To Her ,With Love

I was in a dilemma for quite sometime.It was about whether I should write on what I just wrote. I was hesitant infact even now I'm not sure how to proceed. I was more concerned as to how my readers (which mainly comprises of friends and well wishers) will perceive me after reading this. But then I see the title of the blog it's ' My Ramblings'. That's what gives me encouragement as I write this out to my girl who I have to yet meet, because these are my thoughts and my ramblings.

Hey/ hi /dear
In this world of chats and SMSes where the English language has been battered beyond recognition and the meaning of conversation just lost with whatsapp,BBM (to name a couple.) Here's me making an attempt to to pen my thoughts in some coherent and 'proper' English I'm not sure how to begin,however let me begin as I tell something about myself.
I don't know who you are ,where you are from ( and no I'm not quoting any song you might have heard of ) but I know you are there.
So going by my looks I won't take your breath away , I'm no Clooney or Ian Sommerhalder for that matter and neither am I as dorky as I look on my blogger profile. (That's a selfie I took out of boredom.) ,but yes; I will surprise so much so , that you will be left catching your breath.You'll be so out of breath that you will become hypoxic and might require oxygen therapy.

They say first impression is the last impression , I'd beg to differ. My friends say I came out as reserved , arrogant and a hard nosed person when they first saw me or rather met me but when they warmed up to me, they say I'm not what they thought I was. Yes I do live up to the above mentioned adjectives occasionally but then name me one person who is perfect. My personality is something that will impress you once you get to know me. So you won't be impressed from the word go like the immediate effect of an anaesthetic drug but I'l be like an antibiotic ,you'll have to take the whole course to see the effect.

Talking of antibiotics reminded me that me being a nurse is an added advantage for you ,I can tell your temperature, pulse by just holding your hands. Now how cool is that !! And God forbid,but if by any chance you fell sick. You will have your own personal nurse to take care of you. Now that's a good deal right. One personal nurse always there for you. Seeing the skyrocketing healthcare costs it will be a win-win situation.Also I don't want appear tooting my own horn here but a few friends can guarantee that I am quite good at what I do. Not that I would ever want you to be sick.

Also you might be a fan of dance shows and dance movies, yea I can watch them. And you might have some of the most graceful dance moves but I dance squat. Picture a guy getting electrocuted,yea that would be me ,while dancing. I have a couple of friends whose dance moves will mesmerize you and they can vouch for me that I have two left feet when it comes to dancing. So what if I can't dance ,you can always teach me and believe me I've always been a good student. But even if you don't dance, we can learn it together.

I am a vociferous reader. I read anything , from coffee table books to fiction even the news that is on the paper bags made of newspaper. So you won't be needing to watch news.As a kid too, I loved reading so much that I had made a slit in my school blazer, adjacent to my inner chest pocket to accommodate an extra book ,as our weekly allowance of one book was insufficient for me. So you can understand my relationship with books.

I can cook a mean dish of chicken sometimes. It's only sometimes as,  it's not always that I make a lip smacking gastronomical delight, it's a series of hits and misses. So hang in there and you might still get something that I call as 'the taste of a lifetime' when I'l reach that zenith in the 'art of cooking.'

Movies ,I rarely miss one. I watch even the boring ones and with fifteen minutes into the movie , me and my crazy friends are raring to leave the theatre. Though for records sake I have left the theatre only once. Also ,to be frank I have to yet watch a horror movie in a theatre. (I watch them in my room on my laptop) Maybe I'm waiting for you so that we'll both watch it together, holding each others hands and getting scared together.

I know I'm not a perfect person.I have a number of quirks and I have no inhibition in telling them. I have anger at the tip of my nose. I am trying to shift it down to my toes though. I laugh at the drop of a hat. Na not really. That's an overstatement. I don't laugh that easily. Just the other day when everyone was guffawing at a joke. I just didn't find it funny. I just smiled. Laughter is rare. Also my friends say that I over think and over react but with you on my mind I'l hardly find time to think of anything else.What say. Also I am directionally challenged. My left is right and right is left and vice versa.And if we ever get lost in the wilderness then ,God help us.  I am also called the Lord of Destruction as I have a penchant for dropping or breaking things. So keep all the fragile things far away. Ask my roommate who is also my very good friend from college he'll give a better description.

As I was reading what I had just written, I realised that I was writing only the negative aspect ,as if I'm trying to pawn off a beaten down car.But that's not the case. I just want you to prepared for the 'not so good facets' as you discover the good aspect. Moreover I also don't expect you to be perfect ,yea I know you will have your own set of quirks and idiosyncrasies ,cause that's who we all humans are. Imperfect beings who are a work in progress. And all I hope is that you are worth the wait.

Hopefully yours .....

The Death Care

Let me at the outset apprise you all that this post is related to death and dead people ,so all who are squeamish, depressed or disgusted ; read no further and the rest of you go ahead and enjoy(If not enjoy,then just read.). Also let me add as an afterthought that I respect the dead and by no means do I intend to disrespect them. So here I go...

Death is something we all have encountered at one point or the other in our lives. For me it's a professional reality, and a hazard for the people I take care of in my professional life. Especially during my time working in the ER (emergency room) . And one thing we do as a nurse after a person dies is death care ,in laymens term 'bag em and tag em'. Well it's not as simple as it sounds.

I still remember as a nervous first year nursing I was called by one of my interns( now you see interns are the super seniors and the rank highest in the student food chain and first years like you all know are the zooplanktons and phytoplanktons of the student world. Yea the lowest. ). Anyway there was this patient that had died and the bed was screened from all sides with curtains. Unfortunately for me I was in the line of sight of the intern ,who called me to help her give the death care. That was probably my first encounter with a dead body of a person who I didn't know ,that too in an enclosed space. (Man !! Having watched so many horror movies , I had a flashback of some of the scary scenes.) I had a tingling sensation at the back of my neck , a chill spread all over my body and the hair on my hand were all upright. I would have died of a heart attack had somebody touched my shoulder at that very moment. However, after the initial shock, there I was warily looking around as I gingerly held the hands and tied the thumbs together over the stomach , then I bound the great toes together. (We do this because the body goes into ' rigor mortis ' ,which means the body becomes stiff after few hours.)The intern on the other side was busy removing the catheters and tubes. Finally we took a white sheet which we called 'mortuary sheet ' or in common parlance shroud and covered the body and secured it firmly by tying the head end and foot end. Then ultimately we 'tagged' the body ; i.e. we wrote the patient's name and number.
Finally it was all done. I returned tired and famished to my room after duty but still I couldn't shake off this weird feeling of being watched by someone, as if someone or something is there behind me, it sort freaked me out. This unexplainable cloud hovered my whole being for quite some time ,something akin to a bad hangover.Thankfully after a couple of days one fine morning all was back to normal.
Well after that experience as long as I was a student nurse I didn't give death care I would just scurry off or appear busy. But that was eons ago almost like a lifetime back when I was a novice and wasn't responsible for some ones life. As  I mentioned earlier that I worked in the emergency and have seen many deaths, I have lost count of since the first one. Many have come and gone whose mortal remains were deftly 'bagged' by my now adept hands as their spirits left their corporeal self for the other realms.

Life is all about hits and misses and so is death you can cheat death once or twice but ultimately it catches up with you. And since we are talking about death and all ,let me narrate an interesting near death incident where this patient came unconscious ,no respiration ,no heart rate , most probably in respiratory arrest. He was immediately intubated ( a tube was placed down a throat connected with a bag to pump air into his lungs.) Then one of the doctors checked the pupils , they were pinpoint,(pinpoint pupils is a classic evidence of opioid poisoning), and the history of the patient also corroborated the fact that he had opium overdose so he was given the antidote 'naloxone' . You won't believe what happened next. Here was this guy with tubes in his mouth , not breathing on his own and unconscious at that. On injecting the the antidote this guys just gets up with a bellow and and pulls out his ET ( endotracheal tube) and the tube in nose ( Ryles Tube) and removes his cannula before anyone could react. You can imagine the shock of all the people in the ER that day. Well ,that guy was darn lucky. I hope he mends his ways or there will be no next time for him. Then there are cases where a person who was just perfect a while ago , is now collapsed . Yea people, the uncertainty of it all. Life's like that.

However, I don't want to end this post with a philosophical thought, or something along those lines because death is something we know and it's a reality we all have to face.But I'd like to add that , Yes , I might have been perturbed and distracted with death in the early phase of my professional life, but as time has passed by I have understood that it's an inherent aspect of my work and I have to do it with the same sincerity and professionalism with which I deal the other aspects. Like they say 'it comes with the territory'.

 

The link for the pic    

http://www.google.co.in/imgres?imgurl=http://i.telegraph.co.uk/multimedia/archive/02450/PATHWAY2_2450532b.jpg&imgrefurl=http://www.telegraph.co.uk/health/elderhealth/9796968/The-Liverpool-Care-Pathway-to-dignity-in-death.html&usg=__aAu-bOz9WhO5zGqb8aT8i-BfPng=&h=387&w=620&sz=52&hl=en&start=7&sig2=HqbdDzTmqjtsWAomA6fWUw&zoom=1&tbnid=q5YmR8_bt6j0oM:&tbnh=85&tbnw=136&ei=NFtrUqiFI7COiAexqoGABw&prev=/search%3Fq%3Ddeath%2Bcare%26safe%3Doff%26sa%3DG%26biw%3D320%26bih%3D496%26tbm%3Disch&itbs=1&sa=X&ved=0CDMQrQMwBg

Follies of a fool!!!

Hey guys this is my first attempt at a poem ,so bear with me. Feedbacks will be appreciated.

            FOLLIES OF A FOOL

There was lonely fool,
He was as lonely as one can be,
He never loved nor was he ever  loved,
And lonely was all he could ever be.

So he sat one day and cried out loud
To the almighty God said he,
'How can I ,O God love thee,
When I don't know what love is,
Show me what love is ,cried he.

The fool searched high and low,
For love that no one did show
And his life seemed bleak,
For love was what he did dearly seek.

So one day after all his search with no success
Just when he thought it was a futile excess
He saw this person who met his eyes.

As time passed by,
Into days and then into months
They became as thick as thieves.
So the fool being the fool he was
Mistook the friendship for something else,
And lost what was something pure and selfless.

So off he ran to places as far off as he could
To seek again in places he thought he should
He went across the seven seas
Braced mighty winds and breeze
And reached a place where all find what they seek.

There he saw a maiden,
Who made his knees lead laden,
She batted her eyelids and shook her hips
And he skipped a heart beat and forgot to breathe.

The fool that he was couldn't stop himself
From doing what came naturally to him
Oh the follies of a fool.

He lost his heart his heart ,
He lost his soul ,
And was on the verge of loosing his sanity,
When out of the blue ,
She left him in a lurch,
And he was left holding an empty heart.

He cried and cried for endless days
Till there no more tears,
He was back on his knees ,
Back to where it all began,
With eyes pointed towards heaven
He cried , ' Oh God !!!
'Where art thou now'.

That's when he heard God say
"You have searched in all places you can,
But never once did you
look right next to you ,
where I was always there,
I loved you even before you were conceived,
I love you , I loved you and I will always love you,
I love you the way you are,
All you have to do is come to me."

Birthday Musings !!!!

I'm 26 years old.Yea right !! 26!!!  
I was painfully reminded of how old I have gotten,when a week before my birthday, it was announced in church that I would be celebrating my birthday in the upcoming week. So after church a couple of people from the youth were sitting together when one of them joked'Everyone is invited to Mani's 35th birthday'. To which I replied 'no it's the 31st'. And guess what? To my horror and dismay one of them (don't know about the others though) actually believed that I was 31 years. Dang man!! I had to spend quite some time after that in front of the mirror assessing my face from different angles.And all I could find were three lines streaked across my forehead(the after- effects of years of useless worries). Then there was this time ,a couple of years back when  one of the patients asked me how many kids I had. I literally laughed out loud. I mean granted I had an overgrown facial hair at that time and presently an invisibly receeding visible hairline but still guys we have to draw a line somewhere!!!
         I'l let you all onto a little secret. My date of birth is not the actual date. The thing is that, there was no official record of my birth. So for many years I had no exact date to celebrate. It was only when I was required to officially have a date of birth for my matriculation exams,that I was given a couple of dates to select from. I guess 8th October was easiest to remember. But that doesn't diminish it's importance as I eventually found out.
      And right from the beginning I had no special attachment to the tradition of celebrating birthday.But all that changed in college. Thanks to my friends ,my birthdays became a special event in my life. One which I could look forward to. It's mine to do what I want to do, regardless of what others have to say. So since then I give myself on this day first priority. But like they say 'excess of anything is bad' , which I found out the hard way when I was almost run over by two cars at two different places on my birthday just because I was giving myself priority or when I almost fell from the escalator being lost in my world of thoughts. But that's just me being me.                          

Anyways having celebrated my 26th birthday a couple of weeks back, made me introspect my life retrospectively. I realized my life has been one hell of a ride ,and not everyone gets to live it. It's been a life worth living,with amazing blessings from above. And I'm thankful for the good as well as the bad pages of my life,because that's what has shaped me into person I am today. But that does not mean, I'm all done with my life and I have reached where I'm supposed to reach. No!! definitely not. There's lot more to come. So life' I have a message for you', " Bring it on"!!!....

Sleep and Night Duties !!!

It's night time and the first thing that comes to your mind is the sleep. Oh yea the irresistible urge to fall into the seductively waiting arms of sleep.Most of you if not all of you will understand this allure of sleep.
Right from the start sleep had always been my Achilles heel.Nothing could pull me away from my time with her. There were times when I had slept across my bed with shoes on just because I was too lazy or tired and didn't want to waste my time with sleep.
My upbringing was in a foster home with 35 other kids. So we had a daily timetable to follow. And everyday dinner was at 8pm which was followed by a study session for around two hours usually upto 11pm and as usual my head would be deeply buried in my books, fast asleep. Time and time again being caught sleeping head down I developed the art of sleeping while sitting without nodding off. With only one drawback, I left my jaws hanging wide open . And one day I found my mouth filled with a fistfull of salt as I was caught sleeping during the study hour. Since then I might have left many habits but the jaw opening remains.
So you can understand my state of panic when as a student nurse I was posted in night duties that too for a week. Which meant 12 hours of work while the world slept. I was not prepared for this but there was no way out. And to top that our hospital had this strict 'no sleeping on night duty 'policy. At first I did all the work that was assigned to me.Then came first onslaught of sleep I resisted , then the second,I maintained a stoic appearance. Then finally the on the third onslaught I was standing there like a zombie with bloodshot eyes. I was actually standing and sleeping. Thankfully the nurses were always there to help me out.One gave me a dark corner with a table to put my heavy head down which was getting heavier by the second. And this other time I was given an empty patients bed with curtains all around.Yea as a student nurse I somehow managed the night duties thanks to the nurses.
But then came the time when I started work as a Registered Nurses. I worked in the Emergency Room along with ICU for over two years. So as long as there was work to do in the ICU or a patient in the ER, I was wide awake. Sleep was no where near ,but dang,  on a slack night I would sit on a chair fast  asleep in my old position. Yea sitting in a chair with my jaws wide open. A couple of times I have found biscuits and gauze deposited in my mouth by my fellow nurses as I wake up with a start.
One good thing though, in the night duty is the potluck dinner. The nurses on duty bring an assortment of food as we all share a sumptuous dinner in the middle of the night. It's like a mini picnic ;only the eating part.
Anyhow I just had night shift last week in paediatric oncology. And as I was taking a round around 2am I realized how peaceful everyone looked while sleeping without a care in the world.Well that's what sleep does to us. It just lulls us into a world without care full of peace and rest.
But as for me and my struggles with sleep they will continue. Though thanks to the place where I now work, I get to sleep in between for two to three hours during the night that too lying down on a nice bed. Life couldn't be better !!! Eh!! What say!!

The Intensive Care Unit

                  PROLOGUE
Joe was running very late. He had promised his girlfriend of two years the surprise of her life. A well thought out plan to execute the perfect proposal. And with lots in his mind he was racing through the rush hour traffic at neck breaking speed nearly missing a car .

Mark was working as a nurse in the local hospital for over twelve years. Happily married with three children,Mark had chosen to settle in his hometown after marrying his childhood sweetheart,who is now a full time mother.And today just like any normal day Mark got ready to go to work the evening shift in the ICU. But today he was running slightly late and on the way he nearly had an accident as a maniac on a bike almost had a collision with his car.  
                       JOE
Where am I .And whats that beep beep sound. Why can't I move myself. Am I dead? No!!! that can't be. I can hear voices talking in hushed tones.The last thing I remember is the blinding glare of an oncoming vehicle as I was riding my bike.  And that jarring alarm again. What's that.....Am I floating....  
        
                    MARK
Patients assigned today bed 3&4. Ok let's see. Bed 4 , Joe a  25 year old male patient with history of road traffic accident on the ventilator. Oh oh a busy shift today then huh!!! There goes the ventilator alarm again. Seems the patient is awake. Inj. Midazolam 4mg stat.Sleep away...

                 JOE
What's that gurgling sound.Cough! Cough!! Oh what the hell!! What is going down my throat. Ssss!! What's that sound. Thank God it stopped. And as I  try to look at myself. Which is difficult as it is with this darn thing around my neck. I see tube coming from my nose another one in my chest and a tube for my pee.I see this machine right next to me making a slight huffing noise along with a hum as it tries to take air in and out my lungs , With tubes going from my mouth and into the machine. The gentle whirr of this thing next to my bed and the soft beep beep made me realize that I am in trouble ,deep trouble. Only the regular beat of my heart which the monitor showed in the form of sound gave me a reassurance albeit a weak one that for the time being I am alive.
                     
                       MARK
Well , let's see the orders. Hmm suction PRN(whenever necessary), sides q4h(four hourly I),IV fluids,ok on inotrops too. So blood pressure also to be maintained. I have to change his sides and giveback care too. It's definitely going to be a hectic shift. Time to  suction him. I hope this kid survives. If not hang in there my friend till my shift ends. Thankfully my other patient on bed no.3 Mr.Smith is stable. He is on some oral meds.So not much to worry about him. He will be shifted out of the ICU tomorrow anyway.

                      JOE
As I come slowly out of my drug induced slumber. I see this nurse talking softly to the patient next to my bed who seems to be in a much better shape. Oh oh there goes the alarm again from the machine which I think is the ventilator as I overheard while the nurses were talking.Darn there goes that thing down my throat.That was  uncomfortable,but I think the nurse knows what he is doing. Anyhow!! Where are my parents?How is my girlfriend taking all this in? I hope I get better. There's a lot left for me to do.

                  MARK
Another half an hour and my shift will end uneventfully . Hang in there Joe for a couple of days and you might even make it.Just then the alarm of the monitor that show  heart rate of bed 4 goes off. I think he is crashing. I see the on call doctor rushing to the bed along with a couple of other nurses. Immediately we disconnect the ventilator and connect the AMBU (it's a bag like structure which we connect to a tube that goes down a patient's throat and squeeze it as air goes in ). One of the nurse started a CPR (unlike in movies this one with both hands) . The doctor gave a series of stat orders . Inj atropine stat,inj adrenaline stat blah and blah which were immediately followed . As we all frantically made a joint effort to save the kid.One of the doctor said it's a VT (ventricular tachycardia- an abnormal heart rhythm which can be corrected by giving shock) on the ECG/EKG(It's a waveform representation of the heart beats). So we brought the paddles from the crash cart ,charged it ,shouted all clear and gave a shock of 300 joules.No effect,so the CPR continued.
 
                    JOE
What is happening ,I wondered as I saw a flurry of activity near my bedside. Doctors and nurses running around. Someone was loading injection into a syringe ,other was giving CPR,then there was someone I guess the doctor giving terse orders and finally the shock. It went for almost half an hour but it seemed a lifetime as I saw a bunch of people desperately trying to bring my heart back..... I stood over my lifeless body till I no longer could as I heard the doctor say 'time of death 8:15 pm' ....