Sweet April

The first day I met you we laughed more than once. You were so pleasant and refreshing after enduring a long winter. The days we spent together were light and happy. I will always look back on the time we shared and remember your warmth and freshness. I so appreciated the love you freely gave. Your touch renewed and revived me. Your gaze gave me confidence and once again caused me to look ahead to future days. There were plans to be made and dreams to realize. it was your inspiration and confidence I drew from. You made me a better man.



We have met now some 47 times. Some of our encounters I remember vividly. Do you recall our time in 1985 when my son was born? I was warmed and bathed in a pride I had never before known. How sweet was that time. I often reflect on those moments we shared.



Baseball begins during our time. It is with you I hear that first crack of the bat and the ball popping as it hits the leather of a fielder's mitt. The smell of the grass and youth are symbols of you. Perpetual spring, freshness, and beauty are your traits. I love the flowers that adorn you. The sweet melodies of song birds feed my ears. Such beauty often stops me when I am out. I stand still and listen in awe to their hypnotic sounds. I remind myself how lucky I am to sense such things. I often wonder how heaven can improve on your days.



Our time has come to an end, on this, our 47th meeting. This year, along with the joy and beauty we always share, were tears we shed for the tragic loss of young people to traffic accidents. It was all a contrast of joy and sorrow, and love and grief.



Thank you April for sharing your familiar things. I will miss you and look forward to our meeting next year. It is with you I often begin things. Your memories give me the courage to try. Your warm days are a balm that heals a worn down soul. Today is our last embrace. We will part and walk away from each other, but I will hold your memory in my heart. It will mingle with my other memories of you and cause me to smile when I remember you. Goodbye April, until we meet again.



Until the next time

John Strain

Rules, Rules, Rules

Have you ever thought about how we are surrounded by rules? They are everywhere. Everything from laws to unwritten societal expectations, there must be a zillion of them.



We are taught as little children to follow rules or get into trouble. Observing rules is necessary to make society work and to ensure order.



Some rules must be followed to the letter while others can be broken without incident. Computer programmers must follow rules exactly or face failure. Writers can break rules of grammar and receive praise for their innovation.



Virginia Satir was a family therapist who talked a lot about rules in families. She made a distinction between types of family structure. She referred to family structure as being either an open or closed system.



The closed system has rules which are inflexible, inhuman, and arbitrary. They are not up for negotiation. There is a belief the rules must be followed at all cost. People have to adapt to them not the other way around. The rules do not have to make sense, they are not to be questioned, only blindly followed.



The open system makes more sense. Rules in this structure are flexible and exist to bring order and predictability to the family. A rule is a guide. Sometimes a situation calls for breaking a rule or altering it a bit.



Here are a few examples:

Bedtime:

Open system: "Bedtime is at 9:00, but you can stay up until 10:00 since we have company."

Closed system: "Bedtime is at 9:00 dammit, get to bed, I don't care if your grandpa hasn't been here for two years."



Career choice:

Open system: "Son, you can be anything you want to be and I will help you any way I can."

Closed system: "No son of mine is going to be an actor. We Smith's work with our hands, get that acting crap out of your head."



In open systems the love is unconditional, communication is direct, and people are important. In closed systems, love is conditional, secrets are held, communication is indirect and vague, and the family as a whole is more important than the individuals. The closed system sends messages like, "what would people think" and makes that more important than any one person's wishes. The closed system tries to project a good image even if underneath there is nothing but fighting and tension. You would be amazed at how many captains of the football team and head cheerleaders are from this kind of family. People in these systems are driven to achieve, but inside they may be a wreck.



The way you look at rules is greatly influenced by the type of family in which you were raised. Coming from a closed system, you may resent rules and find it hard to follow them. Folks coming from an open system see rules as a tool to be used not a mandate to follow to be loved.



Some rules I am OK with:

Traffic laws

Rules in games, I don't even cheat at solitaire

Health rules

Physics

Most rules in general which cover safety, assembly, and numerous processes like recipes



Some rules I hate:

Rules of political correctness - thought police

Do not remove this tag . . .

Subdivision rules from tight asses like, you can't have your garage door up or no political signs in your yard.



What rule do you break without apology?



Until the next time

John Strain

Crazy Day: Part II

Desperate times call for desperate measures.



The Screamer: Some things you get used to. While in college, I worked summers with Gene, a brick and block mason. We took a job at a local pig farm to build more pig pens. At first, the smell was atrocious. The smell of pig poop was bad enough, but the Missouri summer heat intensified the odor to something more akin to a boxing glove hitting you in the face. At first, Gene and I complained profusely about the pungent air, but as time passed, so did the smell to our awareness. Case in point, one day we were siting at ground zero of "piggy poo" eating our lunch. One of our friends stopped by and saw us. His comment was, "man, how can you guys eat with this smell around?" We looked at each other and laughed - the smell had lost its power over us. In the case of the screamer, however, no such tolerance seemed to be wired into my brain. The more she screamed, the more on edge I got. Thankfully, my behavioral modification training came through for me.



I devised a little treatment plan and it worked within about 15 minutes. I took a regulation squirt gun and filled it with Tabasco Pepper Sauce. Tabasco is a staple down here. I instructed a psych aid to sit with the screamer and every time she opened her mouth to scream, squirt a little Tabasco in her mouth. The theory upon which I was operating, was the screamer would associate a hot, uncomfortable mouth with the urge to scream. She would soon learn that screaming brought discomfort and not screaming brought comfort.



Just when things looked like they were working fine and the screams were getting farther and farther apart, the psych aid accidentally shot Tabasco into the lady's eye. She really started screaming then, only this time in pain. The attendant, following orders, kept squirting the lady in the mouth when she screamed. When I went over to check on the situation and to find out what all the yelling was about, it looked like a gang land hit in progress. The aid was shooting the screamer all over the place. The screamer was screaming wildly, even worse than before. Tabasco sauce was running all down her face. The situation was not without serendipity. Crippled for years, the screamer stood and walked. The Tabasco squirts in her eyes awakened muscles which had been dormant for years. It was a true miracle.



Amongst her screams were distinguishable strings of curse words along with words of surprise - "I'm walking, I'm walking." We helped her to the sink and rinsed the Tabasco off of her face and out of her eyes. Aside from what looks to be a bad sunburn, Ms. Screamer will be OK. The whole ordeal exhausted her and she slept the rest of the day. A day we spent in quiet.



OK, so none of the above happened, but I day dreamed it that way. Actually, the screamer continued her assault on our hearing most of the day. We have discussed ways of quieting her. Dick's sock idea was one. Duct tape was another. I leaned toward over medicating her myself.



Does anyone have a bark collar? I believe those in the dog business call them trainers. Somehow, a collar is fitted with a device which can deliver an electric shock when triggered by noise - a dog's bark. I would think, such a collar would work on people as well. I could do some research on it. Perhaps the study could correlate incidence of whiplash and collar shock. The article could be published in my penitentiary's newspaper. Well, on second thought, maybe not.



It also makes me wonder what kind of a geriatric patient I will be. I have a hunch I may be a grabber. Let me apologize in advance to any nurse I may grab in the future. We had a grabber once. The nurse victim was standing next to the gabber who was seated. Mr. Grabber had just been admitted and must have taken a shine to the buxom blonde nurse. He grabbed her right in the crotch. She let out a yell of the "I did not appreciate that" variety. She then proceeded to scold the grabber as he laughed in his raspy heh heh heh that only dirty old men have perfected. He jolted Ms Blonde right out of her professionalism. If this seems remotely humorous to you, believe me when I say, it was a lot funnier in person.



Enough silliness for this post, I must spread silliness elsewhere.



Until the next time

John Strain

Crazy Day

While it is still fresh in my mind, I am going to attempt to describe my crazy day. The day started innocently enough. I made coffee, surfed around the net, then went to work. Our census is higher than usual and my case load is nearly double what it is normally. Add to that a lady from a nursing home who screamed all day long. She let out a yell every 10 seconds or so. Only brief respites were granted to those of us praying she would contract laryngitis. AAAAAAAAAAAAAAAAAAAAAA!!!!!!!!!!! Try it at home. Yell out about 60% your maximum volume. Then pause for 10 seconds and do it again. If you keep this up, you are well on your way to recreating the soundtrack of my life today.



She was one of the lesser problems though, she was in a wheelchair and could not roll herself around and get into trouble like some of our other denizens. She had to settle for throwing her blanket on the ground to reenact the Sharon Stone courtroom scene from Basic Instinct. Sometimes I thank God my vision is bad, today was one of those days. So we have an immodest, screaming senior citizen. Add to that a man who is a dead ringer for Billy Bob Thornton's character in "Sling Blade." This guy is the same size and body type, but mostly, he had the voice. He sounds just like Billy Bob. Only our Sling Blade guy was not meek and gentle. He was agitated. He wandered and got into things not unlike a 200 lb 2 year old with an altered sense of reality and a bad attitude. His voice was loud and constant. He was the harmony for the immodest senior citizen's screaming. In addition to that, he required constant attention and redirection to keep him from trouble.



We refer to the patients as the community or the milieu. For a long time, our milieu has been quite manageable. Now, however, we have one of those difficult milieus that come around every now and then. Like a category 5 hurricane or triplets. This is the kind of group that tries the patience and skill of even the most seasoned staff. I worked 10 hours today, when I left, I felt as though I had been freed from a revolving door. I started the day putting out fires and never got caught up. I have paper work waiting for me when I go back tomorrow.



A routine day is full of obligations. Today threw a few more my way. Unexpected discharges, unexpected chats with family members, unexpected individual sessions with patients, unexpected complications to already difficult situations, changes in plans I thought were settled, more phone calls, faxing, copying.



It was one of those days when I would be in my office and need some information. By the time I got to the nurses station to get the desired info, I would forget what I was there for in the first place. Partially because I was stopped by several folks on the way and partially because my brain was fried. Phone calls, questions, pages, faxes, AAAAAAAAAAAAAAAAAAA!!!!!!!!!!!!!!!!!!!!! That was me this time.



I would like to tape some of the conversations I have with patients. One person in particular answers questions with questions. He tries to reverse our roles, asking me how I feel about something or telling me the subject I introduced is not important, we should talk about another topic. On a good day he is exasperating. Today, he is worse



I manage some laughs though to ease tension. Passing by one of the nurse's offices, I saw RN X sitting at her desk with her back to me. She sneezed. I said "bless you," using the Sling Blade guy's voice. She sneezed again and I repeated the words, "bless you." Then I added, "you're a perty lady." She nervously said, "why thank you" as she turned to see me, she wore a concerned look on her face. When she realized it was me she started laughing, then she threatened me. "You sounded just like Sling Blade Guy. You scared me to death."



So here I sit. Tired from a long day. Thankful I can walk away from the mad house. Grateful I do not have their affliction. They were there too today. I wonder how this day played inside their heads?



Until the next time

John Strain

Fun Times Ahead

I know it's Monday. When I get to the hospital, there is plenty of work waiting for me. All things being equal, I would rather not go to work. I was doing just fine with the weekend. It is much more enjoyable doing what "I" want than it is to do what "they" tell me to do. Still, I have grown accustomed to a roof over my head and food in my belly. Work seems to be a necessary evil. It's not all that bad, I enjoy what I do and the people I do it with, and I have fun just around the corner to keep me going.



As I mentioned yesterday, I am going to have a workstation built. Below is the drawing. I have ordered the material and in about a month, it should arrive. By my calculations, I would say it will be completed in mid June. I will do some before, during and after pictures when the time comes. This kind of thing is expensive, but very gratifying.











The next thing I have to look forward to is I have Friday off and we are going to Destin, Florida for the weekend. About two years ago Barbara and another friend Faye purchased one of those, "get a weekend in a condo and all you have to do is listen to our time share sales pitch" promotions. So for $89 we are staying two nights on the beach. The catch is we have to listen to an hour and a half pitch on Saturday morning. I have never done this before, so I will see if it is worth it. How bad could it be? I mean, the sand, the sun, spring break still going on, hehe.











Until the next time

John Strain