Cynthia Stock

An amazing author for your soul!

The Risk/Benefit Analysis

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The discussion of the long term effects of repeated concussions on football players seemed to peak with the Super Bowl. Prevention, signs and symptoms, progressive effects, and league responsibility became common topics heard in the media, the work place, and home. A question asked by some, stated as fact by many, involved career choice. For athletes who love the game, enjoy the adrenaline rush of competition, and have the talent to earn salaries beyond the imaginations of most, would they do anything else?

This quandary transcends high profile, top-dollar sports.

In 1971, my nursing professor, Rose Sandling, told a story about working in the Emergency Room. A window washer fell through a window. He rolled into the ER on a gurney. Without hesitation, Rose scooped both arms under the man to log roll him and examine his back for injury. Glass riddled his back and sliced her hands. This was years before gloves became an essential part of physical examination. Lab tests revealed the man had syphilis. Rose received appropriate treatment and continued her career. I never gave her tale a second thought.

The first time I stuck myself with a needle I knew it was “clean.” Still a novice on a busy day, I jammed an 18 gauge needle through my thumb and thumbnail as I hurried to draw from a vial of sterile saline admixture. It happened so suddenly I felt no pain, grimaced at the thought of pulling it out rather than the feeling. The experience taught me when I could afford to hurry and when I had to take careful, methodical steps.

By the late 70’s, the first cases of what became known as AIDs, appeared. No one knew anything about the disease except that once symptoms appeared, death followed shortly thereafter. Wearing personal protection at the bedside never occurred to anyone until many health care providers, me included, went home with traces of blood and body fluids invisibly stuck in cuticles, knuckles, and skin tears. I never thought about the risk of exposure to what was then unknown.

Jump forward fifteen years. I pushed a syringe into a sharps container so the next person to use the container wouldn’t come in contact. I pulled back a bleeding finger and an18 gauge needle. Hospital protocol during that period did not mandate testing of the employee, and the source of the needle contamination was unknown.

“Should I have myself tested?” I asked a friend who happened to be an infectious disease doctor.

“It depends on what you want to know.”

I grew up in the generation of free love, women’s liberation, female empowerment, and modern technology. I wasn’t promiscuous, but I allowed myself freedom of thought and action. I had been artificially inseminated before donor screening and regulations were instituted. And I had been a nurse before the age of gloves. Indeed. What did I want to know?

I obsessed about my decision. A limit existed between time of exposure and testing. What if I tested positive? What then? HIV. Hepatitis. Either meant a drastic change in my life and that of my son’s. Might this be one of those times when ignorance would be bliss?

I tested negative for all communicable diseases on the screening panel.

Last week I removed a line from the brachial artery of a man who had been anti-coagulated. His line leaked a serous pink fluid and a bruise blossomed around the insertion site up and down his arm. The line had to be removed. I lost count of how many times I had done this procedure. Cut the sutures. Apply pressure with 4 x 4s of gauze. Pull the line. Hold pressure. Hold more pressure. I pulled the 4 x 4s back to assess the site. It appeared stable. For five seconds. Then a fountain of pulsating blood sprayed my face. I felt the reflex blinking of my left eye to wash away foreign matter. I didn’t stop holding pressure on the arm, but flagged down a nurse walking by my room and asked for help. When he walked into the room, his eyes widened just a trace, just enough to share the shock he felt. I applied more gauze while he put on gloves. He took over holding pressure.

I hurried to the bathroom after grabbing a plastic “bullet” of sterile saline used by the respiratory therapists. Thoughts of my sight came first. I flushed my left eye until it felt clean. Then I looked in the mirror. Blood freckled my face. My bangs clumped from the wetness. For some reason, the spots on the bridge of my nose bothered me more than those on my cheeks and forehead. I scrubbed them first. My usually blonde hair remained pink-tinged despite a liberal splashing of water.

This time I didn’t hesitate to get tested. Chronic illness had landed the patient in our ICU three times in the past six months for congestive heart failure and gastric ulcers. I knew his cardiac history, his transfusion history, his social history, and felt confident about his test results. But. While I waited for official confirmation, doubt drilled its way into my head and the “What ifs…” infected my consciousness.

Such is the nature of my career. As a nurse, I bought a house by myself, raised a child, enjoyed some travel, and went back to school. The dangers inherent in my profession have changed. Some are more deadly. It doesn’t matter. I have no regrets. I am a nurse. I would do it all again.

 

 

Why does ED happen

The Cellular Connection

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On Monday if you had asked me how I feel about cell phones I would have come up with a terse reply. I hate to listen to the drone of banal conversation coming from the person next to me on the elliptical machine or the treadmill at the gym. I don’t care about trouble with the HOA. I don’t care about a son who can’t decide on a career as a director or an actor. I work out to nurture my inner peace, to smooth out the kinks in my soul from a job that requires me to navigate a relationship with life and death.

From a nurse’s point of view, thanks to cell phones I predict an orthopedic crisis of “Question Mark Spinal Curvature” caused by incessant curling over a cell phone to text or read a message. I foresee a Darwinian evolution where all our children enter the world prepared to text.

Today ask me how I feel about cell phones.

I had a patient die yesterday. It was not an easy death for her. It was even harder for the family. The woman’s adult children researched and found hope in treatments not available in a small town. They urged their mother to seek help even though it meant leaving home, leaving the things that made her special. You know the things: a work room filled with boxes of first drafts, a classic cookie press that has been in the family for years, a Singer sewing machine so old its parts are all still metal.

For love of her children she travelled several hours and agreed to a procedure with a potpourri of risks and benefits. Everything that could go wrong did go wrong.

After several days of watching their mother deteriorate, the children needed to go home and attend to their own health and home maintenance responsibilities. The day before their mother died I suggested they wait until a stable twenty-four hours had passed. She had been improving.

I started my next shift at 7 a.m. In less than ten minutes, I knew I needed to call them  back to the hospital. I dialed their cell phone and found they had gone all the way home, not to the motel where they, like their mother, suffered their own sort of displacement.

I knew their mother would die sometime that day. The thought of such a loss, handled long distance, tormented me with a sense of inadequacy.  Images of my mother’s last foray into the hospital, the fear of her suffering some catastrophe with none of her children present, haunted me. I had gotten to Mom in time to hold her hand, wipe her forehead, and take her home, frail, but alive.

Several phone calls took place between me and the children, the children and the doctors, then back to me. While we talked and planned, rationalized and apologized, the patient declared herself. Her kidneys failed. Her blood pressure required more potent pharmacological support. She stopped responding to me when I called her name. The most extreme efforts to maintain life began to fail.  The children requested only one thing. They wanted to say “good-bye.” I had told them some research supported the belief that the last sense to leave a dying person was hearing.

This time I called upon the cell phone, the villain in a world filled with too much information, too much noise, and not enough human interface.  We set a time for the children to speak to their mother.

I have big hands and find a cell phone so small and thin. To me it’s like holding a playing card. I have to concentrate to dial. I use mine so rarely it often loses its charge before I make one call. Mine is a scantily functioned Tracphone for the person with 911 calls in mind. My supervisor’s phone facilitated the last good-bye.

I called the children and put the phone on speaker. “We’re holding the phone to your mother’s ear.” Picture a frail octogenarian, skin gray, loose, with patchy bruising along her forearms. She seems asleep thanks to a continuous infusion of a sedative. All the facial features that make her someone’s mother are defiled by tubes and tape and devices. I realize the children left because they could no longer grieve for a stranger.

The words stuttered from a bad connection. But to me they conveyed a simple, beautiful tribute to a woman who created the art of two children’s lives just by being their mother.

“Thank-you for being such a wonderful mother. Thank-you for being there and teaching us how to be good people, to live good lives.  Thank-you for loving us so. I know you have just moved on and will be waiting for us in a place where we will all be together soon. I love you mom.”

I heard words I knew I might someday say to my mother. I sucked in a breath meant to hold back the tears struggling to break free. The tears won. I hoped the children didn’t hear and feel any burden from my sorrow.

“Here’s brother.”

From the phone came sounds of shifting the hand-held device that had become the connection to one of the most important times in the life of a family. A male voice announced “I love you, Mom.” Then it crumbled into sobs.

I have witnessed more deaths than I can remember. I held hands with a family in a circle around the bed of a dying patient. I stood by when families prayed. I caught a woman who collapsed when I told her that her husband died.

What passed between mother and children through a light-weight piece of black plastic felt no less real, no less painful, no less final. I felt the ultimate privilege of having shared such a moment with a unique family. I cried as if they were in the room, quietly so as not to diminish the enormity of their pain.

If you ask me today about cell phones, I will tell you a story about the power of a final connection, a eulogy echoing through space in hopes of finding one woman’s soul. The cell phone, a sacred tool in a mobile world. I never imagined it.

 

 

 

 

 

Why does ED happen

Yogi was never my favorite cat

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Yogi was never my favorite cat, just like I was never a cheerleader or the most popular girl. He replaced, Rascal, an extraordinary cat who thought he was a dog. Rascal roamed the neighborhood for blocks, but always came home when I whistled. He survived getting his head caught in a chain link fence after he trespassed and didn’t see the resident hound in the yard. When the dog charged, Rascal ran without looking and jammed his head through the fence. It took several neighbors holding back the dog and animal control to sedate Rascal enough to free him. He lived several years after that. When it rained or was cold and he ventured outside, he sought refuge in the wheel well of our neighbor’s truck. He backed a Rottweiler down when the dog dared to amble down the alley behind our house. He never clawed the furniture, but left his marks on the crape myrtle in the back yard. I mourned Rascal when he died.

One evening I came home from work and started puttering around the kitchen in an apathetic imitation of cooking. My husband, who usually greeted me with a hug and a kiss, peeked around the corner of the hall. A kitten, mostly white with a black patch on one side, mewled and tiptoed across the carpet. His scraggly black tail curled over his back like the handle of a tea kettle, a trait he never outgrew. “I call him Yogi,” my husband said. “You’ve been so sad. And Tipper needs a friend.”

Unlike Rascal, who gifted me with rats and birds from his daily explorations, Yogi preferred the indoors. He hated automobile backfire and even hid when a visitor rang the doorbell. He had a delicate stomach and bombed us with foul flatulence if fed any dry cat food except Iam’s. I hoped he would outgrow the problem, tried a cheaper brand when he was several years old, but he became constipated and dyspeptic in one day.

Yogi thrived and grew to portliness. He limped for some reason, but managed to get around well enough. He never liked high places, never jumped on shelves, struggled when we picked him up. He preferred solid ground or my husband’s lap. He loved to be brushed and spoke the poetry of cat every morning when he got his brush-du-jour.

Our Tipper succumbed to wanderlust and ran away weeks after we moved to a new house. When we got Yogi a playmate, we saw Yogi as the feline father figure. Smudge was the Yin to Yogi’s Yang. Smudge loved to fly. He climbed the Christmas tree and jumped onto the entertainment center before he was clever enough to figure how to get down. He found a way to get to the top of the refrigerator via the washer and dryer. Sitting atop the fridge with a lion’s mane of thick, long white hair, he seemed to be inspecting his minions from his castle tower. Smudge investigated everything.

Thanks to Smudge, Yogi became a hero. One day, he hung around the refrigerator for no reason, or so I thought. I had been putting groceries away and not paying attention. When I finished, I went into the living room. “Come on, Yogi. Let’s go relax.” Yogi didn’t come, unusual for him since his beloved brush rested on the floor by the sofa. He began to yowl and cry and pace.

Worried he was sick, I tried to comfort him and pick him up. He wanted nothing to do with me and returned to his post by the refrigerator. He amped up his cries and stuck his nose to the crack between the freezer and fridge doors. “There’s no tuna in there for you.” But I opened both doors and out popped Smudge. He had slipped in, his white coat a blur against the interior of the appliance. I had no doubt Yogi saved Smudge from a cold, lonely death.

Despite their differences, Yogi and Smudge bonded. In winter they slept snuggled against each other. They fought and chased and cleaned each other. While catnip made Smudge crazy, Yogi ate it, but stayed docile and pleasant. When Smudge climbed the Christmas tree, Yogi curled up on the tree skirt.

My husband called me at work. “Something has happened to Yogi. I think he’s paralyzed.” He told me about putting out food and how Yogi didn’t go eat. When I got home, I called Yogi. He didn’t budge from his spot outside our bedroom door. I didn’t know what to do. We agreed to see if the problem resolved overnight. If it didn’t, we’d go to the vet.

We watched TV and worried. Then we heard movement. Yogi had dragged himself by his forepaws to the litter box. He couldn’t heft himself over the lip of the box. A trail of excrement followed our noble cat, who above all, had wanted to make it to the box. 

The next day when Yogi saw the carrier come down from the attic, he could not run away. He began to meow, a loud, screeching, desperate meow. Smudge ran to the back door to inspect what we were doing to his friend. When my husband put Yogi in the carrier, he hissed and Smudge lunged and bit down. Yogi continued to cry, and although my husband tried to shake him off, Smudge clamped down on his leg.

The vet knew us well, but he insisted on assessing Yogi’s condition. I sat him on the floor and called: “Come here baby boy. Come here.” As he had the night before, he dragged himself across the floor to me. The vet offered us extreme options he knew we would decline. “I just want to hold him when he dies.”

I comforted Yogi. “You have been such a good cat. You saved Smudge. I loved your tail. I would never let you suffer.” The vet injected Yogi with something; I never asked what. I watched his eyes go blank and shut. His breathing stopped.

Yogi was never my favorite cat, but he was the only cat who saved a friend, who inspired a friend to fight and bite for him, who enjoyed simple pleasures, and who, until his last day of life, wanted to maintain his dignity. I aspire to his courage and nobility.

 

Why does ED happen

Revisiting The End of Your Life Book Club

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I just finished a book called The End of Your Life Book Club. It’s one of those “reads” that is a life changer, just like psychedelic drugs changed the way the world looked. The story revolved around a woman dying of metastatic pancreatic cancer and her adult son. During the course of her illness, they used their common love of books and reading as a vehicle to grow closer during the process that will ultimately separate them forever.

This is not a book about dying. It is a book about living and the barriers that keep us from connecting as human beings. It is a testament to the power of the written word to express what often cannot be said. It eulogizes a woman who knew no limits when it came to living. It reminded me of my mother, who turns 90 this October.

In the aftermath of the book’s epilogue, I asked myself how can I change and better utilize every moment I have left. One of my biggest complaints about life is: “Too many books, so little time.” There are ways to squeeze in more reading time with little effort and big rewards.

But my thoughts turned to my mom. Although we live over 500 miles apart, I can’t imagine my life without her. And it makes me sad to do so.  When I am down, unable to break a habit of decades, I call Mom just to hear her voice, to hear her wise take on world events, or to listen to her analysis of the latest trends in sports. I admit I bristle when she talks about the state of health care. There is no one more critical of the health care system than someone who works in it. But let me pick it apart. I want Mom to be a “good patient,” because I know the challenge of dealing with those who aren’t.

Like my paternal grand-mother, Mom reads and reads some more. I told her about a book called Apostles of Light. This year in the author’s obituary, I read the awards and accolades she received for it and put it on my “to be read” list. Mom said she’d look for it in her small town library. To our surprise, the library found a copy. Mom called and asked if I knew what it was about. I imagined the flashing yellow lights of a caution warning. Apostles of Light portrays the erosion of civil rights of the aging, fostered by changes in health, changes in mentation, and family dynamics. When I read it, I shame-facedly told Mom I never would have recommended it had I known the subject matter. “Why not? I think it is so apropos.”

My shame grew from my own way of thinking about Mom. I worried about her driving and believed her health fragile enough that she no longer should live alone. I wanted to go to her doctors’ appointments with her, although I know she doesn’t need me. I forgot her evident pride when she bought her first car “on my own” at the age of 84. The term “assisted-living” crossed my mind, but seemed incongruent with the woman who is my mother. My intellect, drive, and need to excel didn’t come from just my dad. I grew up the witness to a mom who mom worked, went back to school, raised a family, got two daughters through college, and survived the loss of a man she married when she was only seventeen. I watched her heal and dare to re-explore the  world of dating. I celebrated her remarriage.

And when she lost her second husband, her courage amazed me again when she recreated a life just for herself. She learned to live alone, a change most people emotionally might not have survived.

What does this have to do with The End of Your Life Book Club? In the book, the characters say what needs to be said, either through direct conversation or through their discussion of books. Religion, faith, family values, the dark and light sides of life, both fictional and real, all are shared, argued, discussed, dissected by the man and his mother. When his mother dies, despite the profound intimacy they shared prior to her death, the man revisits conversations and thinks about what else he might have said. But at the end of the memoir, the reader knows he has said all that is important.

Mom knows I love her. But I want to tell my mom how I see her. She was a rebel before it was politically correct. She married someone who did not meet with everyone’s approval. She raised girls to be doers and thinkers and competitors before Title IX and the push to support women’s sports. She set the bar of expectations high, so high, I never felt I got there. But simply by trying, I went so many places. No matter how I drifted, she stood, the lighthouse in my sea of sadness and confusion. Just by being she helped me find my way.

Courage. Strength. Resilience. Determination. Intelligence. Indefatigable. Mom.

 

Six tips about Tadalafil

A Writer’s Petit Mort

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On days when I have no time to write, I feel a vacancy, a black hole in my gut so painful and endless it reminds me of the first time I was in love. His name was Dan. He had a New York accent diluted by years in the Midwest. He avoided the draft because the Army didn’t have combat boots big enough to fit him, and he restrained his hormone saturated body to perfection in a tight slim width of nylon known as a Speedo. I loved him because he admitted I was smarter than he and it didn’t frighten him. We talked every day. And a part of me shriveled and retreated into self-loathing if I didn’t see him or hear from him. I was 17 years old.

I use legal pads and pens or my computer to write. If I don’t sit down and hard copy the words and sentences and dreams that torment me in the early morning hours, I flash back in time and relive the feelings of deprivation  I experienced when Dan and I were apart. There is a longing, even a lust to decorate a page with thoughts I don’t want to forget. When I hold a pen, I think about linking my fingers between his. When I smooth a page before decorating it with loops and dots and t-crosses, I return to a time when I ran my fingers through his hair, around his ear, along his jaw. On the computer, the requisite light touch on the keyboard mimics how I teased his lips when he fell asleep in my arms on a bus trip. I knew every nuanced crease of his mouth. When I finish a scene I experience the surprise and awe of our first French kiss, a kiss making heat and tongue and wet the flavor-of-the-month.

I like to think I am mature now, married, secure, consumed by efforts to crush stagnation with generativity. My writing renders my age meaningless. Passion ignites me via a circle of energy passing through and around me. I wrote the last word to my novel and asked my husband what word should end my work. He chose the same one I had moments before in my work room. “Amen.” (So be it.) I made a hard copy of the last chapter, sent the full manuscript to g-mail for storage, and hooted and hollered and danced around the house. I thought of love and the shuddering final ecstasy of the act. I reeled from the concoction of words birthed from me in the form of a book. The French call it the petit mort. I call it writing.

 

Six tips about Tadalafil