Today, Jeff Gonsalves, registered nurse and author extraordinaire, joins us. He works in pediatrics in a large metropolitan hospital in California and has worked with kids for over twelve years. He has assumed many roles: a busboy who clears the meal trays from your room, a WWF wrestler who clinches psychotic teens in a bear hug when they try to assault me, and an engineer who tries to solder wires together and ends up creating an open circuit through his heart's left ventricle. He has a completely different viewpoint than what we normally get. His experiences in hospitals influences his writing.
Let's give him a warm welcome.
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As you can see, I'm a Jack of All Trades. Forget nursing duties. They come second. I can give blood transfusions, hang chemotherapy, and untangle dialysis hoses, but my most valuable skill is successfully hooking up an XBox. Am I an Angel of Mercy? Highly doubtful. If I am, someone sliced off my wings and stashed them in a refrigerated drawer in the basement morgue.
I relish my job. Working with children is a singularly rewarding experience. They want to play and have fun and I love them for it. Rarely do I have a problem with patients. My pet peeves stem from adult ignorance. Medical care has come a long way in the last decade. Quality care is a given, as it should be. Now people are more concerned about the amenities. Who cares if the doctor saved my baby's life, the ICU doesn't have a frigging Blu-Ray player and the fish tacos taste like Chicken of the Sea!
Compiled is a list of "Situations" that have rankled me over the years. Many of my co-workers share these grievances, and although I make light of them, often times they cause enough stress to make me consider throttling myself with a urinary catheter.
Situation One: Obsessing over ID bands: Name bands are undeniably important. They reduce medication errors and give parents peace of mind. But when I've taken care of a patient twenty times in the last month, I don't need to look at his bracelet to ascertain his identity. Unless he has a biological twin or his soul has trans-migrated into another body, I can recall who he is. This is especially true when I have to give ten medications throughout the night. Most patients need sleep, and if I yank his wrist out from under the blankets a dozen times, he'd probably prefer me hacking off his arm with a bone saw and duct-taping it to the side rail so I don't have to wake him up every half hour.
Situation Two: Inappropriate Doctor Calls: Yes, your baby is fussy. Yes, he probably has gas. Yes, colic is the root of all evil. But sorry, I'm not going to call Dr. Jones at 3:00 a.m. to get an order for Gas-X. A few pats on the back are probably more effective than a medication that pops air bubbles. Dr. Jones needs his sleep, and he'll be more effective treating your child the next day if he isn't awakened because of an infant's absent belch-reflex.
Situation Three: Tangential Illnesses: I get called into room 647B. "My daughter's poop is bloody!" a mother screams. "Something is deathly wrong!"
"Hmmm," I reflect profoundly. The ten year-old girl is here for a dental abscess. I scan the toilet water. Indeed, the bowel movement glows a bright crimson. Next to the bed is a table clustered with fruit punch Gatorades. The red dye could permanently discolor a white shag carpet. Returning to the girl, I find her in tears. I try to calm her down, explaining that a tooth infection doesn't cause spontaneous intestinal hemorrhaging.
Situation Four: Scorched Alveoli: No, I'm not talking about a burnt dinner entree. We're talking charred lung tissue, here! A four year-old needs a chest X-ray to rule out pneumonia. The father is angry, complaining that exposing his son to radiation is dangerous. I reply that the amount of radiation used is quite safe. "Then why do I have to wear a metal-plated vest?" he yells. By now, the son is horrified. "Daddy, don't let them fry my lungs!" he sobs. I explain that the X-ray machine is not an incinerator, nor will it convert his pleural cavity into an impromptu crematorium. By the time the father agrees to the procedure, his son has to be sedated with IV Valium because he's afraid the machine will "sunburn his insides".
Situation Five: Engorged Dumpsters: Hospitals probably discard enough food to feed ten Third World countries for a year. So please make sure your child is going to eat that specially-ordered fruit tray. When it arrives from the cafeteria, and your child pokes at it with a finger, then declares, "I'm not hungry anymore," I feel my bile rising. Especially when the parent leaves and returns with a bag of Doritos or Reeses' Pieces, which the child promptly devours. If you don't think your child will eat it, please don't order it. But if you do, leave the cellophane wrapping intact. That way I know it hasn't been coughed on and I can sneak it off the meal cart later and eat it for my midnight snack.
Situation Six: Chuck Norris-in-Training: Another RN role is resident punching bag. I've been spit on, punched, kicked, and eyeball-gouged. Most parents are good about limit-setting, but others say, "Honey, don't hurt the nurse." To which the kid smiles and tries to connect with greater force. The mother smiles helplessly and shrugs. One night a lady actually said, "Don't hit him in the face, darling. That's painful. Hit him somewhere else." Glad I brought my athletic cup. Often I have to be the bad guy, and discipline the child, which is awkward at best. I understand the hospital is a stressful place, but just because your child's sick doesn't mean he can break my nose.
Situation Seven: Magical Thinking: I've been starting IVs for thirteen years. It's a precise art. Some kids are easy, some near impossible. Searching for a vein under a toddler's chunk can be like finding a needle in a haystack. I can't see it, feel it, or decipher whether the vessel curves or has one-way valves. Couple this with trying to restrain a two year-old who is hysterical, and the IV-starting process becomes a nightmare. Still, many dads will say, "It's okay, bud. He'll get it on the first try." This is compounded by a grim stare that implies, "You'd better not dig around or miss."
This drives me nuts. By saying this, he's making a liar of himself if I can't start the IV. It also makes me look incompetent if I can't accomplish something that's extremely difficult. His naive declaration has increased his child's stress by decreasing his trust in me. But still he keeps saying, "He'll get it this time, or else," and I keep jabbing with the needle, trying to jimmy it into a vein the size of a hair strand. When it finally slides in, proving that miracles do happen, my relief is withered by the dad's obstinate grumbling that "The IV people here suck."
Situation Eight: Knowledge Deficit: Remember that nasal swab? How could you forget the way your toddler shrieked when a nurse shoved a wiry Q-tip down his nostril? Well, the result was conclusive: your child has parainfluenza virus. This means that the respiratory illness is viral in origin, not bacterial. In other words, antibiotics won't help.
Antibiotics work by puncturing a hole in the bacterial cell wall, causing the ectoplasm to seep out like a microscopic egg yolk. Viruses don't have cell walls. They have a completely different structure that is unaffected by antibiotics. So just because your child has a runny nose, cough, and sore throat, doesn't mean antibiotics will magically cure him. Overuse of penicillin and gentamycin leads to bacterial resistance, and soon a super-germ will arise that cuts through the populace like a Reaper's scythe. Standard treatments will prove obsolete, and a terrible epidemic will plague the world like the second coming of the Bubonic Plague. Then again, who knows, maybe the dreadful bacterium will be killed off by antiviral medications!
Situation Nine: Incompatible Roommates: The call light beeps. I grumble that I'm not a man-servant, then flash my most charming smile and hustle down to the room. Inside, a Middle Eastern man is saying his morning prayers while facing Mecca.
Oh no, I think. This is pool of gasoline awaiting an open flame. The mother next door complains that the man's "chanting" is waking up her son. Can't he go somewhere else?
The man is irate now. How dare she take away his religious freedom! A flurry of insults follows.
"He has bad B.O."
"She is a disrespectful wench."
"He looks like a Gypsy and might steal my purse."
"She makes funny grunting noises and maybe needs laxative."
I ask the man to perhaps pray elsewhere, or quieter, and he refuses, citing that the woman is a racist. She starts crying and hurries outside, leaving her ten year-old son alone in the room. He appears to be sleeping soundly.
Outside, the lady whispers that the man was speaking on the phone in a different language. She suspects he may be a terrorist. It's probably wise to get security involved. I explain that she is jumping to conclusions, and I can't call the police on a wild hunch. She rushes back into the room in case the man is harassing her son. A screaming match ensues. Now patients in adjacent rooms can't sleep, awakened by a barrage of insults.
I move the woman to a different room. This disturbs the family trying to sleep next door. After thirty minutes, the woman emerges, complaining that her neighbor "snores too loud." She demands another room. I'm tempted to move her into the utility closet. During her two-day admission, she is moved five times, always because her roommates are unacceptable.
Some folks simply aren't compatible. Others will trump up any excuse to get a room to themselves. The solution is to always move the problem family. Unfortunately, this causes collateral damage. If I had my way, I would move the patient into a comfortable room, then explain to the mother that visiting hours were over two hours ago. A nationwide study concludes that she would be much happier at home in her own bed.
Despite these frustrations, I genuinely enjoy working on the pediatric unit. The majority of families are wonderful. Human conflict is inevitable, and it keeps me on my toes. Rarely is my job boring or monotonous. Just the other day, a cute, funny kid wanted me to cook his microwave popcorn, tickle him until he howled with laughter, put a new dressing on his abdominal wound, and fix his unresponsive iPod. If I had been solely an Angel of Mercy, I couldn't have accomplished all this. And besides, the kid probably would have torn off my wings and used my halo as a basketball hoop.
I guess I wouldn't want it any other way.
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Elliott Andersson is a disturbed young boy with a dangerous psychic talent. His mother believes that he can make a victim's worst fears materialize in times of stress, so she keeps him locked in her house for days at a time. In a fit of desperation, Elliott transforms her home into a fiery vision from Hell, drawing the government's attention. A frantic chase results in the crippling of federal agents and detainment of Elliott in a maximum-security seclusion tank.
Elliott's uncle Chuck is an operative working for the Genetics Bureau, the agency that has subdued his nephew. His job is to interrogate mutants to see if they possess lethal psychic abilities. When Elliott is imprisoned, Chuck embarks on a moral roller-coaster ride, uncertain whether to protect his nephew or society. His nonchalant attitude masks an innate desire to save Elliott at all costs--even if it means leaving casualties in their wake.
An interrogation proves that he can alter reality, and the government decides to evaluate Elliott for use in military combat. Frightened, but with a strong will to survive, he resists the hands twisting him into a weapon. He is reeling on the brink of despair when his uncle forms a band of renegade soldiers to smuggle Elliott out of the Genetics Bureau.
After this daring escape attempt, Chuck and a group of aberrants board a skim-cruiser headed into an uncharted wasteland. Pursued by the military, an android stalker, and a vengeful government agent, their only hope is to reach a leper colony that may not exist.
Shadowing every victory is the suspicion that Elliott cannot control his psychic ability, and is unconsciously using it against the people he loves most.
Chuck must determine whether Elliott can be saved, or whether his psychic ability must result in his own termination. But at whose hands?
I arrived at my sister's duplex in ten minutes. Elliott's agenda had detonated like a nuclear warhead, laying everything to waste. The lawn had been replaced by a volcanic ulcer of lava, neon orange and rippling sideways. Steam sprayed out of the fire hydrant, hovering in a scalding fog over the magma. The driveway was scorched black, paved with charred cinderblocks. His illusions seemed so realistic I found myself stumbling back even after a sludgy wave of lava failed to scorch my shoe.
Ash coated the roof, as if dozens of corpses had been cremated there. Withered trees trailed smoke into the sky. Flowers in the garden became hands clutching fistfuls of air, their wrists submerged in mud. Scarlet light spilled out the windows as though the duplex had been converted into a forge.
Perhaps the most striking feature was a monstrous, forked tongue protruding beneath the garage door, flailing like a bullwhip.
Elliott's doomed, I thought, reeling on the threshold of Hades.
The air around the house was hazy, singed by heat. The odor reminded me of burnt waffles, which is what Velma had told Elliott "Hell smelled like". Amazingly, my nephew was now capable of olfactory hallucinations. He could produce scents to accompany his illusions.
Defying his horrific mirage, I tiptoed across the lava, greasy fumes puffing up to liquefy my vision. Tortured banshees wailed in my ears, hinting at condemned souls torn apart in the netherworld. With each step, chunks of scree belched up and became stepping stones so I wouldn't plunge into the inferno. On the other side, a sooty beach washed up to the front door. The sand was littered with razored shells waiting to mutilate my feet. A raven perched on the duplex's gutter, a lock of Elliott's hair pinched in its beak. Beside it rested a nest made of bones, its pink, squalling bird fetuses eaten alive by maggots.
The living room, too, had been warped by Elliott's raging psyche. Contrasting the childish panorama of Hell, it was transformed into a mortuary. The windows were colorful stained glass, fashioned with images you would see inside a church. The brown carpet was now a plush purple, the sour odor replaced by incense. A flickering TV flashed images of veiled widows mourning the deceased. Watching them turn to face the screen, their faces were identical. Each bore the stern countenance of Ms Horner, a schoolteacher who disliked Elliott because he was an "aberration". Organ music groaned from a radio, casting a pall over everything.
In the center of the living room sat a coffin on an oval dais, a red satin cloth drawn over the casket. Massive holes had been gouged in the lid, the way Elliott might render a plastic box containing his pet lizard.
Chilled, I stepped forward and heaved open the lid. Inside, Velma lay cloaked in her wedding gown, a frilly, white, moth-eaten dress. Shovelfuls of dirt smudged the gown, as though gravediggers had tried to bury her with the coffin unsealed.
Velma's hands were crossed over her chest, clutching a vidpager. She gazed up at me through jittery eyelids. Her face looked grisly, powdered with mortician's attar.
"I can't move," she sobbed.
"Shhh, take it easy." Tears crept down her cheeks. "What happened?"
"Elliott got mad because I wouldn't let him play with a neighbor boy. He created the burning bush, and I told him to stop. He threw a tantrum, screaming that he was a bad boy and was going to Hell."
"Where's Elliott now?"
"A military patrol came by and saw my lawn on fire, so they smashed down the door. Elliott slipped out the back. He jumped on his bike and tore off down the road."
"He'll be okay, sis."
"The guards had rifles."
"They won't hurt him. They're instructed to contain a juvenile, not gun him down."
"I'm afraid I'll never see him again, Chuck."
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