Guest Blogger

My son. He is doing a 6 week training rotation in the ICU. He was prepared for it to be emotionally challenging and the students were advised to journal about it. Having spent my share of time amongst medical professionals of all levels this past 18 months or so, I can say without motherly pride that this exactly the kind of person you want tending you at your most vulnerable moments.

I am so proud of him.

"I love you too"

I can hear these words in the back of mind as I look around the room I am about to leave. The words are soft as if whispered by a lover, but they hold no intimacy in their context. By complete chance, I heard these words spoken and saw the look that accompanied them in this very room 2 days earlier. The phrase was spoken by a man for whom it would be his last, the look of sincerity that joined them given to a son whose face would be the last he would see. I knew almost nothing about this man or his family, yet the significance of what I accidentally witnessed as we prepared to intubate him was not lost on me.

The man had come into the hospital due to increasing dyspnea. He was diagnosed with acute respiratory failure. We attempted to ventilate him with BiPAP and when it did not work we were forced to intubate him. He developed ARDS and as his oxygenation status worsened the family decided it was best not to fight the inevitable and stopped the treatments.

A noise down the hall distracts me from the almost cinematic replay in my head. The ICU area I am in isn't huge; the area I have been living in for the past three days consists of basically a "U" shape, 19 rooms, 19 people, 19 families, 19 stories.

A subtle movement draws my eye to room 3. I remember when I first met the pt in that room. A man with severe neuro defeceit after multiple CVAs. When I first looked at him on that first day, he was so obviously compromised that I never even felt a human connection with him. He wasn't there, he was a vent to me at that point, numbers on a complicated machine. His sister was there regularly, and I had always chatted briefly and warmly with her, it was obvious that she was remaining strong but struggling with it at the same time.

It was decided that he was to get a trach and on my second day we were called upon to transport him down to surgery. My preceptor and I arrived at the room a little early, my preceptor stepped out to take care of something else while we waited and soon after the nurse stepped out as well. This left the pt, his sister and me in the room alone. It wasn't uncomfortable, we made small talk, it was polite and without tension. There was music playing in the background and I commented on it as it was the first time any music was playing in the room. His sister smiled broadly and said "Oh yes, he absolutely loves music. He is a musician. He plays the mandolin".

Have you ever looked at those paintings that have the image hidden in them? I think they were called magic eyes or something similar. You stare at it for the longest time and finally something clicks and bam you see it. There is a microsecond disorientation that always happens when I finally see that image, a nano-dizziness. That same thing happened at that moment. He "is" a musician. He "plays" the mandolin. There was no past tense in her description.

In a flurry the surgical team and entourage sweeps into the room and in a flash I am handed the ambu bag and off we go down to surgery. When we arrive there is the usual delay and wait in the hallway while the surgeons and anesthesiologists get ready to take the patient over from us. I am left alone with the patient, my preceptor a couple of steps away on the phone. I look down at the patient and I can see for the first time that he is not a vent or a set of numbers but instead a man. A man with a concerned wife a few feet away from me nervously talking with the doctors. A man who was a musician, and who used to play the mandolin. It is obvious that he will never again create music from a brain that has just been ravaged by a rogue blood clot.

This man was a child once. He played with little toys, cried for no reason and felt fear from such things as the dark and the boogie man. He went to grammar school, probably played some parts in school plays that were not strong candidates for Broadway yet most likely received standing ovations a Broadway actor waits their whole career for. He went to high school, he had a first love, he met the girl of his dreams and shared a first kiss with his wife in front of family and friends. Now I am connected to this man, quite literally as I am squeezing a two dollar plastic bag so that he can continue to live, and I realize that I am playing a small part in this long production that is his life.

"Excuse me bud, " I hear from behind me, snapping me out of my recent playback. It is the cleaning team and they are trying to get into the room I was blocking the doorway to. I hastily step back with muttered apologies and watch as they quite quickly start resetting the room for the next patient.

"Are you ready?" asks John. John is the ICU nurse who was quite intimidating to me for some reason. "To extubate?"" I reply, really more of a rhetorical delay tactic than a true question. I had known that eventually I would have to do this, but I was caught alone in the hallway, my preceptor four the day two rooms down. "Do you need Jane or can you handle this?" he asks, and I can tell his expression is a little softer than normal. My doubts must have been a blazing neon sign on my forehead. "No, it's fine, I can do it." And with that, the nurse, myself, the attending Dr. Young and a resident walk into the room. I suction him one last time as family is waiting to come back and be with him in his final moments and we do not want him to be choking on secretions when they do,

I had been lucky enough to work quite a bit with Dr. Young during the past three days. He is quite an amazing man, more because of the way he balances his confidence and ego with how he treats nurses and RTs. You are never in doubt that he is in charge but you are never hesitant to voice your opinion either. We had done a few bronchus together and he had even called upon me directly to answer some questions in front of the entire medical team over my preceptor twice.

So it was with a little surprise that I watched him take a deep breath and lean with both hands on the end of the man's bed as I began to extubate. It was obvious that he was genuinely sad about the outcome of this pt. and while this makes complete sense, I still did not expect to see that vulnerability, that emotion. The extubation completed, we left the room, the family was ushered back in and we stood in the hallway watching his little piece of digital real estate on the monitors. We watched as his heart rate and respirations got slower and slower, until they were finally zero.

I started to wheel the vent back to the storage room where I would clean it and get it ready for the next patient, the next fight for life. I glanced one last time at that hall monitor that showed everyone in the unit's vitals. The room I just left was, of course, blank, but the other rooms all had numbers and graphics. 18 rooms, 18 stories. The noise level seemed to gradually increase for some unknown reason and I could see families walking in and out of rooms, I noticed a couple of people laughing and hugging. Nurses and RTs and housekeeping, X-ray techs...they all seemed to come out of nowhere yet were filling the hallways with activity as I watched, going about their days. A small smile seeps across my lips.

This was a sad day to be sure, but it was infinitely more sad for the family that was most recently in the room I just left. I realize that the time I spend in the ICU isn't about me. It is about these 18 remaining stories. 18 remaining outcomes that have yet to be decided. It is about recognizing that each room contains a person, not just a patient, and that the care given and the words spoken need to be done in consideration of this. I am just a microscopic player in this gigantic story, but it is an honor to have a part nonetheless.

Drive-by

I had to do it. My retina doctor is 2 minutes from Mom's house. So, after my appointment, I said we should drive by, see if anyone moved in yet. My brother had stopped by a month ago and it looked empty still.

So, I told Russell to drive slowly but not so slowly as to look like stalkers. Which, of course, we were. It was afternoon, but the porch lights were on. Wait. Lights? Plural? 2 new lights flanked the front door. I sniffed that it was overkill. Then I spotted the couch. It was positioned under the picture window. My folks never had furniture there. It was always a table of some sort with a lamp of some sort. One always had to have a light in the window. Now there was a couch. Maroon. Unseemly.

We were beyond the house, so I asked Russ to turn around and drive by again. Even slower this time because it appeared nobody was home.

Home. Their home, not mine.

The screened back patio looked empty, but it is Winter after all. Maybe in the Summer they will have parties there. Groaning plates of food brought out from the kitchen to the big table outside. Soft breezes through the walls of screen. Laughter. Scrabble. Coffee.

The bedrooms were closed from view with shades. Shades. Hmm. Interesting concept. Did we have shades? How can I not remember that? It felt like they were telling me to quit spying already.

By the time we got to the corner, just 3 houses away, I felt the loosening of ties. I had grown up there and now someone else's life will be tied to that place. To the groaning basement, the distant sound of a freight train in the night, the slight uphill climb on your bicycle that turns into a free ride in the wind when you go back. They belong to strangers. I hope the house welcomes them. I wonder if some little piece of my life..a scrap of a note, the back of an earring, will turn up when they sweep making them wonder where that came from.

I may never have cause to turn on to that little dead end street again. No need now. Nobody, no thing awaits,

More than ever, I feel the shift of change, of loss, of fresh starts.

Just a house, after all. Rooms, walls, floors.

Life.

good morning starshine

It is hard not to think about Whitney Houston today. It was all over the news and the grammies yesterday and today. Snippets of her singing come out of the TV and radio at all hours. People start the inevitable second guessing about what drives celebrities to self destruct, as if they all do. If, indeed she did.

I watched the news coverage of the red carpet at the Grammies last night. The chosen walk up to a area with the appropriate backdrop and photographers at the ready. They strut and stop, pose, practiced smiles that don't always reach the eyes. And the flashes are like strobe lights, like the northern lights, like lightning, like starshine, blinding. How do you not lose yourself in that white light? How can you stay real? I'm amazed that so many do.

I have groupies. Most folks that exhibit at art/craft shows have some. People who love you, love what you do, wish they could do it, want you to teach them, want to come to your studio and watch you, take your picture, yaddayadda. I only have a few, but they always show up and assume I know them as well as they know me. Sometimes I do, sometimes, I have to talk to them for a while before a memory gets jogged. I accept their praise, their affection, try to believe I deserve it but it always makes me a little uncomfortable Like I am a fraud about to be discovered, I dunno. But I digress.

After a groupie takes her leave, compliments dispersed, package in hand, I feel a little happier, a little brighter. It builds me up, makes me remember why I do this. There is a spring in my step, a sense of being in the sunlight. I am an artist. Take that all you people who walked in took a quick look and left without a word. Humph!

Now multiply that by a million, a billion, a gazillion! Add magazine covers and TV shows. Become a household word. What does that do to your head? If a sweet woman in a "hello kitty" sweatshirt can put a spring on your step, put sunshine on your face, just imagine. Incomprehensible.

Maybe drugs dim the burning sunlight just enough? Never been much for drugs, myself. I have trouble taking the ones my Doctor prescibes. But maybe?

There have been times in my life when I have envied the success, the money, the beauty , the poise, the life of others. Not any more. We all find our own sunshine in the end, our own light. I am not destined to find mine on a red carpet, in front of a backdrop with hundreds of photographers calling out my name. I'll take the little white tent, diffused sunlight through its plastic windows, the occasional, whispered, "beautiful" as someone touches a finger to one of my creations.

It is enough. I wish I had always known that it was enough.

making home

There are several reasons why I haven't blogged lately, but mostly it is because we are finally tackling the house. It is pathetically easy to let things go. You stop seeing the need for a paint job. Clutter becomes accessory. The "thing" that was going to be in the dining room for just a weekend becomes invisible. You need something to spur you on, a light needs to be lit above your head. For us, it was new appliances.

I was not about to put gleaming, new stainless into a drab, cluttered kitchen. Once you start, the job mushrooms. I see you nodding your head. So, we painted and re-organzed and cleaned and repurposed and the kitchen is lovely now. Which makes the rest of the house look like crap. So, on we go.

Of course, since this is really a blog about life as an art show artist, I must mention that this is also app season. I will skip my usual rant about why we need to apply for an August show in January. As long as they don't cash my check in January, we can all get along. Because this is also supply-ordering season and studio-cleaning season and tax paying season. I get a little protective about my modest cash supply.

Speaking of supplies, I have caved and ordered some address book text blocks from my bookbinding supply place. And diaries and wine journals. There was a time when I designed and printed my own pages for these things, taking pride in my clever wording and font choices. Nobody noticed, of course. There is a truth about this art business that takes a while to absorb. That is that some of the little things you do, things you are smug about, proud of, nobody notices. I had a knee buckling epiphany some years ago when a fellow artist who also helps run one of our best shows made the off handed comment that the jury had no clue that I made my own paper. Whoa. I had identified myself as a papermaker who used her own paper to make books and stuff. What I learned was that it was my "stuff" that was getting me into shows, not the paper. It was disappointing and a relief at the same time. It freed me to go shopping for amazing papers from all over the world. It opened up a whole new design esthetic. And it freed me from hours over the vat.

I started making photo albums using text blocks from Italy that are already spaced and made of the same quality stock I would choose. And they have glassine interleaves which would have been a real bear for me to do. That allows me to make a classic album and sell it for 25-30 bucks instead of the 50 I would have had to charge if I was laboring over the innards. Win/win. I am still making the book from "scratch". The covers, the case, the design. I get request for address books which would have been ridiculously labor intensive for me to design and print, but I'm going to give them a go with the text blocks. This will be my "new" thing for the coming season.

The studio needs a serious clean up. It always does this time of year. I close the door after the last show of the season and take a month off. When I open the door in February, the chaos is overwhelming. You can see the dash to finish, the lack of discipline. No need to put that tool/brush/paper/glue in a place where you can find it tomorrow. Tomorrow is a month away. I am paying for that now.

So, that's where I have been. My first show is next month. Actually, there are 2 small ones. Then 2 months to gear up for the "real" season.

I hope the dining room is done by then.