Thursday, April 16, 2020

Smokeeters Cleared the Air at Downey VA Hospital


That coffin sized brown box hugging the ceiling of a Downey VA Hospital dayroom was one of the most indispensable elements of the therapeutic milleu; a Smokeeter. This machine droned on with an intestinal rumble as it digested hazy nicotine laden air and expelled a mountain fresh breeze from the opposing end. In with the bad-out with the good.

Downey VA Hospital dayrooms had a dismal aspect about them with bars on the windows and the walls reflecting a gloomy potatoe-y  noncolor with brown gravy like nicotine stains in just about every nook and cranny. Worst of all was the unbearable effluvium of cigarette smoke combined with the scent of men densely packed into a confined area. A palette rinse and sinus lavage was mandatory at the conclusion of a shift. The place just plain stunk.

 The lighting cast a yellowish pall over the entire unsavory mess reminding me of a Foley bag long overdue to be emptied. Smokeeters were an acknowledgement of the foul conditions and an inadequate intervention to remedy the situation, a microcosm of the mental health treatment system.

Serious mental illness does strange things to folks. Emotional channels become intricately wound together so they coagulate and strangle each other. Recreational chemicals like nicotine, alcohol, and caffeine are some how involved in the masking of the pain induced by nervous dysfunction. One of the mantras often heard on the ward was, "nicotine cuts thorazine." Patients truly believed in the therapeutic effects of smoking and would go to great lengths to ingest as much nicotine as possible.

Smokeeters worked by electrostatic precipitation and the nicotine that adhered to the electrodes in the device required daily flushing. In an addition to an electrical connection, Smokeeters required plumbing to provide a water supply for routine cleaning. This maintenance operation called for twisting open the supply valve and making sure the drainage line to a utility sink in the laundry room was patent for the final journey to the sanitary sewer system.. A kink in the drain resulted a most unpleasant blowback of the toxic brackish nicotine concentrated effluent.

Curiously, there was always a contingent of anxious, over eager patients volunteering to flush the Smokeeter. I soon discovered their strange motivation one evening  while making ward rounds. I was perplexed to see a patient whose entire upper torso was contorted into the depths of the utility sink where the foul liquid from the Smokeeter drained.

As I eased his head from the sink a syrupy brown exudate covered his lips. He had been guzzling  the foul drainage from the Smokeeter.  "What in the world are you doing?" I asked. With an ear to ear grin framed in the brown nicotine laden sludge he replied, "I'm drinking nectar from the nicotine gods courtesy of the Smokeeter.Try a swig-it's like smoking a whole carton of cigarettes in one drag. WOW..what a rush." I declined and made certain the laundry room was secure prior to flushing the Smokeeter.


10 comments:

  1. I hope your description does justice to the utter disgust of the place.

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    1. I probably understated the Downey situation. Luckily, as I've aged much of the truly horrendous stuff has been forgotten.

      I appreciate your loyal readership and hope you are doing well during these trying times. I've self imposed a corona news blackout on myself and am very comfortable isolated in my little hovel.

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  2. This sounds so different to our little Psych Unit which had a pretty garden and a pond (complete with resident turtles which occasionally escaped into the ward). I think we were lucky to work in such a nice environment, Downey sounds downright depressing and must have had an adverse effect on patients and staff alike surely...

    We are living self isolating here but relatively few cases compared to much of the world fortunately. Sue

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    1. So glad to hear you are doing so well. I don't think our one for all and all for one healthcare system whose primary function is making money from disease treatment is very well suited to public health crises. Maybe someday those in charge will realize that health impacts everyone-not just those who can afford it. We are paying a heavy price for lack of a coordinated public health response.

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    2. We are very thankful for our free public health system here OFRN! We are hoping to virtually eradicate the virus here, like New Zealand. So far we have had nothing like what we see happening in Europe/ UK/ USA thankfully. We are heading into winter so are being cautious with the usual flu season ahead, but I must say our government and NZ have moved fast on this one. Take care.

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  3. Brings back memories of being sure to never leave my coat anywhere near the nurses's lounge.

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    1. Yep..I used to keep my coat in the car regardless of weather conditions.

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  4. Off-topic OFRN but there was a programme on the situation with covid19 in New York on our national television tonight, and the young nurse who I think came from elsewhere but offered to work in the ICU of a hospital there was interviewed - he was so exhausted and so upset - I know we would have done the same as him, but nevertheless I truly admire the courage and stamina of the young whippersnappers who are on the frontline. Courageous young nurses. Sue

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  5. It's heart warming to see young nurses on the front lines willing to sacrifice so much to care for others. While the office sitters of the nurse academic/administrative complex burrow deeper into their isolated bunkers young nurses are giving it their all. Sad, but I'm thinking the current pandemic will hit the reset button and bring nurses back to the bedside.

    It really upsets me to see nurses wearing PPE that has been so obviously cobbled together from whatever is available. These hodge- podge outfits are not proven and I suspect easily breached. The least front line caregivers deserve is proven equipment to stay safe. Any reasonable form of government would go to the ends of the earth to provide basic safety measures.

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