HOSPITAL BED PERSPECTIVE

/ jonathanrobb / Leave a comment

My previous post detailed how I found myself turning twenty-six in a hospital ward. Happy birthday (Can you hear the slathered on bitterness and irony? You can? Good).

The experience was unanticipated and has been disorienting, but made even more surreal by that fact that I’m normally the one standing over the hospital bed rather than laying in it. I guess I should thank rhabdomyolysis for allowing me a patient’s perspective. I should, but I’m not going to.

When I chose nursing as a career I had only been inside a hospital three times: when I was pushed out into the world, visiting a sick cousin, and saying goodbye to my dying great-grandmother. Except for my birth, of which I oddly have little recollection, my other visits were short and superficial. I was there to be with family and largely ignored the hospital as a whole.

Therefore, when I came to nursing I came with virtually complete ignorance of the hospital system. This ignorance only became apparent during my first student placement; until this point I presumed the various television shows and movies I’d watched that had taken place in a hospital would have adequately prepared me. This was not the case. Apparently, liberties had been taken when writing those scripts.

My first placement consisted mostly of me learning where to stand so as not to be in the way. I soon mastered this skill. Eventually, I saw the overlapping cogs of the multidisciplinary health team and what my expected role was within them. A hospital can seem a chaos of doctors, nurses, pharmacists, physiotherapists, occupational therapists, cleaners, PCAs, patients, and visiting family members. But there is a pattern in the chaos and it wasn’t long until I knew where to go, what to do, and who to speak to; basically, how to be a nurse. Prior to this I had the skills – I could take blood, hang an IV, administer injections – but now I had the knowledge of how and when to apply them.

By the time I graduated and started working as a nurse the wards were a familiar place. I could recognise people by their roles, I knew what to do when a buzzer went off, how to placate a distressed patient, and the perfect place to stand so as not to be in the way (This skill still came in handy when a herd of doctors descended on one of my patients). Like any well worked in workplace, the hospital became commonplace and I could navigate its walkways with ease.

This did not prepare me to be a patient.

The first thing I noticed as I was lead into the emergency department with a patient name band around my wrist was the casual condescension of the staff. There was no intended insult in this; they’re used to speaking to people with little health knowledge, and often, with limited knowledge of the English language. However, with both medical knowledge and a strong grasp of the English language, the small and simple explanations I was given seemed only to patronise. I immediately scanned back to the multitude of conversations I’d had with patients, and prayed I didn’t come off so bad.

I received descriptions of my condition in language usually reserved for five-year olds. I itched to interrupt and explain that I knew all this, that I was a nurse and the equal of them. I didn’t, as I figured the intrusion into their well-meaning explanation would only serve to paint me as arrogant. However, when the natural segue presented itself, I quickly slipped in the fact that I was a nurse. The change was instantaneous. Suddenly, I was a person again, not a patient.

The next insight was of dependence. Even in my state of physical competence, I was dependent on the whims of the hospital. Food came when it came. If I wanted a shower I had to wait for towels. Doctors and answers appeared on their own schedule, not mine. And I waited.

Working as a nurse is a job of hectic tasks, a never-ending to-do-list that begins when you step onto the wards and ends when you handover with a breath of relief to the new nurse taking over. For a patient though, it’s one long day of boredom. You stare at the same four walls, bounce between the same time-wasting activities, and wait. You get excited when the food tray comes, not because the food tastes particularly good, but because it gives you something to do. You watch everyone rush, and you sit, and wait for the moment when they say you can go home.

In here I’ve seen how miscommunication between staff and patients serve to add to the cloud of confusion and unease. Patients don’t quite know how to phrase their questions and staff have no time to decipher their desires. Presumptions are made, things are missed, and the patient settles back and waits.

The other side of this coin however is how vital and appreciated the staff become. Whether the dependence is enforced or genuine, a helpful nurse is a godsend. A doctor who takes an extra minute to explain what the blood results mean gives a patient an afternoon free of anxiety. Simply having a friendly face and a quick laugh to break the tedium is a gift worthy of a bear hug.

What I hope to gain from this enforced role reversal is a better insight into what my patients are experiencing, and what I can do to ease their pain/anxiety/discomfort/boredom. I’ve been shown the other side of the looking-glass and the details reflected back have shown me the importance of small mercies and kind words.

Hopefully, being a patient will make me be a better nurse.

Thank you, rhabdomyolysis.

THAT WON’T HAPPEN TO ME

/ jonathanrobb / 7 Comments

This post comes to you from inside a hospital.

I turned twenty-six yesterday.

This was not how I foresaw my twenty-six birthday.

As a nurse I’ve come to terms with the fragility of health. When you see a patient die from a fractured hip, or a previously healthy twenty-eight year old women yellow with jaundice, you quickly realise sickness isn’t just for the old.

Most of us, understandably, fool ourselves into the mindset of, ‘That won’t happen to me.’ We watch documentaries of people just like ourselves come down with cancer, people of the same age, gender, socio-economic status, and race, and we still tell ourselves, ‘That won’t happen to me.’ We mentally scan our body for aches and pains, and when we find nothing we relax in the knowledge that we are, at least temporarily, invincible.

And despite my apparent insight into the illusion of health, I was still shocked when three days ago I stood over the toilet and watched as brown urine trickled out from me. I did the right thing and saw a doctor who took samples of my bloods, but I felt confident the results would be minor; that I would be fine.

Because that sort of thing wouldn’t happen to me.

And even when I got a call from the pathology clinic testing my bloods at eleven forty-five on a Sunday night telling me to go to emergency immediately, I still couldn’t shake the notion that it was no big thing. Sure, I’d go to hospital, and maybe they’d keep me for a few hours, but then they’ll send me home telling me to keep my fluids up and to take it easy.

Because that sort of thing wouldn’t happen to me.

This was three days ago and I’m still tucked away in my little corner of the hospital.

Let me back up and tell you how this happened.

A week ago I was talking with my brother who was telling me of an exercise boot camp he had enrolled into. Five weeks, three hours a week, improved fitness at the other end. It sounded good, and I signed on. Thursday afternoon found me grunting and swearing as I worked through push ups, sit ups, pull ups, planking, tyre lifting, squats, and a light jog. The workout was hard, my arms shook, my stomach tightened, and I felt a little sick. But you’re meant to, aren’t you? That’s how you know you’ve pushed yourself.

I wasn’t concerned despite the fact that for the next two days my upper arms and chest ached. I struggled to lift my arms higher than my head, groaned when I had to reposition myself in bed, and trembled when attempting to take off my jumper. I figured this was the repercussions of a very thorough workout.

Consternation came when urine the colour of cola-flavoured cordial streamed from my body. I opened my laptop and typed ‘brown urine, excessive exercise’, into Google, and quickly learnt a new term. Rhabdomyolysis.

Essentially what I had done was damaged the muscle fibres in my arms and chest to the point that the muscle cells died. Upon the destruction of these cells, proteins are released into the bloodstream. This is not where they’re supposed to go. What I was seeing when I looked down into the toilet bowl was the dead matter of my muscles.

The risk of rhabdomyolysis is that the kidneys are not used to filtering these proteins, and one, creatinine, can build up in the kidneys. Potential consequences: decreased urine output, kidney damage, renal failure.

Let me reassure you that at this point it doesn’t look like I will suffer from any of these afflictions. Although, for the record, the specialist told me he had never seen creatinine levels so high. I’m marking this as an accomplishment; you have to take wins where you find them.

So here I am, on the other side of the looking glass. From nurse to patient. From the lands of the invincible healthy to the wards of the acutely sick. From twenty-five to twenty-six.

And they say exercise is good for you.

I HAVE AN IDEA

/ jonathanrobb / 4 Comments

Story ideas are elusive things to define. I think the most repeated question writers must encounter is: “Where do your ideas come from?” And even though this question has become a cliché and the bane of writers during interviews, every time I come across an amazing idea/concept/character, I can’t help but stop, lower my book and wonder, “How the hell did they come up with that?”

In interviews, the writers always seem to struggle to come up with an answer that satisfies them. I think the reason for this is that writers want to create an answer that is clever and apt; but there is no clever and apt answer. The question would probably have to be delivered on a case-by-case basis for the writer to provide an accurate answer.

i.e.

Q: “In scene x with character y, how did you come up with the idea for character x to say dialogue z?”
A: “I read it on a cereal box.”

As you can see this process would be rather tedious and make for a long-winded interview.

But despite the logical answer most writers eventually give, “Lots of places,” the desire to know, to understand the fountain of greatness and where it springs from, is still there. As an aspiring writer, I can’t help but hunger to understand the workings of their minds and follow the track their synapses took to come to the amazing conclusion that is their piece of writing. The reasoning is a simple one: If I can understand it, I can replicate it.

Recently I’ve been looking over some of my old writing and found myself asking the question of where the ideas came from to myself. Time has fogged my memory enough that the exact moment of inspiration has faded leaving me in a dementia-like fugue about how I came to put those exact words to paper. But my weak long-term memory gives me the opportunity to answer the question of where ideas come from to myself:

Ideas come from lots of places. (Wait, there’s more). So many times it is a random string of events that results in an idea. It could start with the briefest glimpse I get of a man and a child on the footpath as I’m driving down the road. Maybe the boy is picking something off the pavement and the man is bending down to see what he’s found. And maybe as I’m driving past I’m not thinking about writing or stories, I’m thinking about the dessert I’m going to eat that night, but that fleeting images snags something in my head. The image sticks and dessert slips from my brain and I find myself wondering what the boy might have found. Idea.

The next stage to the answer is that ideas are usually more than one idea, they’re a mutated amalgamation of ideas. Maybe earlier that day I was shopping for dessert when I came across a metallic frog that when you click its belly it sounds like it’s croaking. (This item actually exists, my dad has it, but for the purposes of the example let’s say I found it at the shops). I remember this curious item and suddenly I know in my story what it is the boy has found. He brushes off the dirt to reveal a tarnished and beat-up metallic frog that croaks when you push its belly. Idea.

Now this is just the frame of a story, a starting place, but through this string of memories, moments, and images, a story idea is cobbled together. Questions come from this beginning: “What does the boy do with the metal frog?”, “What does the man do with it?”, “Will the frog become an animated spirit, whispering to the boy in the night, speaking of greatness in a croaky voice?” The answers to these questions are part of the story idea process.

And maybe at this point I want to insert a moral or meaning to the story. Maybe I know an elderly man who collects wombat paraphernalia, only now in my story the old man has a frog paraphernalia collection. And maybe the metallic frog was the first item he ever received, and suddenly the story’s about ownership and lost things. Idea.

The beauty of this demonstration is that anything can be story. Or maybe it should be everything is story. Every conversation, every freeze-frame image, every unique quirk, every memory, or smell, or taste can go into a story. These details are what make a story feel real and special and makes readers like me stop and wonder how they came up with something so original and perfect.

One of the things I enjoy most about writing is there is no such thing as wrong. Anything that is sticking to the roof of your brain can be jotted down, explored, and fed with creativity until it becomes something bigger that the original image of a boy and a man finding something on the pavement. It becomes plot, and interesting characters, and mythology, and a mini-reality put to paper.

Where do stories ideas come from?

Where don’t they come from.

POST-TURBULENCE

/ jonathanrobb / 2 Comments

I’m writing this as I sit in my empty new house. It’s been a busy few months.

I haven’t updated the site in a while for a few reasons. The first and most important reason is that I’ve been channeling my writing efforts into actual fictional writing. I’ve found with this site it’s easy to sate the writing appetite by publishing a new post. One click of the mouse and you’ve dispensed words to a potentially enormous audience. So in an effort to be more productive I’ve been working on some writing that someone else might want to publish.

Secondly, and as hinted at in the opening line, I’ve bought a house. It turns out the process of acquiring a home can take up a lot of your time. The search, the open houses, the negotiations, the meetings with brokers, realtors and solicitors. I was shocked at the cloud of stress that descended once the search began. But the good news is the house is bought (although still far from paid for), and the cloud is breaking apart, and as I sit in my empty house writing this it feels good to be a home owner.

Right now my house is like a blank page, waiting for words and stories to fill it. Empty rooms always feel so strange and incomplete, but right now it just feels anticipatory. Like the heaviness in the air before a storm breaks. I can’t wait to find out what stories unfold to fill these walls.

The final reason for the lack of writing is that I’ve been doing the artwork for a children’s book. I’m not the writer on this project, just the illustrator. Whilst I’ve always enjoying making art, I’ve never been commissioned for any project. When the opportunity came up I thought it would be brilliant. As with purchasing a house, I was unprepared for the effort required to create the artwork for a children’s book. I have sunk hours into sketches, drafts, and learning illustrator software. It resulted in a new found respect for anyone working in the graphic art industry.

The book should come out before christmas, all things going well. I’ll post more as it develops.

So, now that my few months of turbulence is winding down, I thought it only fair to post something on the site. In an effort to entice readers back I’ve posted a new piece of short writing which can be found in the writing page, or simply by clicking here.

In complete honesty, it’s a bribe. Take it. You know you want it.

DEALING IN DEATH

/ jonathanrobb / 2 Comments

I’ve been reflecting recently that a lot of my writing contains death. This is not a conscious decision. Death seems to worm its way into my stories like a recurring character in want of a cameo. And I’ve been trying to decide why I’m drawn to exploring this phenomenon. And I think I know.

The first reason is a rather simple one: I think about death a lot. This is not for any morbid reason. I don’t run fingertips over blades or stand on the edges of buildings rolling a foot over the corner. I’m a nurse. Death refuses to be ignored in my profession. Every time I interact with a patient who is wasting away I’m aware of death waiting in the background. Patients want to talk about it. Family members need to be consoled. Co-workers joke about it. This results in reflection on the nature of death, which in turn works its way into my writing.

The second reason is also rather simple: Death is dramatic. It’s an organic occurrence that shakes things up. It’s a way to test characters, to see their world view when confronted with loss. Death is a catalyst.

The reason I’m writing about death today is that I saw a patient recently who was thick in the absolute and utter realisation of her own mortality. This patient, let’s call her Pat, is a sixty-one year old woman with chronic leg ulcers. She has been in and out of hospitals for the past ten years of her life. She had been ill, recovered, and fallen ill again. And yet none of this was what triggered her sudden confrontation with the idea of death. It was seeing it in someone else that forced the truth of it into her mind.

Pat attended a doctor’s clinic for a regular review and saw another patient whom she had seen in the waiting room during previous appointments. At first she didn’t recognise the man. She though the woman with him was his daughter rather than his wife. It was when she went into the doctor’s room and found the doctor wiping away tears in an effort to compose herself that the connection clicked, and Pat realised that the healthy man from months ago had shrunk into the sickly old man she now saw in the waiting room.

Pat went home shocked. She sat in her empty house over the weekend chewing on the image of the man’s rapid decline. And when I arrived the following Monday she was scared, and desperate to talk to me about death.

So we talked. We discussed the obvious things first; the fate awaiting us all, the loss to ourselves and our families, and the misery of such a loss. And eventually we got to what really was bothering her: What was the point of it all? What surprised me most wasn’t the question, but that a woman almost thirty years my senior was looking to me for answers. And that I had something to say on the matter.

I told Pat that being aware of mortality isn’t a bad thing. It invigorates. It’s not a pleasurable notion to consider, but it forces you to acknowledge that you are alive now, and that that time is limited. It pushes you to make more of your time, and to appreciate the joys you get. I told Pat that I didn’t know what the point of it all was, or whether, in the face of death, our lives held a particular meaning at all. I told her what I knew: that in the face of no meaning, all you can work towards is contentment. That if you spend what time you have happy then you come away on top.

I had some form of an answer for Pat because I had thought about death. My profession meant that I couldn’t ignore the inevitable reality of it like most of us do, and I certainly did before nursing. We, as a race, are too skilled at pushing the knowledge that one day we won’t be on the earth anymore to the back of our minds. We cram it down into the crevasses of our brain and pile trivialities and day-to-day details on top until we can’t see it anymore. And we smile and think we’ve beaten it. But it doesn’t do any good down there. And for Pat, when the truth wiggled its way free and sprung to the forefront of her mind, she had no way to accept it.

Pat listened to my answers like an eager student. She smiled at my closing statement and seemed mollified. The haunted look wasn’t gone from her eyes, but she appeared to be in more control. She was contemplative rather than scared. And I felt shocked and proud that I had been the one to comfort her.

Thinking about death, and writing about it, had given me an answer. I don’t know if it was the right one, but it is better than staring into the void without a form of comprehension.

And reflecting on this, I think I’ll continue to write about death.