Weekly Wrap Up #2389

Thoughts for the week. Because thoughts posted on a Friday probably won’t be read and I can’t think of anything else to post on the Instagram. Even I’m tired of posting dog pictures.

– I finished “Suicide of the West”. I do recommend it. The author has an understanding of classical history that makes me wonder what classes I took in school. I vaguely remember learning something about the pilgrims and I think there was something about robber barons and Egyptians. Definitely pyramids. I remember pyramids. The libertarian in me mostly liked the book, but I’m probably not smart enough to know if I really do or not.cruise2

– After swearing I wouldn’t watch another one, I sat through most of the second Jack Reacher movie. Firstly, what the hell did Tom Cruise do to his face? There’s a weird Wayne Newton thing going on. Second, on what planet did someone think Tom Cruise would make a good Jack Reacher?

– Sticking with the movie theme, I finally watched “The Last Jedi”. Brace yourselves Star Wars geeks… it was unwatchable. Horrible. I’m out.

– On the golf front, I’ve spent approximately 83 hours at the range in the last few days. I’ve got the ball going in the air about 40% of the time. Only a few clubs have been thrown. To the ten year old having her first lesson, I apologize for the words you heard. Those are golf words and you’re going to have to learn them at some point.

– Here in Idaho we went from cold and wet to 100 degrees. To all the friends and family we convinced to move here… you actually believed me when I said we don’t have much heat until late August? <insert Dr Evil sinister laugh>

– Several hundred dollars in ice cream (don’t ask) sitting in the freezer is not conducive to the diet. If this is some sort of Zen/Buddhist/navy seal willpower thing, I’ve failed.

– I’ve been mountain biking with the hound quite a bit lately. It’s pretty hard to tire out a Vizsla when you can’t keep up with him (see ice cream note above). mtb dog

– I’m going down the vitamin/supplement road. I saw some stuff on YouTube, so it’s got to be legit. D, B12, apple cider vinegar. I chase it down with bourbon. Not sure which one is making me feel better.

– Been doing the time restricted feeding thing for a bit now. Down 10 pounds. If I could keep my feeding window from being mostly nachos I’d probably be able to ride uphill better. The downhill part is going well (something about mass + velocity).

– Mrs Troutdog and I officially cut the cable cord. Doing the streaming thing only. The interface sucks and I don’t have the patience to find anything to watch. The end result is that I rarely watch TV anymore. I’m not sure what I’m doing with my time now, but it’s not TV.

– I’m developing a serious love/hate relationship with old people. Some of them are the coolest patients and I could spend all day listening to their stories. Some of them are the nastiest human beings you can imagine. Generally, If they weren’t a nice person to begin with and managed to make it to 80+, there is no filter anymore. Don’t be one of those people.

Until next week (unless I win the lottery, turn pro on the senior PGA tour, get picked for Dancing with the Stars, or the zombie apocalypse)…


Dean Vernon Wormer: Here are your grade point averages. Mr. Kroger: two C’s, two D’s, and an F. That’s a 1.2. Congratulations, Kroger. You’re at the top of the Delta pledge class. Mr. Dorfman?

Flounder: [drunk] Hello!

Dean Vernon Wormer: 0.2… Fat, drunk, and stupid is no way to go through life, son.

Make Your Mark

I listened to a discussion the other day that I liked. It was centered around the thought that happiness is more closely related to acceleration than velocity. When an airplane is at cruising speed you never notice how fast you’re going. But you do notice it when you take off. It’s the relative change from low to high that we remember. On paper you may have every reason to be happy, but if every day is status quo and never changes… it’s easy to feel dissatisfied.

The moments we remember, the events that give us the feeling of happiness are those times when things are new and changing. Going on a vacation, trying a new sport or hobby, visiting a restaurant or museum you’ve never been to. If you’re not continually accelerating you may have an impressive velocity, but are you really noticing it?

Last week I had an encounter with a * patient that made me think. This gentleman was not from around these parts as the saying goes. He was from a country in a different hemisphere that very few westerners would even remotely consider visiting. When it came time to sign his discharge paperwork, he very carefully made an X.

This fellow had never had the opportunity to learn how to read or write. He did not know how to write out his own name. That brief encounter impacted me fmark2or some reason. It’s so easy to forget what a bubble we live in here in the west. Sometimes (very often) we take for granted how fortunate we are. Any why are we so fortunate? Because we won the ovarian lottery by being born here and not in this gentleman’s country. He had no options from day one. So many people in this country have every opportunity you can imagine, yet spend their time unhappy and complaining.

What do these two things have to do with each other? Nothing really. Just sitting here, marveling at how fortunate my family is and how grateful I am. Grateful that I have the ability to worry about something as trivial as daily happiness and what am I going to do to continue accelerating forward.

Today’s acceleration will definitely not include yardwork.

* HIPAA overlords, this is a hypothetical patient. Not real. Definitely did not happen. I made this up. Fictional. Please don’t report me.

___________________________________

Tyler Durden:   I know who you are. I know where you live. I’m keeping your license, and I’m going to check on you, mister Raymond K. Hessel. In three months, and then six months, and then a year, and if you aren’t back in school on your way to being a veterinarian, you will be dead…

Tomorrow will be the most beautiful day of Raymond K. Hessel’s life. His breakfast will taste better than any meal you and I have ever tasted.

The Lost Year

“Know what’s weird? Day by day, nothing seems to change, but pretty soon…everything’s different.” – Calvin from Calvin and Hobbes

This was an odd year. Not bad, just… odd. On paper there’s plenty of memorable moments that I’m very grateful for – completing my mid-life crisis career change, a big anniversary, a bucket list trip, travel to some new cities, rekindling my love of nachos  and questionable relationship with golf.

Looking back however, there were so many things that I didn’t do. I didn’t ride my bike. Or motorcycle. There was very little skiing or rafting. I didn’t take any pictures. I didn’t write much. Didn’t connect a whole lot with friends and family. Ignored the yard work. Ignored the gym. No real hiking. And worst of all, the grill saw virtually no barbeque this year.

When I look at those two paragraphs, I’m embarrassed. It’s a cliché, but what horrible first-world problems. It’s easy to forget how fortunate I am to have such trivial regrets. There is a large portion of the US, let alone the rest of the world, that can’t imagine having the year I had. Yet it’s easy to take for granted what we have and to let time slip by.

Looking ahead it feels like it’s time to reconnect. To realize that I’m way past the halfway mark of my trips around the sun. Nobody knows how many more you get, but it sure seems pretty stupid to waste them. It’s time to add some clarity to the filters that we apply to our day-to-day lives.

It’s time to say no to things that don’t add value to your life… Virtually everything on broadcast TV. Politics. Movie remakes and sequels. Being outraged at everything. Worrying what people think. Being afraid to try new things. To being lazy. It’s time to say no to pumpkin spice. And yams. Yeah, I said it. F**k yams. You can try to disguise them with marshmallows, but they’re still just nasty, mushy yams.

It’s time to say yes to travel and exploring. To being outside and skiing and rafting and fishing. To being back on two wheels and exploring trails. To being creative. To learning something new. To reaching out and maintaining connections to friends and family. To cooking and grilling. To more nachos. To exercising enough that I can eat nachos. To laughing.

Due to my job, I’ve spent a lot of time this year with people who are on their final trip around the sun. I can say with certainty that none of them wished they’d worked more, or spent more time watching TV. I suspect most of them wished they’d taken more risks. Experienced more things. Said yes more often. Engaged more with the people and world around them.

I was wrong about the year being lost. While at the time it didn’t seem like much was changing, at the end it’s given me a much healthier view of what’s important. I’m really looking forward to the new year. My single goal for this year – to minimize the number of days that seem wasted. To more often than not, go to bed and feel satisfied that I had a pretty good day. Seems simple. Harder in practice. Worth the effort.

On Compassion

I received a little recognition the other day at work for being “compassionate and caring”. This was funny to me since that’s certainly not how I see myself, and probably not how others see me. I like guns, teasing fish with badly tied flies, the Darwin awards, and generally have limited tolerance for people who repeatedly make poor life choices. How could I poscallbellsibly be considered compassionate?

Being an RN has lead me down an interesting road of self discovery. I find that I’m becoming increasingly more caring towards people in need, and simultaneously far less tolerant of general asshatery and poor decision making. On my floor we see some pretty terrible things. Horrible car accidents resulting in brain injuries that aren’t recoverable, strokes, spinal injuries, brain tumors with poor outcomes, generally some of the worst days of peoples lives.

When dealing with these patients, you’re reminded of how lucky we are – and how fleeting our time here is. You never know what’s around the corner. I’ve been extremely fortunate and can’t imagine what it’s like to be in their shoes. If I can do something to make the brief time I’m with them better, I do it. It’s a side of me that I didn’t realize was there. It makes me feel good and hopefully eases their burden a tiny bit.

The other side of the coin has hardened me. The repeat drunks detoxing, chronic users sneaking drugs into their room and injecting into their IV lines, pemtdewople who are convinced they’ve checked into the Fairmont hotel and expect to be waited upon, and the 400 pound patient on oxygen who’s eating a bag of Doritos and is pissed at me because I won’t help her waddle to the patio to smoke or give another dose of morphine.

For these people I’m rapidly losing my ability to feel sympathy. Life is short and you have a choice as to how you want to live it. Being a jerk is a choice. Treating others like crap is a choice. Making poor lifestyle choices… and then continuing to make them is a conscious decision. (Yes, I understand addiction and mental illness and its impact but a very large percentage of these folks are just generally not nice people) Knowing that the hospital and taxpayers will be dumping hundreds of thousands of dollars and days/weeks/months of care on someone who is going to check back in for the exact same thing before too long is hard to process sometimes. My compassion meter runs a little low some days.

I think that the reason I received that little nod at work is not because I’m Mr. Compassion, crying and empathizing with every patient who spilled their pumpkin spice latte, but because I treat everyone exactly the same. From the drug user to the VIP, I give the same care. As a patient, you’ll never know what my inside voice is saying. I think the trick to longevity in this job is finding an outlet so that inside voice stays inside.

As the old saying goes, don’t be a jerk to the person fixing your food, cleaning your hotel room, or caring for you at the hospital. You never know when their inside voice might become their outside voice.


“Well the jerk store called, they’re running outta you!” – George Costanza

 

What I’ve Learned

In my short career as a nurse, I’ve learned a couple of things. Mostly that it’s frightening how much I don’t know. It’s a very interesting thing to throw yourself into something that has such a steep learning curve, but with serious real-world consequences… I’m not sure yet if 12 straight hours being scared to death you’re going to accidently harm someone is good for the blood pressure. Anyway, I have managed to learn me a few things I thought I’d share. For context I work on a neuro-spine floor. Spinal surgery, brain surgery, traumas, strokes, seizures, dementia, Alzheimer’s.

  • Your mom was right – wear a helmet. ALWAYS. I’ve been guilty of this. It takes surprisingly little force to cause a life altering injury. Just wear the damn helmet.
  • It is possible to only pee once in 14 hours. Not recommended, but achievable with practice.
  • Drugs in large continuous quantities tend to be bad for you. Forget Mrs. Reagan’s failed campaign, every junior high class should be forced to take a field trip to my floor to see the actual impact of drug use. Whod’a thunk taking too much meth could cause a stroke? The official term for the resulting brain impact is ‘summer squash’.
  • My patient load is 5. That means I get to devote a massive 12 minutes per hour ensuring you’re still breathing or not otherwise declining in a way that would look bad on my record. Let’s just say that the numbers don’t add up, even on the most routine shifts. Somehow it all works.
  • People are dumb, frightening animals. I’d estimate that only about a third of the population are what you’d consider normal functioning humans who can cope with daily life. It’s very scary how many people are out walking amongst us who really don’t have any grasp on basic life skills.
  • As a society we take too many pain pills. Everyone seems to think there’s a magic pill that will take away all pain… and I’m selfishly choosing not to give it to you. Sorry, but a subdural hematoma and multiple skull fractures is going to hurt. A lot. Yes I could give you more opioids, but I’m pretty sure continuing to breathe is important. I think I read that somewhere in anatomy and physiology.
  • Speaking of pills, people have the most bizarre rituals for swallowing ’em. You’ll happily swallow a massive chunk of steak the size of campfire marshmallow, yet swallowing a tiny little pill is like coordinating a moon shot. Water must be the exact right temperature, you must pre-moisten your mouth with exactly three sips, the pill must be carefully placed in the exact right position on the tongue, and you must swallow slowly while staring at the ceiling followed by half a glass of water to wash it down. Could you imagine eating an entire meal the same way you took pills? Dinner would take six hours and you’d drink 2 gallons of water. Considering each patient takes about a dozen pills… you can start to see why the allotted 12 minutes per patient doesn’t add up.
  • The various forms of Alzheimer’s are truly one of the most horrible diseases out there and it gets very little attention. The thought of it scares me.
  • If you tell me your pain is 10 out of 10 while talking on your cell phone and eating pudding… it’s not. Hitting you in the head with a sledgehammer is a 10.
  • No, I’m not going to stop treating the guy in the next room who’s blood pressure just tanked and is getting close to enjoying 300 joules to the chest, so I can get you a warm blanket. You’ll survive.
  •  Medical power of attorney. Yes, have one people unless you want to trust aunt Sally to make your medical decisions for you.
  • As you get older, think carefully about your code status (do not resuscitate, etc..). It’s not like the movies. The brain doesn’t survive very long without oxygen. There’s a bunch of vital gunk in the brain (I read that somewhere) that controls some important stuff. Even if we get the ticker running again, the outcome isn’t always desirable.

I think the number one thing I’ve learned so far is how fleeting our time here is. Every day I walk the floor surrounded by people who thought they were going to have a regular, boring day until they got thumped by the cement truck they didn’t see coming. You can’t avoid all the cement trucks… but you can do everything possible to enjoy today.

On The Big Blue Bin

I shouldn’t tell you this because it makes me sound, well, terribly insecure. I am, but that’s beside the point. The point is to leave you marveling at how manly I am, combined with a deep sensitive side. Stay tuned for the end of the post and videos of monster trucks, tattoos,  blowing stuff up, and American eagles flying majestically over the latest Tough Mudder run.

This week I had two friends make me feel really bad about myself. They didn’t mean to (refer back to insecurity). The first incident followed the horrible running decision from my last post. My friend seemed to truly enjoy the run (no, I don’t understand that) and commented on her feelings upon reaching the summit. One of the things she said was how thankful she was that she had two arms and legs that work and how grateful she was that she could do something like this. At the time the only thoughts I had were #1: beer, #2: I’m never doing this again, and #3: beer.

It wasn’t until later that I reflected and realized that, holly crap I’m pretty damn insensitive. Of course she’s right. I’m sure there were folks in that race that trained most of the year, overcame incredible obstacles, and just finishing was probably a significant milestone for them. Meanwhile I’m writing a snarky post complaining that I didn’t do as well as I wanted and I should probably put more effort into it next time (no, there won’t be a next time). We’re all one horrible cement truck accident away from wishing we could run a race. I should be damn grateful that at my age I still can participate.

The second incident occurred over a dinner conversation. Somehow talk drifted towards garbage and I casually dropped the anti-green bombshell – no, I don’t recycle. After an uncomfortable silence, my friend called me out on my statement and said “why?” I briefly contemplated tales of old war wounds, presidential dispensations, we live in a recycle-free zone, my busy schedule… but quickly came to my senses and ‘fessed up. The answer is that I’m too lazy to sort it and I already take out the garbage too many times every week. Uh yeah, that sounds as lame writing it as it did saying it.

Sadly, I spoke the truth. I really am that shallow. I actually searched “does recycling really work” to see if I could make myself feel better. While there are a number of arguments you could try and make, at the end of the day recycling is a few less things that end up in a landfill. And that’s a good thing. Oh, but the cost!! Err, I looked that up too. In my town, even if I was to add a second recycle cart it’s only an additional .54 cents per month. Dammit, I hate when I can’t be right all the time.

Does this mean there’s going to be a fundamental shift in my outlook? Have I completely given in to the North End, crunchy granola, hippie, 420 celebrating, Tibetan prayer flag, and save the whales lifestyle? Probably not. But I do think I need to be a little more appreciative of what I have. And if I can make a few small differences here and there, why not? I am officially making one of the two garbage bins under the sink a “recycle” bin. We’ll see where it goes, but don’t hold your breath for the hemp clothing and compost bin.

As promised, in no particular order:

egale

Monster trucks  (I tried, but I just can’t do it. Too close to pro bass fishing and “jorts + mullets)

U.S. Marines blowing shit up  (warning, might be disturbing for those who don’t really understand what “stopping ISIS” actually means)

It doesn’t fit me, but I’m fascinated with day of the dead tattoos. (Dia De Los Muertos if you’re not from pigs-knuckle Arkansas. Apologies to any of our southern brothers that actually live in Arkansas. If you’re a reader and live in Arkansas, on purpose… well, I’m sorry. Don’t know what else to say)water

The Tough Mudder. (Relegated to the same waste bin as running races. Never again. Interferes with drinking beer)

On Moments Of Truth

The moment of truth. A turning point. That defining moment. The red pill or the blue? Beer or bourbon? A salad or fries? Jimi Hendrix or… wait, never mind. Hendrix is always the answer. For many people there comes a point in time where you reach a place that inspires you to decide that you don’t want to continue down the same pzig-Ziglar-motivation-quotes-2ath you’ve been on. If I was a motivated guy, this is where I’d insert the inspirational quote from Zig Ziglar and declare that things will be different from now on.

Uh, that’s not really my style. Although, I did have one of those moments yesterday. I’d foolishly signed up for a running race that I’d done before. Except I was lazy and I didn’t train for it. I probably gained did gain weight between sign-up and race day. I assumed that, like when I was 20, I could just show up and get ‘er done. Uh, nope. It was pretty ugly. As I lumbered uphill like a pregnant walrus, it became clear that I can no longer deny reality. I’ve gotten old, fat, and frighteningly out of shape. I was passed by people who, if I saw them on the street, I’d think to myself “there’s a walking heart attack”. I was passed by people in their 70’s who looked like they were going to keel over at any moment. I survived and finished, but it was a humbling day.

I woke up this morning determined to change and to seize this opportunity to improve myself. I vowed to be the like ‘theRock and post my 4am daily workout on the Instagrams. I will be a paleo god and laugh at those fools eating gluten and sugar. I will be pure! I will fuel the engine with nothing but locally sourced fresh food kissed with mermaid tears and love. I will embrace Grok and become a crossfit machine. Then I thought about pancakes and wondered when the new pizza place down the street will open.

I’m not sure if I have it in me to change my habits. I like the idea of it. It’s the doing part that’s a challenge. It’s hard to say what path I’m going to take. I did win the weight loss challenge of ’14. I’ve also managed to put all that weight back on, plus some, by sitting in a chair fairly continuously for a year and a half. Which me is going to emerge come Monday morning? Will it be the motivated and disciplined troutdog or the fat lazy trout taking the path of least resistance?

Realistically, any clear thinking person knows that our actions should be based upon preparations for the zombie apocalypse. And what is Columbus’s rule # 1? Cardio. So there you have it. It’s the 4am wake-up and go time for me. Then again, there’s the merits of being well-armed, don’t be afraid to use your ammunition and rule #2 – the double tap. Go ahead and hand me those pancakes.

Tallahassee: Are you fucking with me?

Columbus: Uh, no. You should actually limber up as well. Especially if we’re going down that hill. It is very important.

Tallahassee: I don’t believe in it. You ever see a lion limber up before it takes down a gazelle?