realize it’s not there any more. In my head I swear and curse that I’ve killed her. So I stick a big hose pipe of a needle in her neck and give her some adrenaline and the pulse comes back at a thready rapid rate, wait no, maybe that’s just mine. But no, it is there, just about…

And I talk my way through this in a strangely calm tone of voice, asking for this and that, betraying the cold sweat that’s just come out on me.

We stick her on the stretcher load her in the chopper while I sit at her head with my finger on the pulse and nothing to monitor except a read out of the electrical activity in her heart. And I search through the drug bag, cracking open amps of bicarb and calcium and adrenaline to keep that pulse there.

And we land and get her into the unit and I stick some more needles and drips and tubes in her. The boss wanders over and I give him the handover and he says I did pretty well even if the induction was a bit ‘vetinary’.

You see in many ways it’s easy to keep people alive. With enough tubes in the right places and enough drugs you can keep that little sack of muscle in their chest going for well past it’s sell by date. But most of the time, in cases like this it’s ‘futile’ (as I say to the family), cause they don’t get better and you never get rid of the drugs or get the tubes out.

My only comment to the boss is that it’s another successful resuscitation of a dead person.

Story two. Again, I’ve just arrived in work (it’s been a chaotic few mornings), and there’s a patient in the fire exit (our emergency extra bed space when the unit’s full) who’s just arrived. He’s been sent down from the ward cause he’s been unwell night and no one can get a needle into him to give him some drugs to make him a bit better. He’s got some horrible advanced cancer in his belly that he only found out about yesterday.

An hour of needles and x-rays and blood tests and fluid later it’s clear he’s dying. He’s in the process of having a heart attack, his kidneys have shut down cause his belly’s so swollen with fluid that they’re blocked. He can barely get a breath cause of the fluid in his lungs and the pressure pushing up from his belly underneath.

I only look at the name on his chart after the first hour’s over. I kneel at the bedside and look in his eyes and he knows his time is up, he just nods when I ask is he comfortable. I know he’s lying. I take his family into a room and sit them down and explain things. They already knew about the cancer but they hoped he might have had a bit time. I say he won’t and I use the ‘futile’ word again. And it echoes through my head that I said the same thing two days ago about the other one. And I curse myself (though I know not why) for having the same conversation over and over.

I take them back to the patient and everyone cries and I ask him again if he’s comfortable, and again he lies and I give him some morphine anyhow.

Two hours later his nurse calls me in cause he’s ‘going’. And he’s breathing his last, and it looks horrible. The deaths I’ve watched (I’ve forced myself to watch, to be there cause they deserve that much, looking away and standing outside would be too easy, cause maybe a few days earlier I’d said it would be OK and now it’s not gonna be) are mostly not peaceful. At least they don’t seem that way. The patient would have lost consciousness a long time before it happens, often uttering their last words days before it comes. But it’s not peaceful for the families. 24 hour vigils at the bedside, resolved to what’s happening but determined that they’ll not be alone when it comes.

And so this guy breathed his last with his wife holding his hand and sobbing that he was a good man and didn’t deserve to suffer. And I stand with my arm round her and let my eyes fill with tears and I pray – though I know not what. The pastor in the room closes his eyes and prays out loud in Maori and I pray along not understanding any of it except the amen at the end. I just say sorry. Sorry it had to happen, sorry we couldn’t do more, sorry it had to be this way. I prayed again, more of an empty ache for God’s presence than a cohesive worded sentence of petition.

Why do I tell you these stories? I tell them cause I like telling stories, cause the retelling of them has been in my head for days.

One of the guys I work with is a fairly thoughtful interested guy and asks why we do the job/ He asks is it cause I get a ‘jolly’ out of it? And yeah, I admit that’s true. I do this cause it’s a buzz. I do this cause in some ways it reminds me I’m alive, cause it seems important and something of significance in a world and society of mostly meaningless dross.

And I know I do it cause of who I can be. Cause of how it portrays me. And I know I tell these stories cause of how it makes me appear. And if I use ‘me’ any more in this paragraph I’ll scream.

And I hate myself for the motives in my heart for telling these stories. I used to make deals with myself that when I did something I knew would make me look good that I’d not tell people. That I’d keep it to myself, but it never happened, I always had to let it slip into conversation at some point. I hate myself for being the self-absorbed, self-referencing prick that I am. That no matter what I touch I corrupt. That the only thing I can contribute to my own salvation is my need of it.

In ‘the great divorce’, probably my favorite CS Lewis book (though please don’t make me choose…), it talks of how when we get to heaven there’ll be such laughter. Laughter at ourselves, at our histories, at how we got so worked up over so little. That we’ll laugh at our own petty little quests for significance in all the wrong places. All our self-righteous rants and arguments, how it was so important that we were right. We’ll laugh just cause we have a better view, a better perspective on our existence and purpose. Kind of like I can’t believe that I had my hair in curtains when I was 16. It seemed like a good idea at the time. I still think our parents made worse choices in the fashion department…

So why do I tell these stories? Maybe I just needed to stand back and have a bit of a laugh at myself…

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Meet Harry

Meet Harry. He’s 20. He’s got severe learning difficulties. He has epilepsy. He’s a pleasant chap. Lies in bed with his etch-a-sketch and sleeps a lot.

Harry has a broken jaw, a broken fore arm (known as a night stick fracture, like putting your arms to defend yourself), he has bruises all over his body, a bloody and swollen mess, so much so he’s lost half his blood volume into the bruises and needed transfusion. He has 4 old fractured ribs, an old fractured femur (the longest, strongest in the body), old fractures of his spine and his back is covered with whip marks from an electric cord. He has a pneumomediatsinum, a fancy term for saying his chests been battered so bad that he’s punctured his lungs.

Harry’s dad did this to him. Harry lives with his dad. Harry dad is meant to be his care giver, meant to be the one to take care of him, to look out for him.

On his wristband it doesn’t say his name as a patient. It says Mr Unknown, so that in all the computer records he appears as an unknown, so that his family can’t find him and visit him and finish the job.

Harry’s dad brought him to A&E saying he’d been having seizures all weekend and injured himself with them. He disappeared pretty quick.

First time I met him he told me he didn’t like needles and to be careful cause he needed to stay safe and would he be safe here? He told me his parents did this to him and he needed to be safe from them. He said he didn’t want to see them and he didn’t know why they did that to him. Then he cried and said again that his parents did this to him. And I sat at the table opposite and squeezed the pen I was writing with so hard that I cracked it. I stared at the page so hard as I cursed his parents very existence with all the curses I could think of.

I live in an insulated bubble where things like this don’t happen. I live in a nice, peaceful, middle class world, in a nice western country where I don’t have to see things like this.

Me and his nurse spent the next hour discussing morality and God and existence. Yeah, I’m not perfect (who is?), but I’m not that. It resonated that I’d heard this from countless alcoholics in the middle of the night in A&E, who weren’t ready to admit who they were. Who lived on a slippery slope where there’s always someone else nearer the precipice. If there’s someone you know who drinks more than you then maybe you’re ok.

I realized, in a rare and brief moment of clarity that perhaps I’m not that far away. In a different country, with different parents, with a different psychology then maybe I could have done the same. The Nazis loved their kids. We all bleed red when we’re cut.

There is a difference between an excuse and a reason. One provides the potential for pardon, the other is merely observation. I’m in no doubt of my arrogance and pride. I’m in no doubt that I fall short of what I should be. But in my head that should be over looked. Cause yeah, I’m not perfect (who is?), but I’m not that…

The Big Trip – Day 20-21

Mostly listening to: the 500 or so songs on my phone on random
KMs: 5300. no more i tell you…
Sleeping in: my own bed
Eating: Hawke’s Bay seafood fish and chips

New things in the flat since i left:
1) the dominion post (Wellington newspaper) is now being delivered to me daily. i don’t why or if it will stop. Shan’t complain…
2) the grass (or rather bush) is growing out onto the footpath. I think I saw some wildebeest
3) a loaf of bread 3 weeks out of date winked at me.

Might keep the list thing going. I like them.

Anyhow. Past few days.

Yesterday spent in Picton in the sun walking round Marlborough sounds and chatting to Larry (a retired US botanist now living in Mexico) and Jock (not his real name, i never got it, a Scottish builder out on holiday).

On the drive up i found a really cool deserted wee beach and sat there by myself watching dolphins jump amongst the waves. Didn’t even have to go on a tour boat. Made my day.

Spent today on the ferry through Marlborough sounds in the sun, with the wind in (what there is of my) hair. Glorious stuff. The ferry across the Cook Strait is one of the top NZ experiences. Can’t say that for Larne – Stranraer…

Took me 4 hours to drive form Wellington, with a full bladder from about Masterton or so. Only took me 6 runs in and out of the car to get all the stuff moved into the flat.

first thing i did (after peeing) was open my mail – two bills, a request to relicence the car and 5 copies of the dominion post – and turn on the old Mac.

Grand total of 48 emails in my absence. Felt quite chuffed about that till i saw that I’d received a grand total of 7 personal emails and the rest were automatically generated reminders to pay the two bills in my hand and one demanding payment for all the newspapers.

So glad to see that the world survived without me. in fact, perhaps didn’t even notice my absence… you call yourselves friends…

I love making people feel guilty from far, far away. Or at least trying to.

Spent the next three hours, tidying up and cleaning and wondering where all the time went. Back to work in the morning. I’m sure they missed me… sniffle sniffle…

The Wittenburg Door

So this is hardly original (pirate) material (you’re listening to the streets…) as I just stole it off http://www.wittenburgdoor.com/home.html

a simply wonderful publication, often accused of heresy and blasphemy but I like it. There is a difference between being offended and being blasphemous. Make your own mind up on it. Both of them made my day.

As a brief note, the guys who publish this live in a community centre in inner city Dallas, caring and taking into their home the homeless people of the city. They are unashamed followers of JESUS.

So much of Christianity has so little to do with glorifying GOD and a lot to do with glorifying ourselves. So many of our rituals, traditions and ideas are nonsense and brought to great excess. I am fully complicit in much of this religiosity, to my shame. The idea of humour and satire is to turn a mirror on the church and show us that we’re not reflecting the sun light too well…

HOLY SPIRIT COMPLETELY RUINS HIGH ATTENDANCE SUNDAY

(The Door News Service) – Southern Baptist Church leaders are up on arms at a Nashville church after what many call “a total disaster.” After months of planning, careful selection of hymns and sermon topic, and hiring a nationally known worship leader to perform the offering, the deacons of the First Baptist Church of Nashville watched all their hard work go up in smoke upon the arrival of the Holy Spirit last Sunday.
Deacon Tom “Landry” Smith said that he first noticed something was wrong during the ten minutes that had been set aside for testimonies.
“I got up to the pulpit and asked if anyone wanted to share something the Lord had done lately in their lives,” Smith said. “Now, we had asked three to four members before the service to share something during this time, and that was really all we had allotted time for. As soon as those four people were done, other folks from the congregation started standing up and testifying spontaneously! It was a complete disaster! We went over testimony time by at least 30 minutes, and had to completely cut the offertory. I doubt we will ever get that worship leader to come back here!”
But the service’s horrors didn’t end there, Smith said. During the worship time, the music minister led the congregation in all four verses of “Holy, Holy, Holy,” even though the planning committee had planned on only three. The music minister explained afterwards that he felt “led to do so.” Apparently, he also felt led to lead the congregation in several unscheduled songs afterwards.
Smith admitted that this was the probably the work of the Holy Spirit, but said that the results were a “logistical” nightmare.
“People started raising their hands, weeping, even bowing down and confessing their sins to God on the spot,” Smith said, ruefully. “It completely took the wind out of the sails of the altar call later during the service, not to mention how embarrassed we were in front of the community. High attendance Sunday is the one Sunday a week when we really push to fill the pews with unbelievers. Now they all see First Baptist as a place where people can’t control themselves or even have the discipline to follow an orderly schedule. My God, man – the Titans were on at noon!”
By the time Pastor D. T. Thomas arrived at the podium, most of the church leadership knew that everything they had spent so much time planning was lost. Thomas, still weeping from the worship time, announced to the congregation that he felt led to preach something different than what he had originally planned.
“It completely ruined the effect we were trying to create that day,” complained Deacon J.S. Simpson. “We very carefully chose the theme of ‘Surfing the Waves of God’s Grace.’ Well, suddenly Rev. Thomas starts preaching about getting free from the past through Christ. Now how are we supposed to keep the service unified with a message like that? What are we supposed to do with the boxes and boxes of leis that we bought to pass out afterwards? Needless to say, those leis will be coming out of the pastor’s salary.”
First Baptist leaders were optimistic about their ability to return things to normal in time for this coming Sunday. Still, last Sunday was a huge blow to morale for much of the leadership.
“We expect a certain etiquette from all of our guests,” Smith said. “This is a church, not a carnival. God really let us down this week.”
First Baptist’s leadership is still debating whether or not to invite the Holy Spirit back for this Sunday. For the moment, they have cut “Come Holy Spirit” from the approved song list.
By John Gram
February 2007

GOD’s Creation blog

Day 1
Listening to: Silence (it’s wonderful)
Mood: Blissful
Created light. Took about 11 seconds. What to do with the rest of the day? Wound up creating the sheet, too. Spent afternoon making shadow-puppets with Jesus (Unable to cast a shadow, the Holy Spirit got upset went body-surfing). Jesus does this thing where He makes a fist then sticks up his index and middle fingers and bounces His hand around – cracks me up. Not sure what to call it; we’ll delegate that sort of thing somewhere down the line. If I ever get a book deal from this blog, I might leave out the part about the shadow-puppets. “Let there be light” is much more impressive than “Let there be light and a bed sheet.” All in all, a good day.
Day 2 
 
Listening to: Silence again (it can’t last forever; must enjoy it while I can)
Mood: Expectant
Had another good day today. Separated water into two parts with an expanse we’re calling “sky” in between. We may rethink the name later, but it works as a placeholder. Holy Spirit spent the afternoon hovering above and below the face of the deep.
Day 3 
 
Listening to: Ocean surf breaking on the beach
Mood: Happy
Good things are afoot. Created land today. Can’t talk about it now, but I see real potential in this “dirt” stuff. I’ll keep you posted. In the course of creating land, we also created “seas.” Spent the rest of the day punning with Jesus and Holy Spirit: “Now see here….” “No, no, the sea is over there.” Must blog on the humor potential of homophones someday: Sea if I don’t. Got a big project set for this afternoon. I’ll blog on it tomorrow.
Day 4 
 
Listening to: The music of the spheres
Mood: Charamblontical (there’s simply no other word for it)
Spent yesterday creating a garden. This was one of the things I was thinking about yesterday when I mentioned that I saw potential in dirt. You can plant all kinds of stuff in it. Trees, shrubberies, vegetables – it’s all good. There’s another little project I have in mind for the dirt, but it’ll be a couple days before I can say more. Today, though, was Moving Day. Created stars and planets – but where to put them? All bunched together, they’re not that exciting. Holy Spirit suggested spreading them out across the universe. That’s good, I thought. So I called Fed Ex and explained my vision to them. I explained our tight schedule, too: “It absolutely, positively has to be there overnight.” They said, “no sweat,” and asked if they could use that as their motto. “Not a problem,” I said. After all, I am a gracious God, aren’t I?
Day 5 
 
Listening to: Jesus telling a “Big Fish” story
Mood: Amused (the “big fish” thing has potential, might return to it one day)
This morning I noticed a cool thing while creating birds and fish. When the land and the seas got separated a couple days ago some water got trapped in pockets of the land. We’re calling them lakes and they’re really an asset to the scenery. 
 While we were walking across one, Jesus said, “Hey, imagine how exciting it would be if this lake was filled with fire instead of water?” “But what would we put in it?” I asked. He didn’t know, but I’ve got to admit a lake of fire would be something to see. Handy creation tip: When creating large white birds to live near the seashore, wear a hat.
Day 6 
 
Listening to: Jungle sounds
Mood: Pleased
Today we really made up for only working 11 seconds back at the beginning of the week. We spent all day creating animals. Like with the plants, we went for variety. Long ears. Short ears. Short ears, long tail. Long ears, almost no tail. Horns on heads. Horns on noses. Stripes. Spots. You name it, we did it. Created dinosaurs, too – Jesus loves the little dinosaurs. I foresee a couple scenarios down the road where there might be problems with the dinos, but for now they’re playing well with the rest of creation. I did my other dirt project today, too. I created man and woman. Adam is handling the names project for us. I ran through the “sea” jokes from the other day, but he didn’t get them (had to be there, I guess). Eve did, though (sharp as a serpent’s tooth, that one). 
 Turns out Jesus was making a bunny rabbit shadow-puppet earlier in the week. Good to know.
Day 7 
 
Listening to: The collected works of Burt Bacharach (there are advantages to being omnipresent in time as well as space)
Mood: Serene (like a televangelist high on hairspray fumes – the downside of temporal omnipresence: I already know about garbage like this)
Taking it easy today, so this’ll be short. I created banana cream pie around 10:30 this morning, but let’s keep that on the QT, all right? Noticed a certain animal in the garden that wasn’t playing well with others this afternoon. Looks like we might be moving ahead with that Lake of Fire project after all.
By Chris Mikesell
Issue #202, November/December 2005

The Big Trip – Day 19

Mostly listening to: john piper sermons
KMs: 4700 or so
Coffees: 3 and counting…

I stayed in Christchurch an extra day to see a friend I went to medical school with who’s moved out here. Hadn’t seen her in 18 months or so it was kind of cool. Spent the time catching up on what’s happened in between and where all the people we know have ended up.

Funny, how I’m much more keen to maintain relationships now than I ever was when I was at uni with these people. I’m a lazy, self-centred man when it comes to people (and pretty lazy and self-centred in general) and so I miss out on a lot of people’s lives, simply because I don’t make the effort. Takes you to come this far to realise how much you… Oh wait, sorry cliché coming there, well you know what I mean…

A careless spark in the back of the car may have started the whole evolution thing all over again it was that messy. The Morsies shape whole in the back had quickly disappeared and I was beginning to find stuff they’d left behind by mistake. The pair of Simon’s Speedos (i kid you not people!) tied onto the window in the back was the first thing to greet me.

Not wanting to repack the whole thing in the middle of Christchurch, I hit the road. When it didn’t hit back I figured it was safe to drive on and headed to Kaikoura up the coast.

The driving is one of the bits I’ve most enjoyed about the trip, it’s a comfy car with (dubious) air-con and decent speakers. Today wasn’t the greatest as it was a bit overcast and the alps were remaining stubbornly out of view – as they have done for the entirety of the trip.

Kaikoura is the place to come if you want to see whales, or dolphins or seals and even swim with them, or take them out for dinner or whatever. I’d seen seals and whales before – mostly on TV – but just cause they’re actors shouldn’t make it less authentic…

I stopped and put up the tent and took the bike out for a spin. I’ve been carrying three bikes the entire journey and they haven’t been used once so I kind of felt the need to use them just to justify the carriage.

From a bad start, the bike was even filthier, with no grease on the chain and a flat back tyre. Though this is roughly the same state the car is in, so I wasn’t to complain. I cycled from the campsite to the seal colony stopping every once in a while to reinflate the back tyre. Again similar to how we’ve got the car round the south island.

At the seal colony were legions of tourists squinting to see seals that had enough sense to be sleeping on the seaward side of the furthest out rocks. I spent my time getting my breath back after the first exercise I’ve done in a month. I think the seals had the right idea.

The Big Trip – Day 18

Weird kind of day. Si and ruth’s flight was in the evening. So we had a day to fill and little idea of how to do it. It was sunny which gives you a few more options. So we ended up at the beach and me and si trying to turn the kayak into a surf board again.

It got a little bit messy. Si isn’t too hot at knowing where is head is in relation to the kayak wheb he comes off. This means he gets whacked on the head by it quite a bit. Today he caught the corner of the kayak on his jaw, sending him underwater for longer than I would have liked, and brought him up with a curse or two on his lips. Well I suppose they would have been curses if he could have moved his jaw to form the words. He’ll live i’m sure.

This manage to fritter away the time till 2pm. Only another 3 hrs till I could safely dump them at the airport and be rid of them. Kidding, honestly…

It frustrated me that I had these people with me who I love so dearly and we were struggling to fill our remaining few hours together. Maybe I was just annoyed that they were going home and i’d miss them. I’m not particularly good at expressing any kind of emotions towards most people, particularly my family. My fondness for them comes across as a sulky, sullen, form of grumpiness, which is only subtely different from my routine sulky, sullen, grumpiness.

I’m not good with goodbyes. I’ve watched too many movies and maybe I expect them to be more like that. All the ones I go through just seem a bit awkward. We sat in the airport café and drank our coffees (morsies on the hot chocolate) and passed the time as best we could.

And so i’ll not see them for another four months. Which is no time at all really, in the grand sheme of things. But i’ve spent 6 months here already getting used to the idea of not having my family with me and now I have to do that again. If it sounds like i’m moaning, then i’m not. Si said – you can always come home. And it’s true, i’m in the wondeful position of being able to do pretty much anything. I could come home at the drop of a hat.

I’m still not going to though.

And so I went back to the car park and got in the RVR and realised how bad it smelled, and that it was mostly my shoes so even with them gone it wasn’t going to change. I bought the paper, turned on the miserable old git music that I love, that i’d been banned from playing and drove back to town. Parked the car and spent the whole evening, walking the length and breadth of chistchurch and lying in the park watching the ducks and sizing them up for bowler hats.


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March 2007
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