Rant – Barrelhaven

Resurfacing

Please allow me to fill in the blank space between early July and late August. First off, I have to say I thought it had been much longer than that since I had written anything here. This last month was a long year.

Sometime back in June we learned that the mega-pharmacy chain we had been using was going to close and all our prescriptions would be shifted to another mega-pharmacy chain unless we specified somewhere else for them to go. This would have been our third mega-pharmacy chain, and really there isn’t much difference between them, but this one was a bit further away than was convenient so we instead had all our prescriptions transferred to the pharmacy at a mega-grocery chain that is closer to where we live. The kind of choice in the consumer market our government’s economic policies have worked for years to achieve.

I want to take a moment here to talk about the Swiss Cheese Problem. This is a topic of frequent conversation in health care and, I suspect, management circles in other high-risk professions as well. We’re all human and everyone makes mistakes, like the holes in a slice of Swiss cheese. You’re never going to get rid of those holes in the individual slices so what you do is, you build systems that stack slices on top of one another. If something falls through the hole in one slice, it gets caught by the one below it. The difficulty is, every now and then, by sheer chance all the holes in the individual slices line up and something drops clean through. This is the situation I found myself in over the last month.

The pharmacy that was closing was supposed to transfer my prescriptions. They didn’t. The new pharmacy insisted that I had picked up a refill of my medication. I hadn’t. During all this, Dr. Psychiatrist was out of the office and unavailable. The result of all this was that I was out of my heavy-hitter antidepressant for about a month, and out of all my medications for 2-3 weeks. I have been on at least one antidepressant for at least ten years so facing reality without any kind of chemical filter was challenging. Also, in addition to two different medications that help turn down my sympathetic (fight-or-flight) nervous system, I have been taking a combination serotonin–norepinephrine reuptake inhibitor (SNRI) / norepinephrine-dopamine reuptake inhibitor (NDRI). The physical withdrawal symptoms were rough.

The good news is, all the medication issues are resolved and I have a reasonable supply of everything again. The automatic refill service at the mega-grocery chain pharmacy even seems to work, which is nice. The bad news is, I have essentially been starting from zero with all my medications again. I am feeling much better and much more stable than I was but Dr. Psychiatrist estimates I have another couple of weeks before I’m back at a steady state.

Best healthcare system in the world.

July 4

I am not going to delve into the irony of celebrating the independence of the United States from England while the country is busily installing our first king ourselves. Anyone likely to be reading this shares the same existential dread I do but that is a different conversation. What I want to talk about today is explosions.

I don’t know if the brain-stem level enthusiasm for blowing things up is uniquely American or something that is just a product of the recklessness of youth but either way, people just don’t let up. Fireworks are, as far as I know, illegal county-wide now but that doesn’t really seem to have discouraged anyone.

The hypocrisy coming off this post is obscuring my screen, so allow me to justify my change of stance. Not just change, I suppose, but polar reversal. I was as mindlessly enthusiastic about blowing stuff up in my youth as anyone and, like most American males, the recklessness of youth lasted well into my 30s. Since then, however, I have had a number of experiences which have led me to change my position. The key experiences, unsurprisingly, were working in an ER, developing a hyperactive startle response¹, and owning a dog. As I have aged the risk to my own personal fingers, toes, ears, and nose has diminished considerably of course but one still has a certain sympathy for the people who will spend the rest of their lives, starting tomorrow, unable to count to twenty unassisted. The startle and the dogs continue to be an issue in the household. Having a ninety pound dog trying to hide underneath you because some yabbo in the street set off a firecracker is a unique experience.

I suspect nothing is going to change how my fellow Americans choose to celebrate their rapidly vanishing freedoms so if anyone needs me I will be hiding under the bed with the dogs.

It is possible that these two things are related. ↩︎

Life’s little annoyances

Why does Windows not tell me when my graphics drivers are out of date? I get notifications that I can link my Android phone, which I don’t have, to my computer, which I don’t really want connected to my Android phone, which I don’t have, or any other phone that I do have for that matter but there isn’t anything that will tell me that my drivers are two patches out of date.

Apparently this is what I worry about when I stop watching the news.

Seriously, Fuck Cancer

Disclaimer: This post will be mostly me venting. I’m not necessarily looking for solutions, assistance or even a response. This isn’t an indictment or condemnation of any person or anyone’s behavior, it is merely me shaking my fist futilely at the universe.

Something else I have struggled with since the beginning of this saga, before even I knew for sure what was going on or told anyone anything, is finding a way to express my general dissatisfaction with the world and my position in it without either sounding like I was blaming someone for something they did or didn’t or hadn’t done, or just sounding whiny.

This may also be connected to my nurse brain in a way. In my professional life people don’t generally tell me anything unless they want me to do something about it. In this way, physical medicine is quite different from mental health medicine. No one tells me that they’re having crushing chest pain because they want a sympathetic ear and a shoulder to cry on, they tell me so I’ll do something about it. There is certainly a component of compassionate and therapeutic listening to what I do (I hope anyway) but mostly I’m expected to actively try and intervene in some way that will improve the situation. This is, I think, a large part of why I didn’t really tell anyone that anything was going on; there wasn’t anything for anyone to do. I’ve had versions of the following conversation a couple of times now:

Me: Hey, turns out I have cancer
Friend or family member: Why the f(*# didn’t you say something before this?
Me: Why would I? There’s nothing you can do about it.
Friend or family member: [ExpressionlessFaceEmoji]

It took someone pointing out that I would very likely be kind of pissed off if the situation were reversed and it was one of my friends or family members that had cancer and hadn’t told me to get me to finally realize that people might actually want to know what is going on with me, even if there was nothing they could do about it.

[ArloGuthrie] But that’s not what I came to tell you about [/ArloGuthrie]

I feel like hammered shit today. I worked last night and, due to a combination of things that includes the unhelpful capriciousness of my brain, I haven’t really been able to sleep. Minus three or four hours of fitful dozing here and there I’ve been awake since around noon on Tuesday. I work again tonight (and tomorrow night) but I can’t really call out sick because I don’t have any sick time and I don’t want to miss a whole bunch of shifts this early in the process when it is very likely I will need the time off more in the coming weeks.

So I’m exhausted, dissatisfied with my job (this is a completely separate subject that is more complicated than will fit right now), I still have to go to work for the next two and there isn’t a whole lot that can be done about it.

This shit sucks.