Nursing Was a Great Sanctuary from the Forlorn Politics of the 1960's

Chicago Police vs. Demonstrators 1968

 On this election day, my thoughts turn to the days of old school political tomfoolery. Some things never change. The day to day political process in Chicago during the late 1960's was a mine field of toxic emotional response fueled by the unending Viet Nam War. There was the police riot just outside the doors of the Democratic National  Convention in 1968, followed by the mayhem  so freely sewed by Jerry Rubin's YIPPIES.

Richard Nixon's  election and subsequent inability to bring the war in Viet Nam to a conclusion, incited a renewed rift of student demonstrations. SDS or Students for a Democratic Society was the mover and shaker on college campuses and had divided over the issue of violence as a means to end the war.

In the fall of 1969, the Weathermen contingent of the SDS staged the Chicago Days of Rage. Stores were ransacked and police cars overturned. Lengths of chain, slinging case hardened padlocks were one of the weapons of choice. The police countered with batons and tear gas, bringing many of their more seriously injured customers to the ER. Some of the victims arrived at the ER strapped to the back of Harley-Davidson Servicars which were unique 3 wheeled motorcycles. A rough ride on the back of one of these contraptions was one of the social engineering experiments by law enforcement. A ride on these bucking broncos was enough to deter further bad behavior.

I was a 19 year old student nurse at the time and often came in contact with some of the hapless student demonstrators as they were triaged. These well intentioned youngsters sometimes asked me if I was going to attend the next demonstration on Halsted Street in the morning. "No, I have clinical all day on 3B tomorrow. There is no time for any of that if you are a student nurse."

Nursing was a wonderful shield from the political tumult of the day. Being present to my patients in their time of need felt so good compared to the emotional cauldron stewing within the tear gassed and beaten demonstrators. Diploma nursing schools, with instructors like Miss Bruiser on your back all the time, could be trying, but  the monastic life did have it's peaceful moments-some of which I would like to call to mind on this strained election day.

Corona Pandemic Hits the Nursing Culture Reset Button

A few days ago, I passed by a nearly empty hospital parking lot. The  ER entrance was backed up into the street with all sorts of emergency vehicles  so there was  no shortage of patients. Sirens screamed in the background and the place was hopping.

 The lonely vehicles present in the parking  lot were of the Ford Focus or Toyota Corolla permutation. It wasn't too hard to deduce where the BMWs and Infinitis  with  their nursing themed vanity license plates had gone. The self proclaimed  elite members of the nursing academic/administrative office sitter complex were holed up in their fancy abodes while a dedicated contingent of bedside nurses were slogging it out  in a challenging environment with a crude hodge-podge assemblage of personal protective equipment.

The righteousness of the busy body administrators at the top of the nursing administration pyramid looks especially iffy when lowly bedside nurses lack even the most basic equipment for safe patient care. Bedside nursing is a tough, often thankless undertaking and a lack of support from above for necessary equipment exacerbates the misery. Bedside nurses have a long history of facing insurmountable difficulties. Florence Nightengale lasted only 3 years at the bedside.

In years past, charity hospitals with no concern for personal financial gain were the  institutions that sanctioned and preserved nursing culture.  No patient was ever asked for an insurance card or copay. Everyone was welcome and eligible for care rendered out of kindness without a preoccupation with remuneration or the bottom line on a spread sheet. There was a strong feeling that we were all in it together for a greater good.

Money is the sand in the gearbox of healthcare today and the end result is a public health meltdown. Reimbursement for heroic, expensive  procedures without improvement in  patient outcomes grease the skids in hospitals of today. This one for all and all for one approach does not meet the needs of a population that  is threatened by a pandemic.

It's no wonder countries with readily available healthcare not dependent on an individual's wealth or yoked to employment  are doing so much better. You cannot buy your way out of a pandemic with profit centered care. In the land of the free and the home of the brave we do have the very best healthcare money can buy and it's proving to be lacking. Folks here are lucky if they can even get tested for corona virus.

Nursing is about to change and nobody is sure of the "how," but people in crisis help each other. Caring  for those near us begins widening the care net for others. Maybe the nurse office sitters will emerge from behind their computers and help others because it's the right thing to do. Experienced nurse "rockstars" will rejoin the band and help young nurses at the bedside instead of soaking   funds from a vulnerable group of nurslings for overpriced video courses. Nursing is not about being an Instagram influencer or money changing hands. It's about helping others without concern for self.

Just maybe the pandemic will  transform nurse entrepreneurialism  with it's  inner impulses geared for money grubbing and influencer prestige to more charitable  values delineating our nursing lives - duty and responsibility to our patients. Preoccupation with over indulgent, extravagant, nurse "self care" be damned. We were meant to suffer along with our patients. Oh..and  don't let me forget, sometimes at the hands of our patients.https://oldfoolrn.blogspot.com/2015/08/knock-out-punch.html

Show Me the Money and I Will Show You Why That CVP Line Stopped Transducing

It really grinds my gears when entrepreneurially minded nurses seek to monetize assorted tutorials for learning clinical skills. Theoretical nursing in an academic environment is ridiculously overpriced and I understand the plight of whippersnapperns facing exorbitant school loans, but bedside procedures should be passed along  with a sense of pride and  respect for the history of nursing. The sense of well being gained by seeing a young nurse confidently perform a procedure you showed her how to do is priceless. It's your extension in time and will bring a warm feeling to your foolish heart when you are old like me.

Image courtesy Maklay 62

Diploma schools were big on ceremony and pageantry with ascent through the nursing hierarchy. Youngsters today may have dollar signs in their eyes, but for us, the ultimate reward was that coveted pin. Dreams of walking down the aisle  with our Nightengale Lamps leading the way to receive our pins were what we thought of in troubled times. Thinking about money was distant in our minds and any mention of financial gain earned you a speedy exit from the program. It was just palin wrong headed thinking and an egregious example of putting your needs before others.

How do you unite nurses from different generations with different values? One  way was  passing on  clinical skills from experienced nurse to novice. The scrub nurse tricks of the trade that I learned from my nemesis, Alice, are precious beyond any means of monetary compensation. I didn't learn how to load a sponge stick one handed or count out ten 4X4s in a nanosecond by paying money to watch a video. No, she never smiled or encouraged me like the glad handing  nursing procedure hustlers selling their videos. Humiliation was a powerful motivator.

I shudder to think of the consequences incurred by  offering a Greatest Generation nurse money for procedure tutorials. They could survive on next to nothing because working as a nurse was a reward in of itself. Their  notion of self care was a 15 minute nap in the lounge after being called in for a middle of the night case and working 9 hours the next day. Life was meant to be difficult and nurse's were destined to a life of poverty. I admired them with unbounded abandon and was a mere sissy compared to their resolve. I wish a few of them were around to deal with today's nurse monetizers.

CVP lines were in their infancy when I was practicing and I made it my mission to learn all I could about central line procedures. Obtaining a central pressure involved a carpenter's level, a three way stop cock, and a manometer. Connecting them to a transducer opened up a Pandora's Box of problems and involved endless fiddling for a reading of dubious value. They were a real pain to deal with. I was thinking of producing a video explaining some of the pitfalls of CVP lines and possible solutions. Of course this is going to cost you, but, in all honesty, I would rather sell a kidney than profit from teaching the next generation of nurses. We are all in this together so let's pause and think about the needs  of novice  nurses before whoring out something sacred like the mastery of bedside procedures.

Custom Made Signage by Nurses

 Hospitals are infested with signage developed by office sitting busy bodies promoting policy, giving direction, or threatening grave consequences for those with the nerve to be non-compliant with their all important edicts. Signs have authority and grab your attention. Who  in the world is going to fool with a red bag tagged with the warning: CHEMO THERAPEUTIC INFECTOUS WASTE? It's enough to scare the daylights out of a Pope.

Bedside nurses  put other's   needs before their own  because they are wired differently at the factory as compared to business minded hospital big shots. Information flows down from the top with a remarkable efficiency, but enlightenment gained in the trenches stays there. Hand made signs posted by harried nurses are an attempt  to break this communication barrier. It's difficult and dangerous to transition a one way street to bidirectional traffic, but that doesn't stop sign maker nurses from trying.

Nurses can be their own worst enemy. In nursing school we had a bulletin board for posting NLN test results that we called the wailing wall. Instructors were also known to publicly humiliate their students by posting signage advertising particularly egregious clinical  blunders. One memorable sign announced with great fanfare that "Gwen had attempted to irrigate her patient's Foley catheter with a TB syringe." That was cringe worthy because the syringe was too small by a factor of 100cc. or more.

Step down units are typically located adjacent to critical care units and the staff members get along about as well as cats and dogs. Step down nurses think ICU nurses are cowboy or girl know-it-alls with overblown egos and are eager to put these hot shots in their rightful place. I noticed a huge poster plastered on the ICU locker room door stating "THIS CAME OUT OF ICU." It was a double heparin locked IV catheter. An ICU nurse was probably doing a gazillion things at once and failed to notice the patients IV was capped with a heparin lock and hep locked the needle previously inserted. I figured out a scheme to convert the sign from an admonishment to amusement by inserting several more needles and hep locking  them in place so there was a series of hep locks about a foot long. A dose of good natured badinage helps improve relations among feuding groups of nurses.

UPMC, the health care behemoth here in Pittsburgh has power. When they acquired Montefiore Hospital which was built into a hillside ala Pennsylvania bank barn style they changed the names of the institution's floors. What nerve!  The hospital was entered from the summit of the hill on a floor called "Main." A, B, and C floors were underground and the floor above main was the first floor. UPMC renamed "C" level as the  first floor and the other units followed in numerical sequence. A series of lengthy, confounding memos and signage flowed from the corporate geniuses at UPMC explaining the new nomenclature. Leave it to a nurse to explain things in simple, straight forward language with her sign explaining, "MAIN HAS MOVED TO 4TH FLOOR AND FIRST FLOOR HAS MOVED TO THE 5TH FLOOR." It may have sounded whacky, but everyone knew what she meant.

Who made this sign? Not me!

Coffee is an essential on any nursing unit and anything impeding it's consumption must be dealt with. Our neuro ICU coffee pot shared electrical outlets with a vending machine and somehow the coffe maker was often unplugged. A nurse attached a sign to the electrical cord running from the coffee maker: "DO NOT UNPLUG-VITAL LIFE SUPPORT EQUIPMENT" Folks honored the official looking sign and we always had hot coffee.

Professional Courtesy - A Lost Custom

Forty years ago physicians would have never considered denuding fellow doctors and nurses of their limited financial resources to pay for health care. Any doctor would see any colleague without money changing hands. Physicians were apex predators in the hospital food chain and they always got what they wanted without question.

One of the ideas behind professional courtesy was to prevent doctors from treating their own family members. Physicians and surgeons tend to overthink and overdo things when caring for close relatives. Laproscopic minimally invasive surgery was in the distant future and overdoing procedures like radical mastectomies or laryngectomies was not a pretty picture. Professional courtesy spared fellow health workers from lots more than financial pain. It was a grand idea that was a tradition for many years.

I worked with the internationally known ENT surgeon, Maurice Cottle, who thought virtually anyone could benefit from a "Cottle Nose." The purported gas exchange improvement by breathing through remodeled nostrils was  claimed to improve everything from longevity to energy levels  Student nurses were among his favorite subjects  patients and many took him up for the free, albeit painful rhinoplasty which of course was done as a professional courtesy. I treasured my native proboscis and politely declined his frequent offers for cost free, fragile nasal bone crunching surgery. When scrubbed with him I made darn sure my mask was covering my nose completely so as to not give him any bright  ideas. There was something about hearing those loud snap, crackle, pop noises as he plied his trade on a wide awake, locally anesthetized patient that gave me goose bumps. This was not for me.

A triangular alliance of administrative busy bodies, health insurance companies, and governmental regulation put a halt to the long standing tradition of  professional courtesy. Physicians now had to kowtow to a host of  policy makers outside the medical world as managed care became the norm. Healthcare became technology proficient, but empathetically deficient. Balance sheets and quarterly reports were the metric that defined hospitals. Professional courtesy was gone for good as business minded bean counters controlled the medical landscape.

Some old time docs did not go quietly into the night when it came time to abandon professional courtesy. When an old school surgeon like Dr. Slambow received a medical bill for banding a series of uncomfortable internal hemorrhoids he went ballistic with the poor young lady from the billing office. I only heard one side of the memorable  phone conversation argument, but the snippets were permanently engraved in my long term memory including  phrases like: "I demand professional courtesy - I'll bend over and extricate that overpriced elastic ligature and  mail it back to you C.O.D.- if I ever see you on the OR table." I don't know if his medical bill was forgiven, but the hapless young lady from billing received an earful.

There have been many attempts to reform medical billing such as the ill fated Medicare DRG schedule where hospitals received fixed amounts for procedures. Maybe it's time to go one step further and take a lesson from attorneys with their contingency fees. Simply place all the funds paid to correct a health problem in a reserve fund. When a physician accomplishes the final cure, he gets the whole pot. This would incentivize finding a cure rather than finance a medical goose chase with pricey diagnostic studies that produced minimal result. Now that's something to think about.

How Hospitals Transitioned From Chairity Care to A Corporate Cash In Culture

The land of the free and the home of the brave is home to some  the most expensive health care in the known universe. What the heck happened? The last I remember,  the  rate for nursing, room, and dietary in a big inner city hospital was 68 bucks per day. The charge was known as the hospital NRD fee and it covered just about everything except for OR fees and pharmaceuticals which were dirt cheap.  A visit to the ER was 28 bucks if you had it and no patient was ever out of network or even asked about insurance.

 Hospital superintendents were paid slightly more than nurses and there were no big bonuses for anyone. We were all in the same boat and everyone knew and respected frugality. This is my anecdotal account of what happened during the transition to the current cash-in culture of today's healthcare. One caveat, these notions have been filtered through what's left of an ancient nervous system that remembers old school nurses who never expected to own much of anything and lots of MDs were content with an apartment.

It's easy to rattle of a list of culprits in the stratospheric rise of healthcare cost. Entrepreneurially motivated physicians and nurses wth the notion that I worked hard and deserve bountiful financial compensation for my work is a part of the story. Patient care in of itself was the old school compensation and material deprivation produced a sense of solidarity among nurses with everyone looking out for one another.

Old nurses like myself really had it easy compared to the all for one, and one for all whippersnapperns of today when it comes to salary. Our basic needs were met without worry and there were no school loans or financial demands. If we needed medical care any MD would gladly see us as a professional courtesy and if a hospitalization was required, our diploma school had a private "alumni room" for our exclusive use. It was the only room in the hospital with genuine Karastan carpeting. Nurses lived the good life without money changing hands. It's no wonder we affectionately referred to our hospital as "Mother."

Explosive growth of technology and electronic record keeping consumes lots of dollars. So do mindless Press Gainey surveys. Old school physicians would argue until they were blue in the face that patients are not qualified to make judgments about the quality of their care. I can see their point. Some of the very best surgeons I worked with were not very touchy-feely, and that's putting it nicely. Dr. Slambow would visit post-op patients with part of his breakfast and/or lunch spilled on his tie and shirt. I can see why folks would question the credibility of a surgeon wearing his breakfast and lunch, but he was one of the best when it came to minimizing post-op complications.

In the late 1970s my humble school of nursing was closed down for good after being in existence for almost 100 years. The building functioned as an oncology clinic for a couple of years and was then razed for the construction of a multi-level, monstrous parking garage. Fancy hospital parking facilities are given short shrift when considering how corporate interests made health care such an expensive commodity. This is where the rubber meets the road (or parking garage) in my woe filled tale. Parking garages are at the root of the problem.

Parking garages became the welcoming mat for hoards of greedy go-getters

Very few nurses owned cars when I was toiling at the bedside. We made do with the CTA, bicycles or good old fashioned shoe leather, those Clinic shoes were made for walking, It's interesting to note that our nursing school was way ahead of the curve when it came to alternative transportation. The first object to greet someone approaching the school was a massive bike rack, usually at least half full. There were no worries about locking your bike. Who would even think of stealing a nurse's bike?

Physicians and the fortunate few that owned autos found ample space on the street or small unregulated surface lots. Patients arrived at the hospital by taxi, bus, or walk-ins. There was no EMS, and trauma patients frequently arrived in the back of police cars or paddy wagons. Chicago police operated unique,  three wheeler Harley-Davidson motorcycles  which could be ridden just about anywhere. I vividly recall a drowning victim from Montrose Beach being hauled up to the ER secured to the back of a police officer's tricycle motorcycle. The officer even went so far as to suggest the road bumps jostled the water out of the victims airway. The patient survived with quite a story to tell. Maybe the cop had a point.

Hospital parking garages dramatically demonstrate the ridiculous profusion of administrative busy bodies, clerical, and unnecessary hucksters attempting to sell everything from pharmaceuticals to medical equipment. Visit just about any hospital parking facility on a Sunday morning to observe first hand how few workers are  really necessary to take care of patients and it's not because administrative big shots and pharmaceutical representatives are attending church. The Sunday morning deserted parking garage syndrome is even more acute at government agencies such as VA Hospitals.

Hospital parking garages are like a beacon to pharmaceutical hucksters. In the old days drug reps were a non-entity. No one needed to sell penicillin because it really did kill strep and everyone knew it. Much of drug pricing today is done with blatant extortion. A marketer of Zyprexa might claim that his drug will negate the necessity of long term hospitalization saving untold tens of thousands of dollars, hence,  his product is worth a ridiculous charge.

Epinephrine was dirt cheap. Everyone  knows what Mylan's Heather Bresch did with exorbitant charges for that "lifesaving" drug. I betcha if drug reps had to ride a bicycle to hospitals they would be few and far between.

Parking garages and the influx of money seeking hucksters changed how doctors and nurses thought about their patients. Money changing hands at every corner of the hospital amidst a bean counter culture changed who people were. Mega bucks doled out in bonuses to administrative big shots who never helped anyone except for themselves became the rule. It was so  much better when all I had was a Raleigh Super Course bike to ride to work and to heck with all those monstrous parking garages.

Illness Stories for Profit

The local healthcare giants have discovered a new advertising strategy that must be lining their corporate coffers with gold. I was sitting in a crowded waiting room awaiting my next "experience" to begin a new health "journey" when the giant flat screen  flickered to life with an engaging story of  a profound, deep illness tale and subsequent recovery thanks to the miracle workers at the corporate hospital giant. I don't have one of those magical flat screens  in my little hovel; my 150#  Baby Huey tube TV brings in more nonsense than I can stand and all I use to get a signal is an ancient rabbit's ear antenna.

These corporate generated gems follow a predictable script and typically involve a respected member of the community such as a minister or retired kindergarten teacher sustaining a life threatening illness or injury but with treatment at "Big Bucks Hospital," is now back as a functioning member of society. Here is a sample.

Reverend Bagley was singing a hymn to the congregation with his lovely wife of 53 years accompanying him on the recently restored pipe organ. He suddenly clutched his chest and fell over backwards impacting his head on the altar rail. BBH  cardiothoracic surgeons performed a triple coronary artery bypass and repaired a septal defect that was found incidentally. Neurosurgeons promptly averted a life-threatening subdural by performing an occipital craniotomy. Now the good Reverend is back to singing in church with his grateful wife at his side. Remember -  choose your healthcare as if your life depended on it.

Old time nurses like to tell stories too but I don't think they would serve BBH's marketing needs. These stories are usually of complications (surgical are  the most profound,) that change someone's life forever. The purpose of these grim tales is to alert others of the mechanism of action so the event never happens again. Here is a sampler.

Officer Friendly was helping a stranded elderly lady change the tire on her old Ford and felt a sudden surge of disabling dizziness. He was transported to BBH where an MRI of the brain revealed a rather large juxta cortical area of increased signal uptake that could be neoplastic, encephalopathic , or vascular. A brain biopsy was recommended but the stereotactic head frame was ferrous and could be only used with CT. The lesion failed to visualize under normal CT protocols so two large bore IVs were established and contrast media was infused as rapidly as possible in a futile attempt to visualize the lesion. The fluid overload prompted a hypertensive crisis that ruptured the intracranial lesion which on autopsy was found to be a fragile arteriovenous malformation.

Somehow, I recall the later tale much more vividly than the feel good corporate fairy tale stories. Must be my age.

Emerging Nurse Leaders - What in Blue Blazes?

It doesn't take all that much to rankle my hackles these days. From nurse office sitters that don't know the basics of setting up a Mayo stand or how to cut a series of ligatures all the exact same length with just 2 snips of your Straight  Mayos. These are the same folks who dictate aseptic procedures while sneezing without a Kleenex. Regulatory and office sitting busy bodies regularly let loose with more crap than a chimp on laxatives and it's high time they stopped circling the bowl.

What the heck is an EMERGING nurse leader. It's high time they got off the pot and did something for a patient. Find someone to suction, milk a chest tube, load a Raney clip and by the way that Foley bag needs emptied. Emerge already and do something. Back away from that desk, arise out of that comfortable chair and for gosh sakes do something. While you were preoccupied with emerging other nurses were out there actually doing things for patients. Enough is enough!

Nursing Theory

Martha Rogers, esteemed nursing theoretician
exclaims, "Call the doctor! The patient is
deresonating his energy fields and his
helicy is dropping too fast."

Oh boy, subjects like  the theoretical basis of nursing really rub me the wrong way because they are waste  products of the nursing academic/administration/ office-sitter complex.  When my alma matter was fighting for it's life in the 1970s one of the survival strategies involved replacing operating room experience with a Martha Rogers nursing theory class. The rationale; "Anyone can learn how to be a scrub nurse, but few can master Martha's theories."  No fooling!

 If you want to drive yourself crazy check out this gem courtesy of the eminent Martha Rogers: "The integrainess of people and the environment that coordinate with a multidimensional universe of open systems points to a new paradigm of nursing:  energy fields, pattern, helicy, and resonance whereby man is always becoming."

Nursing theoreticians were in their heyday  several decades ago when diploma nuring schools were closing and nursing education was being shifted from the hospital to academic enetities. Nothing wrong with that, but educators needed a new curriculum to differentiate themselves  from diploma schools. Nursing theory and nursing research were what they came up with. One explanation of the relatedness of these two entities was that nursing research served to validate nursing theory.

I might be foolish, but I know when someone is trying to hoodwink me. Why do these highly educated academics term it "nursing research?"  If the research is to benefit patients it should be called clinical research and based on accepted fact, not unfounded theory. Facts are facts so why muddy the waters with nursing specific nomenclature. There is no such thing as pharmacist research or doctor research. Combining two entities that are not fact based or scientific does not increase their credibility. It's like stacking bafflegab on top of bolderdash which exponentially increases the inherent subjective content of any conclusions.

Conferring objective status to subjective findings never turns out well. It's how we came up with the old time surgeon's rationale for removing an organ that has no pathology. "I'm taking out his spleen based on empirical experience."  In contemporary times subjective matters like pain have been scientifcated  by pain scales. It's not doing anyone any favors to confuse subjective matters with scientific fact.

Probably the biggest failure of nursing theory was a failure to relate to clinical practice. This is facilitated by the fact that nurse theoriticians are office sitters of the highest order. My message to them is this.

Leverage yourself out of your comfortable chairs and remember it's not that difficult because once you get the largest body part moving, the rest is sure to follow. Find a sick person to help. Find a chest tube to milk, a Foley bag to empty, a trach to suction or learn how to load a sponge ring forceps with just one hand.  For crying out loud, find a patient to help! Don't just sit there..do something.

BREAKING NEWS: Office sitting nurse theoretician studying

field gradient theory becomes flying nurse theoretician courtesy

of a friendly local MRI machine. Never fear, the OldfoolRN product
development institute is working on a nonferrous theoretician's chair.

Election Day 1972

Richard Nixon appeared on the political landscape in a very stormy time. There was the Vietnam war, looming inflation, and as always, unemployment. There were many divisive issues lurking about and people were really involved in the various arguments that were flying about. Reminds me of our current situation.

I remember walking to work on election day in the dark, long before polling places opened. In Chicago, voting always had a kind of underhanded, cynical theme attached to it. One of the favorite half true and half funny jokes was "Don't forget to vote early and often."

I remember thinking how great it would be to relieved of all this political mayhem when I finally arrived at my destination, the tiled temples of the operating rooms which were safely isolated all the way up on the very top 7th floor of the hospital far removed from toxic political themes below. Everything that I ever needed was here and the nonsense and noise of the world seemed pleasantly removed from my consciousness. Peace at last.

My co-workers were like family. Yes, we were at times, a dysfunctional lot when it came to interpersonal relationships, but we would all do just about anything for a patient or a colleague. Everything from donating blood for a trauma or playfully pinching one another with a sponge ring forceps if they made the mistake of bending over to reach something under the table while too close to the kick basin. From personal experience, I can say that really does hurt depending upon the mood of the person handling the forceps. The only way to avoid the unpleasantness of the sponge ring forceps encounter was to lean under the table by bending laterally rather from the waist at a right angle. It might have looked unusual, but it was very purposeful.

This was back in the day before seasonal affective disorder caused by increased darkness was recognized, but I really did love those bright, OR lights. They did generate lots of heat which contributed to their comfort inducing quality on cold winter election days. I often thought that standing under those bright  lights  helping patients with people that cared about me was as good as a beach vacation, maybe even better.

Election day moved by very quickly and toward the end of the shift, Dr. Slambow asked for volunteers to help him with an after hours case. I jumped at the opportunity, not giving it a second thought. When the case closed at about 7PM, Dr. Slambow asked if any of us had voted and we all had the same answer, "No, we forgot all about it."

Dr. Slambow announced he neglected to vote too. We all were wise enough to keep our mouths shut. If Dr. Salmbow was ever questioned about civic duty, he launched into a lengthy, bitter diatribe regarding his experiences as a trauma surgeon during the Battle of the Bulge during WWII. The stories were not pretty.

After the fallout from the present day political shenanigans, I often long for a warm, very brightly lit, green ceramic tiled ceramic oasis where there is no name calling or wall building. It sure was peaceful. I'm pleased my long term memory is intact to relive those days, now if I could only recall what I had for supper!