GOOD-BYE BROWN EYES; YOUR STORY IS NOT OVER

BROWN EYES – 1997

I first met in her in mid-May, both of us in a strange place in a strange state of mind. Neither of us could adequately explain what brought us to that place, but her company there in that isolated pocket of sadness was an unexpected source of happiness, of companionship, and, eventually, guilt. But for those two weeks, she was my rock, my angel, and above all, someone who understood.

She had the most beautiful brown eyes. In fact, that’s what I called her: ‘Brown Eyes.’ Peering into them was as if I were at the edge of deep pool of still, dark waters, both calming and dangerous at the same time. There were several of us there, about twenty, but Brown Eyes was the only one close to my age; myself, 23, Brown Eyes, 22. We hung close to each other those two weeks. Practically every hour of the day.

Soon, however, we understood that it was pain, a deep hurting, that brought us to that place. Sometimes, a mind will work against its own, the cause of which could be a host of things, and will damage that soul, driving them down, causing pain, causing despair, madness, and, all too often, death.

Brown Eyes was an incredibly gorgeous young woman, both to the eyes and to the mind. She was caring, compassionate, prone to giggling, and a devoted listener. She radiated a warmth that I was instantly drawn to, a solace in a world gone mad.

Yes, we stuck together. We loved each other’s company, yet we were both afraid, both hurting. No wonder, then, that we were drawn to each other. But though our time together was brief, the days we spent together were full of closeness, friendship, and a kinship that I will never forget. Brown eyes and I used to have wonderful times together. We played poker, told hilarious stories about ourselves while we smoked cigarettes on the patio, we watched (and mocked) the nightly film, we ate together, and sometimes we were just together. We were as close as two young people could be in a place such as there. We shared a bond. We shared everything.

I remember once, one of the older residents, at one of our sessions, noticed the spark between Brown Eyes and myself. She remarked: “You two are going to get together when you get out of here, aren’t you?”

We both blushed. Brown Eyes managed a: “Well….” I smiled broadly, in the hopeful affirmative.

But Brown Eyes was hurting. Deeply. I so wanted her to get better, to see that she had value, to myself and to the world. Once, when we were journaling together, she had written ‘I am hopeless’ repeatedly across her worksheet. That crushed me. No one is hopeless. All life is precious.

I never discovered what brought her to that place, but her pain, so evident when it manifested, was so profound, so powerful, I could not help but be wounded further myself. I would find herself alone, trying to sleep, but crying. The suffering Brown Eyes would be curled up into a ball, clutching a Roald Dahl book, no doubt a book from her childhood, from a happier time. I went to her then, and felt her pain, stronger than my own. I did not understand it wholly, but I knew what it was like. I would hold her. Our little world, however, was constantly monitored. Such is the nature, the precautions the physicians must take, when two young people find themselves in the psychiatric unit of an old hospital on Seattle’s First Hill.

I remember what brought me there. I had been diagnosed with clinical depression only a year before. The treatment was still new to me, and I was battling old demons at the same time. Note to self: certain medications and alcohol are a terrible mix. My physician saw the signs as I collapsed, the ideations. Thus, this was how I met Brown Eyes.

Her eyes. Those deep worlds of both pain and compassion; never will I forget them. I remember the day Brown Eyes was discharged. She had given me her phone number. I will always remember this moment, the last time Brown Eyes spoke to me: “Please,” she said, “Do call.” I promised I would.

I don’t know why, but I waited a day. Perhaps I wanted to give her time to reacclimate with her family. Perhaps I thought it too early, for whatever reason. This is a regret that haunted me, ate at me, damaged me for several years.

I eventually did call her, the next morning after breakfast. The phone just continued to ring. I called several times that day, but no answer, no machine. The phone would just continue its incessant ringing. Finally, that evening, someone picked up. “May I talk to Brown Eyes, please,” I asked. The voice replied: “Who’s calling?” There was a sense of disbelief, and also inconvenience in his voice. “This is Andrick,” I replied, “A friend of hers from the hospital.” There was a long pause, followed by deep sigh. Finally, the voice, an uncle, spoke: “Brown Eyes is dead.”

My world collapsed. My time in the hospital was extended. I recall very little of the first few days afterwards. And yet, even in those dark days, I strongly disagreed with Brown Eyes: There is always hope. With the skill of the mental health providers at the hospital, and the daily visits from my psychiatrist, I improved. I wanted to improve. My father, whom I recently lost, would visit me everyday. Friends would call me, offering support. This is crucial to a recovery from a mental illness: a strong social support system and a team of dedicated professionals. And recover I did, more determined than ever to live. This was the first gift that Brown Eyes left me with: the will to push on, to live, to change the lens and see the world, and myself, as a wonderful place to be. This was her second gift to me: suicide will destroy those left behind.

RECOVERY

I was not in the hospital much longer. Though I had learned painful lessons, this is often how one learns and grows, especially in the assessment of those lessons. Pain is there to teach.

My psychiatrist was very skilled. He was both a physician of the brain, and a psychologist of human behavior. My Doctor was a rare breed then, and now, practically, an anachronism.

I have written on this before:

Now, these days, an unfortunate schism has happened: the divorce of psychiatry and psychology. But in 1997, I was very fortunate to have my physician and my confidant in the same office. Our visits were for an hour, several days a week after my discharge, as I began the healing process. We would discuss medication, but we would also discuss the illness, and the guilt.

Though I had only known Brown Eyes for two weeks, the bond we shared, in that environment, with someone my age who suffered a similar illness, was strong. My Doctor and I spoke of her extensively, and the choice she had made.

For that is what her suicide was: her choice. But the nagging guilt still gnawed at me; why didn’t I call sooner? What if I had said something different in our time together? What could I have done?

My recovery was strong. I returned to acting. The local theater community in Seattle was a strong source of support. I loved to perform for an audience, an emotional release you might not be able to tap offstage. I worked in hospitality, and rose to the position of Operations Manager. I switched to banking, where I eventually filled the same roll, with Chase Bank for fifteen years. I tried my hand at writing, and had a couple of books published (they were not very good, nor well received…. it turns out I am better at writing essays than I am at writing novels). At the tender age of 47, I made another choice, one of the best I have ever made. And so now I find myself in healthcare. Ironic, perhaps, but a profession I love nonetheless.

But those early years after the hospital were a steep climb. And yet, recover I did. Those who have recovered from a mental illness are aware that this is an affliction that may forever be a part of them. But, along the way, you learn skills, and ways to cope, so that each time the affliction attempts to return, you know what to do. Oftentimes, this involves one the hardest things there is to do: ask for help.

But there was always that little demon in the back of my mind, worming its way into my consciousness: that feeling of guilt. Eventually, as part of the healing process, you must accept that certain things are not your fault. There was nothing I could have done. Brown Eyes had made her decision. I understood her pain; I understand why she did it. Sometimes, the dark night of the soul is so powerful, one sees the only relief as oblivion. It was a decision I myself could never make. This was her choice. It was not my fault.

SUICIDE IN AMERICA

Suicide is the most destructive act one can do to those that love them. Survivors of those who have lost loved ones are often adrift emotionally and mentally, sometimes for years, or for the rest of their lives.

It is a difficult subject to broach, as it always stirs feelings of confusion, sadness, resentment, depression. Those who have lost loved ones to suicide oftentimes find themselves alone and misunderstood. Conversations can be awkward. The guilt can be overpowering.

Survivor’s guilt can lead to complicated grief, a kind of post-traumatic stress disorder than can degenerate into depression. Most of us have faced death, and we feel the hole it leaves within us. But to lose a loved one to suicide is a wound that is very difficult to heal.

Yet talk about suicide we must. Here in America, though we have faced profound problems for the last year and a half (to put it rather lightly), we have the resources and intelligence to address this problem. And a problem it is:

https://afsp.org/suicide-statistics/

In 2020, over 48,000 Americans died by suicide, making it the 10th leading cause of death in the country. On average, 132 Americans died by suicide every day.

Suicide is to succumb to the darkness, but it is also a desperate cry for help: a staggering 1.4 million Americans attempted suicide.

Suicide is the 4th leading cause of death of those aged 35-54.

A statistic that is absolutely heartbreaking: suicide is the 2nd leading cause of death of those between the ages of 10 and 34.

Every day, 22 American military veterans take their own lives. That is 1 suicide every 65 minutes. This number is appalling and unacceptable. No matter what your stripes, these men and women put their lives on the line every day, for very little money and insufficient appreciation.

THE LACK OF MENTAL HEALTH RESOURCES

Though suicide is obviously a profound problem in the United States, there is an unfortunate lack of resources for the mentally ill. At every clinic I’ve worked at, nearly every provider has decried the lack of options and availability for those who are on the edge. But, these physicians do their best. If one is depressed, and contemplating suicide, it is better to seek help from any Doctor than none at all. Every Doctor you will meet, every Nurse, every Medical Assistant; all of them will do their absolute best they can for you. I have worked among some of the best. They are dedicated to their craft, and to helping you heal as best as they possibly can.

Though we have come a very long way in understanding and accepting the existence of mental illness, we still have quite a ways to go. The social stigma still exists. The lack of awareness, though decreasing, is still present. There are often limited options and long waits to see a mental health professional. And, though I realize this is a subject of debate, healthcare in America can be egregiously expensive, and oftentimes, recovering from a mental illness takes in-depth and lengthy care.

WHAT YOU CAN DO

First and foremost, if you are having thoughts of suicide, and have made plans: CALL 911.

If you are depressed, or feel that life is not worth living: reach out for help. See a Doctor. See your religious counselor. Talk to a friend or family member you can trust.

If you are a survivor of losing someone to suicide, take care of yourself. It will take time to heal. As so above: reach out for help, wherever you can find it. Someone out there knows what you are going through. You are not alone.

In fact: Anyone suffering from depression or thinking of hurting themselves; please realize, you have value, you have a future, and you are not alone.

National Suicide Prevention Lifeline: 800-273-8255

Veterans Help Line, for those currently serving: 800-342-9647

Disaster Distress Helpline: 1-800-985-5990

suicidepreventionlifeline.org

https://afsp.org/ (American Foundation for Suicide Prevention)

https://www.nimh.nih.gov/health/topics/suicide-prevention/ (National Institute of Mental Health)

https://www.mentalhealth.va.gov/suicide_prevention/data.asp (for veterans)

https://www.militaryveteranproject.org/22aday-movement.html (for veterans)

https://youth.gov/youth-topics/youth-suicide-prevention (for teens and young adults)

As the saying goes: I would rather listen to your story than attend your funeral.

PROJECT SEMICOLON

Project Semicolon, stylized as ‘Project;’ is an American nonprofit organization known for its advocacy of mental health wellness and its focus as an anti-suicide initiative. It was founded in 2013 by Amy Bleuel of Wisconsin, who lost her father to suicide in 2003. Tragically, Bleuel herself committed suicide in 2017.

Project Semicolon defines itself as “dedicated to presenting hope and love for those who are struggling with mental illness, suicide, addiction and self-injury”, and “exists to encourage, love, and inspire.” A semicolon ( ; ) is used as a metaphor: the author could have ended the sentence, but chose not to. “The author is you and the sentence is your life.”

Today, one might see or notice people with the semicolon tattoo. Many celebrities have been seen with such a tattoo. I dislike it when entertainers use their positions of prominence to talk about politics, but if they are bringing awareness to mental illness, more power to them.

My heritage is far too Teutonic for a tattoo; hence, my necklace. I swear I’ve got a little Bigfoot in the family tree, somewhere…

https://projectsemicolon.com/

IGY6

IGY6, or: I’ve got your six (I’ve got your back) was inspired by project semicolon, created by military combat veterans to advocate for suicide prevention and awareness. One may occasionally see a veteran or first responder emblazoned with “IGY6;22.” The number 22 represents the number of combat veterans who commit suicide every day.

https://www.theigy6.com/

BROWN EYES, 2021

It was not until earlier this year that I accomplished something that I had neglected to do, perhaps unconsciously. I have lead an exciting and successful life; setbacks, here and there, to be sure, but with my new education and my new love of healthcare, I have a great future to look forward to, full of potential. But it occurred to me, 24 years later, that I never officially said goodbye.

It took a little digging on the internet, but I found it. I drove across town, and visited Brown Eyes’ grave.

There was an outpouring of emotion, to be sure, as memories came back. But there was also a sense of relief, of closure that I was not aware I needed. Her grave is on a beautiful, gentle hill, overlooking Seattle. It sits underneath a Japanese Holly tree, surrounded by trinkets and memories of those who had come by.

I said goodbye to Brown Eyes. I said I loved her, that I was not angry with her, and that it was her choice, but I wish she had made a different one. I imagined the conversation we might have had then, had she survived her illness, so long ago, as if we were two old friends, catching up on old times. I have absolutely no idea what happens in the world to come, but if we persist, in whatever form, after death, she will be the first person I hug.

Good bye, Brown Eyes! I remember your spirit, and our memories, both of which I will carry; your story is not over.

Dedicated to Hannah Elaine Harvey, 1974 – 1997

HIATUS

This will be my last blog post for the foreseeable future. Though I have loved writing my observations and thoughts on healthcare, it is time-consuming, and there are things I must move on to. All of you who enjoyed reading my posts, I can’t thank you enough. My website will still be there, and, somewhere down the road, I may post again. Thank you all, and do feel free to contact me.

Thank you all! Wash your hands! Get vaccinated! Take care of yourselves! Take care of each other! Bye for now….

A BAD ROLL OF THE DICE: THE MEDICAL DOUBLE-WHAMMY

Okay! I have a guest post today. It’s my brother Pedro (his name is Peter, I call him Pedro), and I asked him to share his experiences with a seriously bad roll of the medical dice. When he was about 11, in the 6th grade, he came down with a disease known as mononucleosis. He recovered, but six months later, he came down with another nasty disease known as meningitis. Dang! That’s some bad luck, big brother! So, he was kind enough to share his experiences of the ordeal(s). He was young, so many of his memories are hazy, but he clearly recalls the more painful moments during this time span of infections. Myself, I would have been about 6, so all I remember is that my big brother was home from school, not feeling well, and we had to have separate eating and drinking utensils for him. Then I probably played with my legos.

Both mononucleosis and meningitis are serious and potentially deadly diseases. During his narrative, I will jump in and do my best to explain what he may have been experiencing. Take it away, Pedro!

I left school one day, feeling kind of weak. By the time I got off the school bus, the weakness and fatigue had increased. I went to school the next day, but the teacher sent me to the nurses office, as it was obvious to her that I was feeling tired. I had also complained of a headache. By the time I got to the nurse’s office, I ended up barfing on her desk. Mom had to come pick me up.

It is widely known that younger adults, and specifically children, are more susceptible to disease. This is simply because their immune system has not been around long enough to develop antibodies to the various pathogens that love to call human beings home. Their defense mechanism is simply not yet developed, like the rest of their bodies. Most young children have 6 to 8 colds per year, according to John Hopkins Medicine.

Mom and Dad thought it might just be a cold or a flu, but I began to gradually feel weaker, I had a fever, no energy, and I had trouble keeping food down. I had a pretty bad sore throat. The weakness is what I remember the most. After a few days, Mom and Dad took me to the Doctor. My lymph nodes had begun to swell and actually felt like little rocks. I barfed in the Doctor’s office. Mom says I cried when they drew blood from me, but you ought to see my brother try and practice blood draws.

Shut up.

Later that day, the Doctor called to say that I had mononucleosis. I had no idea what that meant. Mom and Dad tried their best to explain it to me, but to me, it just felt like a really awful flu.

Unlike most diseases that infect children, mononucleosis typically effects young children in the early and mid puberty stages of life. Adults can definitely be infected with mononucleosis, but in those instances, the symptoms are usually mild to moderate. There is no vaccine against mononucleosis.

Yeah, like a bad flu. But it just wouldn’t go away. I started to feel better, but only gradually. I was out of school for almost two weeks. At the beginning of the second week, I started to feel a little better. My lymph nodes had returned to their normal state, I was no longer nauseaus, and my fever lowered back to an almost normal temperature. But I was seriously fatigued.

There is no specific treatment for mononucleosis. Like a flu, bedrest, OTC painkillers and a simple diet will do the trick. The disease itself is usually caused by the Epstein-Barr virus, one of the eleven or so types of herpes that can infect human beings (hey… it doesn’t have to be sex… my brother was 11…) In fact, about 90% of the world’s population is infected with the Epstein-Barr virus at some point in their lives, usually with no ill effects.

https://www.sciencedaily.com/releases/2010/12/101215121905.htm

The little virus is generally spread by contact with an infected person’s saliva, hence, it is often called the ‘kissing disease.’ My mother recalls the kids our age that lived in the house being sick just before my brother came down with mono, and if they were playing around, and shared a swig of soda pop, that might have done it. However, we all have to eat and drink, and we typically use utensils to do so, so Pedro could have caught it just about anywhere.

The virus usually attacks the epithelial (goop, mucous) that lines your alimentary canal (the passageway from your mouth to your pooper) in the pharynx, often causing a sore throat. Later, the virus goes to war and tried to replicate your B-cells (a lymphocyte, one of your system’s bodyguards). In most cases, your B-cells win this round, and develop antibodies, a sort of ‘memory’ of how to defeat this antigen (a substance, a pathogen, anything nasty that invades your body).

Viruses like human hosts. Viruses exist. Viruses can be easily transmitted. Some viruses are particularly nasty, aggressive, unpredictable, and opportunistic. Some of these viruses can kill over 600,000 Americans, even though there are precautions you can take to avoid them. If there is a vaccine against this virus, it would probably be a very good idea to get it. I don’t know what made me think of that. But I digress…

In the few days before I was supposed to go to school, my teachers started sending me stuff I had missed. I don’t know how people found out, but when I first got back to school, my friends were avoiding me like the plague. It didn’t last long, though, they could tell I wasn’t sick anymore, and I had a bunch of missed class stuff to catch up on.

Mononucleosis is not a reportable disease in Washington State, despite it’s prevalence to easily spread. It rarely causes serious problems, and it goes away with time. That’s not to say it’s an easy ordeal; like my brother said, it’s like a bad flu, only it last about two weeks.

I felt fine for a long time after that, with no lasting effects. But then, about 6 months later, I woke up Sunday, after going skiing on Saturday, with a sudden fever of 102 degrees. I felt cruddy and tired, worse than the mono.

Again, children and young adults have weaker immune systems. It was postulated, later on by his physician, that my brother’s mononucleosis, though he had recovered from it, was still doing lingering damage to his immune system as it rebuilt itself. The pathology is not well understood, but it has been estimated, by one study, that 1-18% of children who are infected with mononucleosis are susceptible to meningitis:

https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-11-281

I was no better, in fact I was worse, Monday morning. My parents took me to Children’s Hospital. By that time, my fever had increased, my neck was terribly stiff, and I had trouble looking at bright lights. I had no idea what was going on.

Well, I’ve said it before. Seattle is a good place to get sick. Some of the best healthcare providers in the world are here. The sudden, rapid symptoms my brother was describing immediately cued the physician that this might be a case of meningitis. The definitive diagnostic to test for the presence of the disease is the performance of a lumbar puncture, better known as a spinal tap.

I remember laying on my right side. The doctor put anesthesia on my back, but it really didn’t do any good. Dad had to hold my legs down so that I wouldn’t buck and break the needle off in my spine. I really can’t describe the pain. Incredible pain. It was more like an electric shock. Thankfully, the needle was in my spine for only a few seconds.

A lumbar puncture is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid (CSF) for diagnostic testing. The main reason for a lumbar puncture is to help diagnose diseases of the central nervous system, including the brain and spine. In my brother’s case, meningitis. I love the movie Spinal Tap, but after hearing my brother’s story, the medical procedure is not something I’d look forward to.

There are protective layers covering the brain and spinal cord known as meninges. There are actually three layers of meninges: dura mater, the arachnoid mater, and the pia mater. I’ll take anatomy for $600, LeVar. The word meninges comes from the Greek ‘membrane.’ Then: ‘itis’ is the medical term for inflammation. Hence: meningitis. This puts enormous pressure on the brain and spinal cord, causing severe pain for the victim. The entire human body’s entire nervous system stems from this area, and the entire body will be in pain.

There are a few different types of meningitis. The most common are bacterial and viral. Either one, particularly bacterial, left untreated, can cause septicemia: the poisoning of the blood, frequently fatal.

I remember when the doctor pulled the needle out. There was an odd little kind of wet ‘pop’ sound. As the doctor took the specimen to the lab, a nurse brought me an orange popscicle. They offered one to Mom and Dad, but they passed. I was still in incredible, intense pain. Evidently, the testing procedure did not take long, as the doctor returned before I had finished my popscicle.

The ‘good’ news was that my brother had viral meningitis, as opposed to bacterial. There are vaccines against this virus, and my parents were good about keeping us up to date, but sometimes the little creature will find a way. Viral meningitis will generally go away on it’s own. Some virus do not.

It’s most likely that my brother, with his immune system still rebuilding itself after mononucleosis, caught the virus while he was on his ski trip. On the bus, in the lodge, who knows. Viruses are opportunistic pathogens, and can spread very easily. It’s too bad that my brother was not wearing his ski MASK. And staying safe while speeding down the slopes, practicing proper SOCIAL DISTANCING. Because viruses are REAL and can easily spread if you don’t take PRECAUTIONS.

Hey! Is this my story, or your rant about Covid again?

Sorry. Go on.

When we got home, and I tried to sleep, I couldn’t. The pain was incredible. It felt like a third-degree burn all over my body. Cold beverages didn’t help. Aspirin didn’t help. I was in misery. The folks called the hospital, and the doctor told them that I’d pretty much have to ride it out. It sucked.

Had my brother had bacterial meningitis, there is a good chance he would not be here today, or, at the very least, be severely crippled. Children that are fortunate enough to survive bacterial meningitis face a lifetime of medical problems: memory loss, cognitive difficulties, difficulty retaining information, motor-skill and coordination problems, headaches, hearing impairment, epilepsy and seizures, paralysis and spasms, speech problems, potential blindness; all or none to varying degrees. I understand now why my mother could never watch the Jerry Lewis Telethons. To see a child suffer is the worst image possible.

Unlike the mono I had, this one didn’t last as long. I gradually felt better in about a week. But those first few days were fucking awful. It’s impossible to describe the pain. You cannot comprehend it until you have been through it.

So, back to school I went, and once again, I was way behind on schoolwork, and my classmates steered clear of me. But, eventually, life returned to normal.

Meningitis is a reportable disease, as it is contagious. How myself and my parents, and anyone else at my brother’s school, managed to not catch it as well is… just a roll of the medical dice.

Thanks Pedro!

THE ENDOCRINE SYSTEM: AND YOU!!!


Here are some more notes that I sent my parents last year, while they were in lockdown. This one’s about the endocrine system.
The endocrine system, generally speaking, uses hormones to give your body certain commands. It’s like another control system, like the brain and the CNS, but the endocrine system does things a little differently. A lot differently. To cluster things up even more, the endocrine system is involved in about every other system.
It should be noted, that when we talk about the various ‘systems’ of the human body, these are all really just arbitrary designations of convenience. It’s really all one system, working together, at the same time. Hopefully.
Well, this one is a little more wordy, and has fewer pictures. But it does have a more aggressive sense of humor. What can I say? The human body is hilarious! Also, these notes that I wrote to my parents should in no way be considered a reliable source of anatomy and physiology. I did get a lot of things right; there’s nothing in here that’s way-off-base wrong, as near as I can tell. But when I studied the endocrine system further, and continue to do so, I realize that it’s even more complicated than the smart-ass jumble of words that follow. So, hopefully you can learn a little something about the endocrine system, and get a few laughs, too.

A NEW MEDICAL STUDENT KINDA GETS IT RIGHT

Back in early 2020, when the world began to unravel, when I had just finished my first quarter of school, the lock-downs across the country had begun. My parents, I had both at the time, were considered vulnerable (right… remember when it only infected elderly people or people with compromised immune systems? It’ll go away in April! Like a miracle! Drink bleach!) and they were living in an assisted living facility. In fact, it’s only recently that restrictions have been relaxed, and I’ve been able to regularly visit my mother.

Anyway, I was having such a great time in school; I was particularity blown away by anatomy and physiology. The human body is an amazing machine. When our instructor first started lecturing about the roles that the cardiovascular and pulmonary systems play together, I devoured his words, scribbling furiously in my notebook. I read through the relevant chapters in our massive textbook. I was fascinated.

I wanted to tell my parents what I had learned, but that’s hard to do over the phone. So, I scribbled together these following pages and mailed my attempt to understand the human body off to them. They got a real kick out of it!

Needless to say, I was a green student, and I got plenty of things wrong in my notes. I think I got the actions of the diaphragm mixed up. I left out the other semilunar valve, the aortic valve. I did my best with the white blood cells, but I’m no biochemist. I got the test tube of blood wrong; white blood cells and platelets are actually in the middle, in a thin layer called the Buffy coat (seriously). There are also plenty of spelling and grammatical errors, and a few pages have this evening’s PB&J on them. Sorry about that.

If you manage to make it through my mangled scribbles of a new student barely understanding, and get to the part where I talk about platelets, you might notice something interesting. Platelets, the cells in your blood that form a mesh to stop bleeding, use serotonin in this process. This is the same serotonin that rattles around in your brain, affecting your mood, and are the primary target of most antidepressant medications. Huh. The human body’s kinda weird like that… Anyway, enjoy!

Thanks for reading! Wash your hands!

Sometimes It’s Good to Wait

“Patience is not the ability to wait, but the ability to keep a good attitude while waiting.”- Anonymous

Well, I THOUGHT I was in the final stretch of my preparation for employment as a Medical Assistant, but there is one more hurdle to jump through, one that I did not adequately see coming.

I have completed all of my academic requirements, with pretty darned good grades. I successfully completed my externship. I passed the National Healthcareer Association’s federal exam. I have been granted the certification of Certified Clinical Medical Assistant.

However, the merciless machine of political bureaucracy, that impacts us all on some level, is the last flaming hoop I have to jump through. And it’s being mighty obstinate.

Every healthcare practitioner in Washington State, from CNA up to MD, needs to be granted a license to practice medicine from the Department of Health, after they have completed their training. Fair enough. I suppose it’s a good thing that the government checks you out before you start treating people. However, Olympia does like to license things. I think we need a license to flush our toilets now. But I digress…

I finished all of my academic requirements, and was granted my credential, in the last week of December, 2020. I filled out the application and sent it off, with a money order for a paltry $145, on December 2nd. I paid for the application to arrive in Olympia on January 4th. My instructor had advised me to send it certified mail. Now, I hate to knock an agency that’s trying it’s best, and has been under political attack for some time now, but I’m not entirely certain that the USPS has their heart in it. I don’t know, maybe book a Tony Robbins seminar with the New York Jets or something.

My application arrived on January 6th. Good golly, Miss Molly. Olympia is about an hour drive from Seattle. If I had known that this was going to be the case, I would have just driven the application down myself. Scenic drive, too, once you get to the Nisqually Delta.

I called the Department of Health later that week, to see if they had gotten the application. They couldn’t find it. Well, alright! Things are going great!

Well, the wheels spun for a little bit, and I called Olympia on January 22nd. Bear in mind, I knew that the licensing was going to be a requirement, but I had figured about a week, at most. Wha-wha! Anyway, the courteous representative I spoke with said that they indeed had received my application, but had only started work on it 2 days earlier.

The representative told me that they were running very far behind, and that it will take some time. I asked him if it would take longer than 2 or 3 weeks. He did not hesitate when he said: Definitely.

I call the DOH every now and then, just to make sure everything is still going okay. The assure me that it is, but it will still be awhile. Every representative I’ve talked to has been extremely courteous and friendly. I guess you can afford to be when hold the power. The big smile says: “You have to wait, jackass! Anything else I can help you with? My pleasure!”

I know the Department of Health is busy. I know they are behind. Covid, you know. That virus, I tell you… Handy excuse for delays. Can’t put a man on Mars yet? Covid.

I suppose, also, that because of the need for healthcare workers (Covid), that there may be quite a few former healthcare veterans who are reentering the field. But really, you would think that the DOH might expedite things a bit for people getting healthcare licenses. Because, you know, Covid.

The DOH, of course, needs to do a criminal background check. That makes sense. But I can’t possibly imagine what else they are investigating about me. My grooming habits? My shoe size? Whether or not I remember cursive and how to hook up a dial-up modem? (Yes on both.) Whether or not I remember to put my pants on everyday? (Most, days, yes.) Are they going to call my Mom or something?

So I sit and wait. The school did warn us that this would happen, but I wish there had been some way to engineer things a little more expeditiously. I had assumed I would be working by about mid-January. That hope collapsed like a Seahaws offensive line, and Russell Wilson is lying dead on the ground.

Even though there is a high demand right now, it’s tough for a new Medical Assistant to find work. Naturally, clinics and facilities prefer experienced people. I’ve had a few interviews, and things went well, but they always ask when I think I’ll get my license. It’s not like they can put a position on hold while they wait for the DOH to press the right buttons. Healthcare needs help now.

But, everything happens for a reason. So they say. I’m not sure I believe that, but, as it turns out, this might not be entirely bad timing.

As it turns out, I could use the time off right now.

It’s no secret, and I’m not ashamed to say it: I have an anxiety disorder. Anatomy and physiology fascinated me in school, and I’ll write a post soon on what goes on in an anxious person’s head.

Over the last month or so, I’ve had several stressors develop. One is being unemployed, and living on my dwindling savings. Another is the licensing process itself. An anxious mind tends to do what’s called catastrophising, playing out, repeatedly, the worst case scenario. I got anxious with the DOH and their delay. What if they find something? What if I filled something out wrong? What if they tell me that I belong in healthcare as much as that loony lady from Georgia belongs in Congress? What if I can’t perform as an MA once I do get a job? My externship was fascinating, but not without its problems. That’s for another post, as well.

The main stressor is my father. He is 92, and has had several strokes recently. My family found out recently that he has weeks, 2 months at most, left to live.

I tell you, there’s a lot of work that needs to be put in when someone is checking out. Calling extended family members, contacting various agencies, that sort of thing. In the meantime, you still have to find a way to experience grief.

I could feel the spiral happening again, and for the first time in a long time, I experienced a panic attack. It’s a horrible sensation. I wouldn’t wish it on anyone. The brain is like any other organ in the human body; sometimes things can go wrong with it.

But, I have a very skilled psychiatrist, Dr. Dispensapill. With a small tweak of my medications, the anxiety has largely abated. It will still be present, along with periods of depression. These are normal as you watch your father die. But there is a difference between situational anxiety and depression and clinical anxiety and depression. With some good therapy, the anxiety has lowered dramatically, and I have had no further panic attacks.

And so, life goes on. It’s really not such a bad thing that I have this time off.

I’ve been going over the healthcare basics again. It’s surprising what I’ve committed to memory, what now comes naturally without having to think about it.

I bought one of those dummy arms so that I could practice my phlebotomy. My brother Pedro says he’s willing to be my human test arm. Er……

I’ve done a ton of writing and research, and will have plenty more posts coming.

And I’ve done that usual trick people do when facing the loss of a loved one: I have cleaned the HELL out of this apartment!

My head is getting screwed back on, and I’m feeling better. But I have grief to come. It’s good then, to have a little time off.

Make every moment count. Don’t be afraid to tell someone you love them. Wash your hands!

The Long Journey Is Nearly Complete

Well, how about that! I have passed the National Healthcareer Association’s certification exam, my next to last step on becoming a medical assistant. It’s been an incredible ride, to have success in an academic program in a year such as this. I’m not quite out of the woods just yet; in just over a week, I will start my practicum at a clinic in Woodinville, Washington. I am required to put in 165 hours of clinical time, the last bit of my training. This last step will be a massive challenge, but also a fantastic academic opportunity. I imagine I will learn more actually working with patients, in a clinical environment, than I have in any classroom. I am extremely eager to start! If all goes well with my practicum, the state of Washington’s Department of Health will grant me a license (well, after I pay for it) to practice healthcare. One more mile to go….

At that point, then, I will have obtained the credential of CCMA, or certified clinical medical assistant. There are four different guilds that have been granted legal authority to certify low and mid level practitioners; the NHA, the AAMA, the RMA, and the NCCT. All of them may certify medical assistants, with slightly different titles, but for all intents and purposes, all four are greatly similar. My certification focuses more on the clinical aspects of healthcare, whereas the others may focus more on administrative, or both.

The NHA exam was an absolute bruiser. It was 150 questions, multiple choice, and we were given 3 hours to complete it. That may sound favorable, but those details mask a brutal, demanding trial. I needed 2 and a half hours to complete it… There were very few black and white answers on the exam; most of them were abstract, so to speak. The exam would present you with a scenario, and you would need to pick the most relevant answer pertaining to the legal scope of practice, ethics, and training of a medical assistant. Only about 65% of students pass it on their first try. Not everyone in my class made it.

That was last Tuesday, the 10th of November. To be honest, today’s the first day in a while where I’ve felt I can actually relax. I was in a daze after that exam. I had a sense of accomplishment, sure, but I was also exhausted and burned out. I have been hitting it hard since my academic training started, January 7th of this year. When I was younger, college didn’t work out so well for me. This time, as an adult, I pushed myself incredibly hard. For the first time in my life, I have succeeded academically. At age 48. An old dog, a new trick.

So today, I’m allowing myself to relax a little. For about an hour, anyway. I played my beloved video games, something I haven’t had time to do in a very long time. I was holding off the advancing alien horde, defending Earth, before my work ethic/guilt started nagging at me again. After this post, I’m going to practice some more with the sphygmomanometer and read more about the endocrine system. There is no off position on the hardcore switch!

Be that as it may, this is all still very surreal. I still have the practicum, the last, largest hurdle to jump through, but I have come farther that I thought I might. I am thrilled beyond belief to be entering this field. I have come to enjoy the subject matter greatly; healthcare is like a job and a hobby to me. In this regard, I realize I’m very fortunate to have found something, later in life, that I enjoy, and, if my grades are any indication, something I show some aptitude for.

I have a cumulative 4.0 gpa for the entire program. I am on both the Dean and President’s list. I am a member of the American Association of Medical Assistants, and I have been invited to join Phi Theta Kappa. I find it odd that I am being recognized for my intelligence and dedication in a field that, until I started this program, was completely foreign to me. Yet, here I am.

I fully realize that I will be entering a field that is already dealing with a substantial burden. I’ll hit the ground running with the flames at my feet, but I feel more than up to the challenge. If I can contribute, in my own way, to helping improve peoples’ lives, the sense of accomplishment and pride may be more of an intrinsic reward than the paycheck.

It is also surreal, and humbling, to consider how far I have come, and how much I have turned my life around. It was not easy to get here. 2019 was an incredibly difficult year for me. I had already been on a long, extended medical leave from my former employer, for a rough, intractable anxiety and panic disorder. It just would not abate. Things collapsed for me in the summer of that year. I ended a 13 year relationship, as neither of us were happy. I had become addicted to opioids. Needless to say, this phase of my life was incredibly painful and difficult. It took me a few months to recover. It was hard to leave that relationship, and it was profoundly difficult to kick the painkiller habit. I didn’t sleep for about a month. But I came through. The anxiety disorder was still debilitating, however. Eventually, my skilled psychiatrist, Dr. Dispensapill, reached deep into his back of tricks, and tried a medication that is very rarely used anymore. Damned if it didn’t work, and continues to work. Since August of 2019, I have had no panic attacks, and no anxiety (well, plenty of test anxiety, but that’s situational, not clinical), and I am the happiest I have ever been. I returned to work, I enrolled in school, and I have excelled. There is no way I could have done that had my anxiety disorder still been present. Say what you want about psychiatry, and many reactionary people do, but I can say that it has definitely helped me.

My training started in January of this year. I had a only a vague, naive idea of what a medical assistant did. They just take vitals and answer the phone, right? Hoo-doggy! I could not have been more wrong. It turns out, they don’t let just anybody walk in off the street and start practicing medicine. You need a little training, first. I was not prepared, at all, for the amount of material they threw at me. My textbook is over 1300 pages long! It was a serious mental shock, at first, being in an academic environment for the first time in a very long time, and absorbing information that was completely new to me. I quickly settled in, though.

All of it was fascinating, all of it. I was expected to learn an enormous amount of information in a rather short time. I called it med-school light. But, as it I found it so interesting, I dedicated myself completely to this new endeavor. Every class was something new and fascinating.

So, in less than a year, I learned, and became quite proficient in, skills and knowledge that, had you told me I would have had just a year ago, I would have chuckled in disbelief.

The technical skills, though challenging, were a blast to learn. Palpating a pulse. Drawing blood. Using a sphygmomanometer. Calculating medication dosages. Giving an injection, wherever you need it. Audiometry. Assessing vision. Not only running an ECG, but knowing what the process meant. Lavage. Pediatric measurements. Microbiology. Laboratory procedures. Autoclaving. Sterile fields. Using the AED. A jolt of adrenaline (it doesn’t go in the sternum, Pulp Fiction style).

Administrative components, as well: scheduling, ICD coding, CPT coding, patient screening. And, just for fun, I can now tell you everything about health insurance you need to know. And yes, in America, it’s a bit of a mess.

Soft skills, also: the long history of medicine, the names that made a difference. I’ve now achieved a rudimentary law degree; healthcare is replete with legal and ethical obligations, and I’ve come to understand them fairly well. Basic psychology was part of the ciriculum. I’m more Jungian than Freudian. Learning terminology was brilliant, as well. Most of what you hear in healthcare has its roots in Greek and Latin (that’s another story), and I can practically speak the ancient tongues now. Terms that I’ve heard all my life; now I know what the heck that actually means.

Above all else, my most favorite subject, the one I found to be profoundly captivating, was anatomy and physiology. Brilliant, fascinating stuff. The human body is an amazing machine. We can talk about the different body systems (cardiovascular, pulmonary, endocrine, nervous, integumentary), but these are all just simply arbitrary designations of convenience. It’s all one system, working together, dependent on each other, all the time, constantly striving towards homeostasis. It’s an absolute miracle when you look under the hood. The more I learned of the internal workings of the human body, the more it both reinforced the concept of intelligent design, while at the same time rendering it completely absurd. That’s for another time, as well.

There were 3 things I learned in the program that are not only crucial to healthcare, but, I found, greatly applicable to my everyday life. The first was the concept of adaptability and flexibility. Plans, schedules… those are adorable, but when you are dealing with the sick and injured, or with life in general, things do not often go according to plan. Or ever, really. It is a skill to change and adapt to the environment around you while maintaining composure and dedication. Think of your feet, move to the next issue. The second thing I learned was the concept of empathy. Empathy was drilled into our heads since the first week of class. You never judge how a patient came to be how they are, you are there to help them get better. However, the concept took on a deeper meaning to me, the more I studied. As I mentioned, I greatly enjoyed anatomy and physiology. At the end of each chapter, of each particular body system, were several pages of what could go wrong with that particular system. Some of it was absolutely heartbreaking. Each of us in our own way is broken. My empathy developed into a deep sense of compassion. A lot of work goes into a human being. All life is precious. The third thing I learned, and kept to heart, was simply this: you never stop learning. I have found that the more I know, the more I realize I don’t know. There is no ‘done’ in healthcare, or any emerging field. There is always more to learn. I have developed an insatiable desire to learn more. Being a healthcare practitioner requires continuing education, but there is no need for the industry to mandate it to me. Though at this point my academic commitments may be complete, I intend to keep learning and studying. We have come a long way since bloodletting and leeches, but there’s still so much we just don’t know.

Near the end of my third quarter, on the last day of class, my instructor told us a story that finally hammered home the importance of what I was learning, what I had dedicated my life to. He was always a supportive and jovial man, but not at that moment. We were finishing our training in advanced life support. He told us that he wished someone who knew this material had been there for his son, who would have been 25 the following week.

Well, as you can tell, I’m quite excited to continue this journey. Thank you for reading, and thank you for letting me sound my triumphant, barbaric yawp. I’m excited, thrilled, and profoundly optimistic about where my life has now taken me.

Wash your hands! Wear the mask!

Andrick

Medical Terminology (and the ancient Romans were kind of jerks)

Well, the third quarter is underway, and so far it’s going great! I’m taking 2 courses; one is Pharmacology and Medication Administration (this is what the chemical is, this is how I will inject you with it) and Administrative/Clinical review (this class is a lot of fun –  the instructor basically sets up exam rooms, and we practice on-boarding patients; the instructor, playing the MD, then gives us a procedure to carry out with the patient), which ties together everything I’ve learned so far. We are also studying medical terminology, and where it comes from. Not sure why that wasn’t covered in the first quarter; perhaps they just wanted us to get familiar with the jargon before we closely studied the etymology.

Everything in healthcare seems to have a needlessly fancy name, but there’s a good reason for that. Just about every bit of terminology a practitioner uses is either Greek or Latin in origin. There is also the occasional eponymous term, a word named after the person who discovered/invented it (Pap test, Alzheimer’s, Tommy John surgery). I’m oversimplifying the history a bit, but a long time ago, when Hippocrates and his colleagues figured out that illnesses and diseases were actually environmental and not divine punishment (although that unfortunate concept still exists today), and began to actually study the human body, the ‘English’ of the day was either Greek or Roman. Many people in the known world (which was much smaller then, than our own) spoke one of these two languages; much like a good portion of the known world speaks English today. This way, a physician in Rome could correspond with a physician in Roman occupied England, who perhaps spoke a local dialect, and they would know what they were talking about. The practice continues today.

The word ‘doctor’ comes from the Latin ‘docere,’ which means: to teach. It also shares its roots with the word ‘docile.’ The thinking here is that one cannot properly learn and absorb information if one’s mind is not calm and focused on the matter at hand.

But, as it turns out, the ancient Romans could be a little flippant. The word ‘hyster’ comes from the Latin ‘hystera,’ the word they used for uterus (think: hysterectomy). The Romans believed that women got moody and emotional because of their menstrual cycle; therefore, the word ”hystera’ shares a root with the word ‘hysteria.’ Well, that’s charming. Sure, some women do occasionally get a bit out of sorts on their menstrual cycle, but that is not a character flaw or an indication of a psychological or psychiatric disorder. A woman’s endocrine system is simply in overdrive, if you will, forcing an ovum into the uterus. So there you have it. The etymology of medical terminology is fascinating, but glib, dismissive opinions are nothing new.

Wash your hands!

3rd qtr so far

Cute Animal Stories and Physiology

cat nursing puppies

The link above is a very cutesy video, but it had me reaching for my textbook.

According to this video, the mother cat had recently lost her kindle (I love collective nouns) and was, quite naturally, profoundly depressed. This animal foster family took the cat in, and found the cat to be needy, sad and distressed. It was only after the introduction of a litter of puppies that had lost their mother (what is this, a Disney movie?) that the cat came around.

There is an endocrine gland (that means it makes hormones) in the middle of your brain called the pituitary gland, answering to your CNS by way of the hypothalamus, a bridge between the CNS and the endocrine system. The pituitary gland is often called the master gland, because it does a lot of stuff, probably gets paid more. One of the hormones it secretes is called oxytocin. In mammalian females, oxytocin plays a major role in commanding the body for pregnancy, birth, and nursing. However, in both genders, oxytocin, by the very nature of its primary function, also engenders feelings of attachment, belonging, and intimacy. This cat was flooded with oxytocin, was depressed, and needed attention. When the puppies were introduced, the oxytocin returned to its primary role, and the cat became a surrogate mother. At this time, the cat’s pituitary gland produced another hormone called prolactin, and enabled the animal to nurse the puppies.

I’m not trying to reduce the powerful emotions this cat felt, emotions that would also easily occur in a human being, by explaining it away in technical terms. I’m not trying to take the ‘awww’ out of it. Just two things:

1: It is profoundly interesting that external, emotional events have a direct, physiological impact on how your body functions. Your emotions are very real, can be very strong, and, if you need proof, take a look inside and see the physiological process. If someone tells you to suck it up, if someone shames you for mental illness, if someone tells you to stop feeling a certain way, then they are A) ignorant of how the body works, and B) an asshole. “It’s all in your head!” Well, of course. Everything is. But that’s ontology, for another time.

2: It’s also profoundly interesting that we’re looking at two completely different species here. That’s incredible. That speaks to the strength of the survival instinct, but that’s for another time.

Well, I’m procrastinating again. Gotta hit the books. Wash your hands!

Fight or Flight in America as a Sociological Phenomenon

Crisis Fatigue

The link above is an interesting article. The physiological phenomenon known as ‘fight or flight’ exists in most living creatures, and is deeply ingrained into every human being. It’s a crucial component of the survival instinct, and has been for hundreds of thousands of years, existing as well as in our progenitor ancestors.

As simply as I can put it: Your 5 senses and your intuition will perceive a threat. This gets crunched in your consciousness, a poorly understood concept. This threat then gets sent to your amygdala, a part of your brain, for verification. This triggers a response in another part of your brain, the hypothalamus. The hypothalamus wears many hats (and we really don’t know how), but it kind of serves as a command center for a lot of things. In this sense, it triggers the fight or flight mechanism. Admiral Hypothalamus will activate your sympathetic nervous system, a part of your electrical wiring, which fires up your adrenal glands, which generally have about 8 cups of coffee in them already. Your adrenal glands will freak out and push the panic button, and secrete a number of hormones, mainly adrenaline, cortisol and norepinephrine. The adrenaline will ramp up your blood pressure and your pulse, and accelerate the actions of your lungs and muscles. The cortisol will adjust your glucose (stuff you get from food) to provide a burst of energy. The norepinephrine will flood your brain, increasing alertness and response times. Every other system takes a back seat, including rational thought. At this point, you’re ready to kick some ass. This goes back to the time when our ancestors had to face off grizzly bears. We don’t have to do that anymore (except for those idiots in Yellowstone who want a better picture), but fight or flight is very much with us today, in response to both physical (a mugger, a mean dog, road rage) or emotional (fight with your spouse, boss wants to see you, the principal called) experiences. Eventually, the response will abate, and you are left exhausted and weak.

Problems happen when people are under constant fight or flight, and the response does not get a chance to wear off. This will result in anxiety, depression, PTSD, heart problems, or all of the above.

I know nothing of sociology. However, this article posits the idea that American society has been living under a steady, constant fight or flight response ever since 2020 started. We are now suffering from the effects of 3 social phenomenons that are causing Americans a huge amount of stress. It started with the emergence of a virus we thought we may be able to control, but we were very wrong. Then, racism reared its ugly head once again, when George Floyd (and, let’s face it, he’s not the only one) was murdered by a police officer. This has triggered a massive social disruption of anger and violence. Perhaps worst of all, the federal leadership (dammit, GOP, I hate to say I told you so… I take no glee in his failures) has been fully exposed as incompetent, dysfunctional, and unwilling or unable to rise to these challenges. In fact, our President’s behavior has gotten worse, and it is clear that he is in way over his head. In the meantime, the violence continues, and the pandemic has now killed 111k Americans. At this point, things do not show any signs of significant improvement or healing. As with an individual, problems will arise when the fight or flight response does not get a chance to settle down. We are seeing that now, in the hatred, anger, depression, isolation, anxiety and general “I’m pissed off today” attitude in nearly every American. If things do not settle down, the damage to society, as with an individual, will be massive, and will take longer to heal than we can imagine.

Well, I’m just babbling instead of doing my homework. Sorry for the long post. I better hit the books. Wash your hands!