So, it’s been a few weeks since I’ve posted.  I’d like to say that it’s because I’ve been far too busy doing homemade crafts and spending quality time with the kiddos, or because I’ve been boning up (pun intended) on tantric sex moves in an attempt to strengthen my marriage, but, no.  I’ve just spent the last three weeks caught in a horrific web of crappy night shift schedules at the ER.  Three shifts on, then two days off.  Repeat x 3 and you have a very irritable nurse/mother/wife who has only one thing on her mind: survival.

When I come home from work in the mornings, there are three things I always do: eat, clean up, and read.  Okay, well, if I’m perfectly honest, I don’t always do the “clean up” thing.  Sometimes I just throw my scrubs in the hamper, pee, and crawl into bed.  Yes, I know this is gross and my nurse friends will probably lecture me about MRSA* under my fingernails and C-Diff* spores living on my shoes.  And so I am just gonna get it out of the way and boldly say to my fellow RNs: I know.  I know.  I KNOW.  But sometimes the night has been shitty enough that the few extra minutes I get to spend with my pillow and comforter are absolutely worth the risk of contaminating my entire house with a flesh-eating bacteria.

For the last few weeks I have been reading (okay, well, me and a few friends I like to call Herpes Zoster and Pertussis) the first of a three-part series on Lyndon Baines Johnson…and it is at precisely this point that your eyes glaze over with boredom.  Because, let’s face it, when most of us think of LBJ, one of a few images come to mind: the grainy, black-and-white picture of him taking the oath of office on Air Force One after JKF was assassinated; the horrific shot of him on the white house lawn, shirt uplifted, proudly showing the country his scar from some abdominal surgery during which, apparently, the surgeon attempted to removed his thyroid via his grundel* and then allowed his blind, hunchbacked palsy-stricken assistant to “stitch him up.”  Okay, I honestly have no idea what surgery he had, but the incision looks awful.  If you don’t believe me, look it up.  I dare you.  The third image – and this is the one that always struck me as a kid, and was part of why I started this series – is of him holding one of his dogs (I believe a Beagle of some sort) by the ears.  I remember staring at that picture and thinking, “What horrible, cruel person would hold a 25-pound dog by its ears???”  Well, the 36th President of these United States, that’s who.  And, judging by the look on his face, it’s great fun.

That picture sort of sums LBJ up.  He was incredibly selfish, manipulative, heedless of the feelings of others, and desperate for the attention that comes with having absolute power.  He was also terribly lonely, highly intelligent, and possibly the most insecure person to have issued orders from the Oval Office.  LBJ was very much a product of his environment.  LBJ was a survivor.

His family is from one of the harshest regions of Texas – the Hill Country – that, with it’s arid temps, fallow fields, and murderous Comanche Indians, has been chewing people up and spitting them out like empty peanut shells for nearly 200 years.  The individuals who initially settled the Hill Country did not have time for politics, philosophy, art, music, beauty, or really anything that required abstract thought.  Their entire being was focused – for every single second of every single day – upon simply surviving.  Turn your back for a second and you’ll lose your harvest to quixotic weather, leaving you to starve in the frigid winter.  Lower your guard, and, in an instant, your scalp is being removed by a tomahawk-wielding Comanche Indian…while you are still alive and screaming.  And it is from these early settlers that Johnson descended – settlers who were so utterly changed by their environment that life’s narrow focus was upon simply making it through the day with all their body parts intact and food for the next.  Living like that changes you, and your children, and your children’s children.  You become harsh and emotionless.  The sadnesses of life that would reduce a normal man to a quivering mass of tears barely produces a frown.  Life becomes about the big, big picture: am I going to live or die?  There is no time for pity, empathy, commiseration.  You must simply survive.

I’m realizing more and more that the ER is alot like the Hill Country.  It is an environment that utterly alters you, that forces you to have a hard exterior so that you are impervious to the barbs constantly flung at you by the dregs of humanity.  The other day I walked out of a room and said, to no one in particular: “I hate people.”  Immediately I was disappointed in myself.  Mostly because my mother would never allow me to say that I “hated” anybody, but also because I don’t really want to feel that way.  (Although in this case I sort of did want to feel that way because I had just been called a “bitch” by my patient.  Apparently I had not brought her some peanut butter and crackers in a timely manner, so I totally deserved it.  In retrospect I should just start carrying around a small cat-o-nine-tails so that I can begin whipping myself and save my patients the trouble of exerting themselves by verbally abusing me.  Oh, did I also happen to mention that this patient was brought in via ambulance because she said she was having chest pain?  And that said chest pain just happened to begin as she was being arrested for shop lifting?  But seriously, folks, I’m sure she’s a fine citizen.  She probably sells Bibles on the weekend or plants community gardens in her spare time.)  A nurse sitting nearby heard me and said, “Aw, our little ER nurse is growing up.  That’s so sweet.”  And we all chuckled.  And you know what?  It actually made me feel better.  Her statement made me realize that I’m not alone in this “Hill Country.”  I am surrounded by other people who have undergone the same transformation – the transformation required in order to survive and thrive.  Sure, our coping mechanisms may need some fine-tuning (but self-medicating with booze and wearing a hardened mask of cynicism can’t be all bad, right??) but they are what help us, well, help others.  They are what enable us to survive.  So I’m not going to hate myself and the person I’ve become. Yet.  But if you see me holding my pug up by the ears, you’ll know I’ve finally gone completely off the rails.


*MRSA: methicillin-resistant-staph-aureus.  Basically a staph infection that is resistant to any variety of antibiotic that is in the penicillin family.  It is most known for producing hideous, pus-filled abscesses on embarassing parts of the body (i.e., the grundel.  See below).  Most of our patients refer to these as “spider bites.”  Too bad it’s a spider that can easily be avoided by investing in a bottle of Dial soap and practicing what we in the medical field like to call “adequate personal hygiene.”

*C-Diff: clostridium difficile.  A nasty, spore-inhabiting bacteria that gives you stinky, runny poop.  For days.  This is not something one finds “out in the community” (for the most part) but is an infection more commonly experienced by long-term hospital patients, especially those on heavy doses of antibiotics.  How to avoid: um, don’t get sick and land in the hospital.  Also, don’t get old or ever require antibiotics.

*Grundel: Also known as “the Taint,” or that weird no-man’s land between your second hole and your anus (for women) and your scrotum and your anus (obviously for men).  Sorry to be so graphic.  I do work in an ER, afterall.