And the sun pours down like honey on our lady of the harbor...

I hate clothes shopping at the mall.

Sometimes I forget that I hate it. And I try to go do it. Then I remember. I dislike dressing and undressing all my winter layers. Never a place to hang my coat. And nothing is my size. Nothing.
The trip becomes time consuming, and frustrating. I somehow have never eaten enough before I go, and somehow always have to use the bathroom. I get claustrophobic and I can't make good decisions, and nothing fits anyway so I'm really just choosing between which whatever looks less ridiculous. It's a waste of time. I'd rather be doing almost anything else.
Thrift store shopping is different.

In general, I do all of my personal shopping in thrift stores, which surprises no one who has ever seen me in person, I'm sure.
I like the idea of recycled clothes and I always have. I like to find "finds," like the time I bought a Betsey Johnson dress for $8 and found out later it was worth $400. Even in Tokyo, I went shopping in thrift stores. I don't like to spend outrageously on what I wear. That way I can buy things that are more important to me. I'm happiest wearing rags and feathers from Salvation Army counters.

However, I needed dress pants for my shows at Improv Asylum and I have never successfully found nice dress pants in my size at a Savers. Plus IA gives us a wardrobe stipend to make the spending easier. So today Laura and I set off to the Cambridgeside Galleria.

I mentioned all the reasons I normally hate shopping. But the size thing is the biggest one. Even in a no pressure situation -no goals, no time limit, an empty bladder and full stomach in a thrift store, if I can't find anything that fits, I start to get frustrated.

I'm too small for women's clothes, even the petites usually. And I'm all the wrong kinds of shapes for most youth clothes. These hips don't lie and do not fit into high rise tapered Gap Kid jeans.

It's so inconvenient to buy nice new things that I'd rather just as soon not. But pants to perform in are a necessity. When I asked around, a similarly sized friend of mine recommended Express specifically for their small sizes. I found that she was correct, and also received wonderful customer service.

As I was looking for more pants to try on at Express one of the saleswomen approached me and asked if she could help. I usually say "Thanks, I'm just looking." Because that's the truth. I love to look. But today I said "Actually... yes. Is there anything smaller than a zero?" "We have a couple of 'zero short' pants." She happily picked out two different styles and asked if I'd like her to prepare my dressing room while I continued looking.
That never happens at thrift stores.

Although the pants are 'zero short,' they still need to be hemmed. But all the XS tops I tried on fit me really well. At a lot of other stores, even an extra small is too big for me. Plus, getting these pants was so pain free that I almost don't mind the extra step of having them altered.

I'm not in any hurry to switch from Boomerang's to Forever 21 anytime soon. I'd like to travel some more and can't afford to keep racking up cute knit sweaters that I can't wear in Mexico anyway. But it's nice to know that a retail store exists with friendly and accommodating sales people where I can count on at least some items being in my size.

... and to dust you shall return

Today is Ash Wednesday, the first day of Lent for Western Christians.

Because I am a practicing Christian I am often asked questions like "Do you really think that God cares about what you eat?" and "Isn't fasting actually just ungrateful since so much food goes to waste every day?"

I love to answer these questions and can do so ad nauseum because I have put a lot of thought into my beliefs over the past five to seven years or so. Additionally, I think questions like this are important because they help me to look at my beliefs from new perspectives. Who knows, maybe I'll change my mind.

I will be doing a lot of writing about Lent (I hope), so please feel free to ask me questions, even the most inflammatory ones. I'm not easily offended.

Today was the first time in maybe 16 years that I did not attend a Catholic service for Ash Wednesday. Instead, I attended an Episcopal service meant for homeless men and women and their healthcare providers. It was very similar to what I'm used to except of course, for the Eucharist* which I was prepared for, having attended some Protestant masses in the past.

(Is this the beginning of a metanoia? Only time will tell.)

I enjoyed this particular service because there was a real community involved. It was so much better than going to a big half empty church on a cold Wednesday night. Patients and nurses alike sat in a circle and the service was informal. Three men volunteered and did the readings. One of them stumbled over the words of Matthew and looked up apologetically to say he was nervous. Everyone nodded in understanding and the reading continued. A woman dabbed her black rimmed eyes.

The reverend spoke about second chances and forgiveness, and I felt a real chill run through me. To my left was a man I know who is dying and who is scared. He kept his eyes downward until it was time for the peace offering. We shook hands and hugged. I accepted the Eucharist from a woman patient who I've seen around but do not know. It was a really wonderful reminder that we are all here to serve one another, this breaking down of staff versus patients for the hour long service.

I felt a bit odd not going to a Catholic Mass to begin the season. But in some ways, this might be the best start a Lent has ever had.

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* Protestants and Catholics differ on the opinion of whether or not the bread and wine actually become the body and blood of Jesus during the Mass. Protestants, because they believe the bread and wine only represent Jesus may use various substances to fill in. Catholics have stricter requirements about what substance may be consecrated. After a brief speech about the unity of Christians in the breaking of the bread, we all ate a doughy cookie and drank grape juice.

These thoughts melted onto my mirror

Can I just ask: What emergency room doctor thought it was okay to discharge a ?mentally retarded, and + mentally ill homeless man to the streets with a suprapubic catheter?

Why why why why why WHY would you think that's ok?


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I'm going to bed. My dear friend Conor S. has started a Facebook group called Countdown to St. Patrick's Day for the express purpose of sharing Irish music. When I was living near (and then with) Conor I was spoiled because he exposed me to all kinds of amazing music. My love of Irish music of course comes from my father, but it was Conor who made sure it stayed in my life even when Dad was gone. Here is one of my favorite songs that Conor used to blast through our house on McClellan Street, he sent the video to me today:

Ramalama Bang Bang

Edit to last post: The Dowry has six members. Sorry, guys!

I worked a double today so in place of anything else, here is one of my all time favorite group dance numbers:



If I could dance like this I would do it
all
the
time.
People would have to ask me to stop.

Ten True Stories About Laura Clark

I like this game. Happy Birthday, Laura!

1. Laura lived in Chicago. Chicago, which she reminds me on a weekly basis, is a better place than Boston because of its bike lanes, grid system streets, and lack of hills.
1a. Laura rides a bicycle.

2. As part of riding a bicycle Laura used to deliver sandwiches for Potbelly's in Chicago. Bike couriers are some of the most bad ass people I know. Laura is no exception. She even has a tattoo.
2a. It's the logo from Umass Amherst's sketch group, Sketch 22.

3. Once, when we were both living in Amherst Laura and I had dinner together and then tried to go to Bart's for ice cream. We met a man who claimed that he was the inspiration for the movie The Matrix. He carried around a photocopied resume in tiny tiny font of all the movies he had supposedly written or been a part of including Crouching Tiger, Hidden Dragon and ChaRly. He told us he could tell the future. He had a large wooden stick with him and also "special" water that could enlighten/purify anyone who drank it. Of course, Laura and I drank the water. Then we spent the better part of the evening babysitting each other in case something happened. Nothing did. But that is the kind of person Laura is. She drinks the water.

4. Laura also has synesthesia. We've agreed that "5" is the meanest number.

5. Laura writes for and performs in The Dowry which is a four person sketch troupe she co founded with her man Paul Barner. The two of them started off just by writing sketches together for a class, and now a year later, The Dowry (different link this time) has became a house team at Improv Boston!

6. I can credit Laura with introducing many new things into my life that I embraced fully, including but not limited to: quinoa, The Decemberists, Girl Talk, Imogen Heap, The Wire, avocado, guacamole (I didn't eat guacamole until Laura's guacamole dip and still prefer it to anyone else's), and singing in hawkit (sp?).
6.a Blood oranges did not catch on for me. Laura loves the concept of blood oranges enough that she almost once bought really expensive soda just because it was blood orange soda.

7. Laura's mom once showed me an old home video and one of the best parts of the video was 5 or 6 year old Laura demanding that the camera be turned back to her so she could do interesting things like sing a song and dance. If I had the video I'd post it here.

8. For my birthday this past year Laura prepared a pancake breakfast for the two of us. She had to get up at the crack of dawn to do it since I leave for work at about 6am. She was up before I was and greeted me smiling and singing. As I recall, they were the best pancakes ever. That is also the kind of person Laura is. She makes the pancakes.

9. One night Laura and I "broke into" Plymouth Rock when it was under construction, and we had to climb a big stone wall to do it, and we did it anyway and we still didn't get to see the stupid rock because it was crated and and the crate was nailed shut and we didn't bring a crowbar, not having expected any obstacles between us and our first hand witness of our nation's most famous boulder.
9a. Laura and I don't plan well.
9b. Laura is my only friend who says, "OK" and gets her flip flops on when I say "let's drive to a beach right now."

10. Laura has an amazing voice. She doesn't sing for other people often, and sometimes when she does she acts goofy about it, but if you ever get to hear Laura really, really sing, (especially "Ave Maria" ) you will weep the tears of happy angels.
9a. She joined a choir here for a little while which was wonderful, but she left after their Christmas concert that year because comedy and sketch writing are the things she would rather spend time on. Girl has pipes and goals.

Bonus:
11. Laura used to scream while driving over bridges. I can not remember why. But that was basically my introduction to Laura. I drove to Worcester with her, Liz and Zach for a show at WPI. Up until then I only knew her as "Laura the funny girl from the sketch troupe who wrote the squirrel sketch I liked so much." As we went over the Connecticut River we all screamed at the top of our lungs the entire time to make it more comfortable for Laura. Sometimes now I wake her up from naps the same way.

Yay! Happy Birthday, Laura!

Indulgent Entry Spoiler Alert

When I was 15 years old I saw my first professional improv show and it was at Improv Asylum. I went with friends from my high school improv troupe. We were floored. I was hooked.

Fast forward ten years. Last night I performed on the I.A Mainstage for the first official time. I was subbing into the show that is currently running, and the immersion was quick and quiet. I will not be writing about every single show I do because there are going to be a number of them*. But I wanted to mark this occasion because it is a big step and I did not take it alone. The cast could not have been more welcoming and supportive. They made my first night easy and fun. Everyone helped orient me to the show, they made time to walk through all the sketches with me beforehand. They told me to ask any questions I needed. And afterwards everyone offered hugs and congratulations. It was the perfect first step. And in fact, that's all it really was: a first step. A drop in the bucket. From here on in I start the real work that lies ahead of me in my transition to a full fledged cast member. And because of how wonderful the cast is, I feel strong enough to do that.
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* Aiiiiiiiiiii!!!!! (ahem)

Skipping thoughts like stones across your willingness

This week at work my med cabinet was selected for a random auditing by "Narc Guy." N.G is a private consultant we hire to make sure no one is diverting medications. That is the field he has chosen to work in, that's his business. That makes him very interesting to me. Oh, and he carries a gun, double the interesting factor. He dresses snappily, has a disarming smile but a no nonsense jaw, and he is everything I imagine a private investigator should be. I just wish he said "swell," and "tight," more often and maybe drank some scotch or smoked a pipe.
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An edit to yesterday's post. The topic of HIV and AIDS is actually filed under LGBT Support in the Civil Rights section. Which is understandable. But it should also be listed in the health care section. The LGBT section also mentions that HIV is transmitted via needle sharing, and mentions President Obama's opposition to the federal ban on needle exchange programs. This belongs under Community and Public Health. The final sentence of the blurb reads, "President Obama has also been willing to confront the stigma -- too often tied to homophobia -- that continues to surround HIV/AIDS." Maybe we could start with not having the only mention of the virus on the web site linked to the gay community. ************************************************************************
This wasn't the first or the worst, but it came to mind today as a point of reference for my development. When I was just taking my third bite of a warm pile of Shephard's Pie and a patient called out for me that she was ready for me to witness her urine tox screen I didn't flinch. Neither did the my co-witness. We did the thing, I dipped the urine, she recorded the results. We washed up, and sat back down. Appetites intact. Food still warm. My mother, who was not a nurse but was at one point an EMT, and at another point a radiologist, told me very specifically that there'd be days like these. As a nine year old I never believed her.
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All of my EMT friends will be happy to know that today instead of calling a truck for a non emergent transfer to the ER across the street (we don't have an ECG) we wheeled him over in a chair. Everyone was happier. Even the aide who brought him because she got to leave work early. Huzzah!

And The Band Played On

A few weeks ago at work a co worker pointed out an oversight on one of the government's health policy web pages. "I'm going to write an email," she said, "because HIV/AIDS is only mentioned one time on the whole site and it's under the heading of gay female sexuality."

We all echoed her thoughts. It's good that the government hasn't gone off again and filed HIV/AIDS away under "a gay man's disease," however, is is a disease that effects everyone, so why is it filed away under anything at all?

I suppose I should be thankful. Thirty years ago doctors had just started to notice the epidemic and the media nicknamed it GRID (gay related immunodeficiency disease) but Ronald Reagan wouldn't even say the word "gay," in public. The CDC desperately tried to find scientific proof that the disease was viral, was sexually transmitted, and was also blood born. Meanwhile the Red Cross was unintentionally infecting thousands of people through blood transfusions per year, refusing to believe without reasonable cause that the blood must be destroyed, and donors screened. Besides, how could they screen for a virus no one had identified yet?

All of this and more was brought to my attention in the 1993 movie And the Band Played On.
It's not that I didn't have a vague idea that we had come a long way in the past few decades (making bounds and strides since the late eighties), but the details were fuzzy and now they are clear.

This is not a movie recommendation for people who like fast paced films.
It just wasn't a great movie. It is, as they say "star studded," and the plot is interesting, but the dialogue is cliched and terrible. Laura and I laughed where we should have been silent many times over. B.D Wong, I am sorry, but you do not have to pause for thirty seconds after every line you deliver to Ian McKellen.

That being said, there were some very touching and well acted moments. For example, when Bill Kraus (Ian McKellen) has to tell an otherwise healthy woman, (Swoosie Kurtz), that she got a tainted blood transfusion and she finds out that although the CDC has recommended it, blood banks are not screening donors and now she will join the ranks of the walking dead.

Mostly if you see this film you should watch it for the history.

Roger Gail Lyon was in the movie as himself, recreating the famous moment where he stood before government officials as they debated whether or not HIV even existed and said:

This is not a political issue. This is a health issue. This is not a gay issue. This is a human issue. And I do not intend to be defeated by it. I came here today in the hope that my epitaph would not read that I died of red tape.

Our government was hardly on the up and up when it came to solving this epidemic. Although the CDC was hard at work, no regulations were made, no changes in policy, and not a lot of trustworthy information about transmission was making it out to the public.
By 1985 according to the film, there are 8408 US Cases listed, versus 6805 Deaths. And Reagan still hasn't made a speech about AIDS. People were dying from red tape.

Similarly emotionally stirring were the actual clips and footage from all the gay rights and GRID riots in the late 70s/early 80s in San Fransisco, and to realize that one city really did change the face of homosexuality as the world once knew it.

I'm going to find the book and put it in my reading queue because the story and the history were fascinating. I didn't know about Patient Zero at all, nor about France's major contributions to isolating the retrovirus. I had no idea about the Dr. Gallo controversy, and I am guessing most people don't.

As a nurse I found the whole thing really inspiring because although I have seen HIV/AIDS kill many people I also know a growing number of people with the virus who are living their lives thanks to early detection and medication compliance. It's an entirely different world than the one people had to live in thirty years ago. And although we have a long way to go, when the times get tough it helps to look behind us and see how far we've come. And it makes me proud to be a part of that, no matter how small.

A Diagnostic Mystery

Ok, my medical world friends, help me out. I got a phone call from a friend last night and I'm puzzled.

We'll start with:
27 y.o male presenting with complaints of spontaneous "shooting" left sided knee pain for two weeks. He denies traumatic event.
Pain started as "an ache" in his knee which he ignored. Ache worsened over three days until he was walking on the third day and could no longer straighten his leg completely, causing him to limp.
Joint mobility worsened to the point of inability to bear weight.

At this point he went to the doctor. Doctor guessed torn meniscus and ordered an MRI.

The MRI came back with no damage to the meniscus. The nurse in radiology said "looks like pre-patellar bursitis," but that too was ruled out by the doctor.

Then the patient went home and developed the following new symptoms:
- swelling in foot (left side)
- foot cold to touch
- positive pedal pulses

The doctor ordered "blood work," and told him to go home and if the results came back for a positive clot, to go to the ER. The results were negative.

The newest idea is that it might be a degmoid. So the doc gave him an oncology referral which he is now waiting on.
The meds he came home with are:
Vicodin 5/500mg 2 tabs q 8 prn and
Neurontin 300mg p.o t.i.d
He's been shunning both and taking Advil.

My questions are:
- I'm assuming the "blood work," was a D-dimer test, but my friend doesn't know. That's not a test that's 100% accurate to my understanding... and additionally they didn't do a CT scan or a venography. So, can they really rule out a DVT? He's a young, non smoking healthy young man with a very active (rock climbing , scuba diving) lifestyle, however he just got back from a plane trip to Europe.

- Why wouldn't a degmoid have showed up in the MRI? Especially if it's big enough to be (apparently) crushing a nerve and compromising circulation?

- What is the prevalence of degmoids in joints? I've only really read about them in relation to the ovaries or to cartilage (like the nose or ear). And what would the next step be if it is a growth?

- Do you have any other ideas?

Thanks for any help you can dig up, guys.
Dr. House wouldn't pick up his phone when he saw it was me calling.

Weekend Lessons

1. You can make lofty literary jokes in a 10pm free, experimental improv show as long as at least one, attractive foreigner in the audience likes it. (Intelligent Irishman: "I really like The Fountainhead, and I thought your joke was very funny." His friend: "I did too, once he explained the joke to me."

2. It is cheaper to go to Costa Rica in March than in April. Bump 'em up again!

3. Girl Talk is possibly the best music to work out to I have found yet.
3a. I need to buy better headphones. My ear buds kept falling out during my cardio workout.

4. I am a better bowler than Laura, but not as good as her boyfriend.
4a. Samplitizers make it impossible to concentrate on "the game."

5. I was wrong. I'm On a Boat is better than Dick in a Box, now that I've heard them side by side. It was just nostalgia ruining objectivity. Tsk.

6. I pride myself on being tough and having a faith characterized by rugged individualism, but it has been really nice to have someone to go to church with regularly for the first time in four whole years.

7. Girl Scouts are not ignorable. Between the two of us Liz Kaminga and I bought seven boxes after church Saturday night.

8. Alison Royer is one of the funniest, most talented and kind people I have ever met. I am sad she's leaving mainstage which means I don't get to perform with her, but super excited that she's still going to be performing in Boston. I didn't get up during the night to tell an Alison story because I felt like other people had more of a right to the mic, but I will tell mine quickly here:
Backstage at an NXT show:
- I was unhappy.
- Alison noticed.
- Alison asked, "Do you want to pray?"
- I thought she was making fun of me but she absolutely wasn't.
- We prayed together, right then and there.
- I felt instantly better, and, she said, so did she.

9. Steven Donovan is a very generous and giving man. Within an hour of meeting me he drove me home at 3am so I wouldn't have to take a cab.

10. The Team Lick Origin Story contained aspects even I hadn't heard. Which is impressive considering how long I've known Team Lick East and how much she talks! Nice work out of you two, Liz and Nick. Can't wait to start planning the ceremony with you.

On this special day of ...love my heart is full of... blood

Tonight I'll be at Improv Asylum for Alison Royer's last night on Mainstage.
The 8p and 10p are sold out but you can still come down to the Midnight Show. For a mere $10 you get a night of improv that usually ends in a dance party. What could be better?
Plus you'll get to see me, Stephanie Jones, and Alison Royer reprise our roles in Four Bitches from Brockton one last time!! You know you have a burning question only the Bitches can answer...

Meanwhile, because it's Valentine's Day I'd like to give you the gift of a song that always made 16 year old me giggle: Heart Of Blood.

Ed in the Refrigerators are a local band Johnny and I fell in love with when we were in high school. These two guys were very clever lyricists and multi talented musicians who played all their own instruments. Oh, and they were 11 and 12 at the time. I was delighted when I found out they're still around and making music.

Happy V Day!

At the end of the day you're another day colder...

I don't like to share work anecdotes that could potentially link specific patients back to me for obvious HIPPA and human decency reasons. I wait until they are long gone from the building, no longer my patient. And I still change some of the details. Now it's been long enough for this one:

I had a patient who was in his mid to late eighties and has been living on the street for years. He came to us for an upper respiratory infection. He was quiet and barely made eye contact when I introduced myself. "I jus want to sleep, ma'am," he said, closing his eyes. Within 24 hours we realized he had a case of scabies. Another nurse and I helped him to the shower. He was frail, with paper thin skin, and almost cachectic looking. When I helped him undress to do the scabies treatment I drew in my breath sharply. Without his four protective layers of clothes his body bore a striking resemblence to the haunted photos of concentration camp survivors. He was a real life walking skeleton. That was when we noticed the mass on his back. The nurse practitioner and I shared a look. The man did not notice.

As the week rolled on, sleeping in a real bed and eating warm food began to liven Mr. S up. In his good moods he smiled and joked and wore a baseball cap. When he was angry the small man became so sassy and entitled that it was unintentionally comedic. "Damnit, woman!" he would scream, as I tried to hide my smile, "I wanted eggs for breakfast! "

For weeks I changed his dressings and medicated him against seizures while we waited for MassHealth to come through so he could go to a nursing home. We joked when he was in his pleasant moods. He could never remember my name and instead would simply ask for "My nurse. The little one." Meanwhile, the mass on his back went unchanged and he developed blood in his stools.

The whole team found ourselves in an ethical dilemma. The man was very old, and had come in for a URI. One of the docs argued against having anything followed up. "It's a can of worms we don't want to open. It's not why he's here." Another argued, "he has a right to know." We scheduled a colonoscopy. Mercifully someone finally realized, "let's ask him if he wants to know."

As it turned out, he didn't. He said, "I'm old. If it's my time, it will be my time." He refused to go through any kind of testing, he refused all procedures. Another week went by and then suddenly, without much fanfare we got a phone call and he was leaving.

The private ambulance arrived to pick him up but he wasn't ready to leave. And having to get ready put him in a sour mood. "Your coat?" I offered. "Now what am I going to do with a coat?" he asked, putting on his eighth sweater. The EMT waiting for us was the most patient I've worked with in the capacity of non emergent transport.
He never once sighed, never rolled his eyes. In fact, when Mr. S got particularly rude with me he and I exchanged a smile and a nod. We kept him waiting for about twenty minutes, and once I had Mr. S in the hall he began to tear into the EMT demanding that he "go on, I'll meet you there by cab." Mr. Amazing EMT was kind, firm and waved goodbye as he and Mr. S got on the elevator.

I was relieved but nervous. What if Mr. S didn't get in the truck? My fears were grounded. He did get on the truck, and even got off and into the nursing home. But a few days later he eloped. We got the phone call, but no Mr. S. I wonder if he's okay. If he's eating. If it was cancer we saw on his back. If he'll ask for help if he needs it again.

But the thing that always gets me about Mr. S is this: what if he had said he wanted to know? Or what if he wasn't actually mentally able to make that decision about his health? Who would have won? Would we have had the mass biopsied? Then what?
We were lucky, we got taken out of the choice because we gave it to Mr. S. But he could very well have demanded to know. And then demanded treatment. Treatment that probably would not have saved him in the long run but would have made his quality of life miserable while costing a ton of money. Or what if he couldn't have told us? What if he was mentally incapable? Would we have listened to doc #1 or doc #2? Run the tests or not?
For now, I don't have to think about it. But someday I know I will.

Things that Go Dreamy

Ok, first: Three Hole Punch has been accepted into the Chicago Improv Festival which is huge and exciting news! Had to let you all know.
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The past few days have been rough around the edges, clawing at the binding on my day planner trying to escape. I've had far busier weeks, but I feel knocked for a loop anyway. I imagine it was mostly the -- falling action surrounding the show at Thacher ending. (I almost just called it the postictal state which might have been more appropriate, the show then becoming something like an artistic seizure I had one night in this metaphor).


The stuff of dreams.
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I've been dreaming very vividly. I had a sequel to a dream I had a month ago about President Obama. But more often I dream of people I know, waking up feeling as though I just spent the last few hours in their company. Feeling like they just left my apartment. I chalk it up to sleeping hard after a month of not sleeping at all.
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Last night I had the night off completely and so after an eight hour shift and then dinner I put Left and Leaving up on iTunes, lit a stick of incense and crawled into bed with Motherless Brooklyn. By 6pm I was asleep. I had set an alarm against this so that I could still have a productive night.

Here is the key to taking naps in the evening (for me). I absolutely can't go to bed in the light and wake in the dark. It disorients me too much. It has induced actual panic attacks at the worst, and at the very least leaves me feeling foggy and generally useless.
The way I learned to combat this is to sleep with the lights on. It works every single time.

In this case, it hardly mattered because I slept through the alarm. I woke up at 10pm, completely oriented and decided to "nap," more. At 1am I called it an actual night, shut off the light and set my alarm for 5am.

Thus began a strange and unwieldy dream in which I was in various settings, but in each setting the time was between 2am and 4am and I was awake because I had gone to bed too early. I wandered around college campuses and my childhood home interacting with other insomniacs, including one where I just chatted with my Dad as he folded laundry.

At 6:30am the sun woke me up and I realized, to my dismay that despite twelve hours of good sleep I had missed my alarm and would have to take a cab to get to work on time.

I didn't touch a drop of caffeine today. And still going strong.

Toy Boat Toy Boat , T-Pain, Bless my throat

Laura called me into her room to watch this last night when I got home from work.
I loved it. It's no Dick in a Box, but these days what is? Without spoiling it I will say that the exposition to the joke is quick and easy, the rhymes are clever (and some of them are even tight), and the simplicity is inspired. Of course, as soon as T-Pain got involved I was hooked anyway. My favorite very quick shot (don't blink, you might miss it) involves a man who is very unhappy with grass.
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In other internet news my favorite blog author is back in the country and is writing again. When Other People's Emergencies lit up again in my Google Reader I thought I was imagining things. Welcome back, TS!
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Annnnd in real life news, I was at St. J's Saturday night for the 7pm Mass to lector when Sister M informed me that I was also going to be helping with the Blessing of the Throats. I got a bit anxious. But then I thought about all of the things I usually dislike about the Church and one of them is how I feel that the hierarchy can get really possessive about God. So for a lay person like me to go around blessing throats, that's way more in line with my actual beliefs. I don't think we always need intercessors. We can bless each other.

So I stayed and blessed throats after Mass. The absolute best part was that once I memorized the blessing I could look into people's eyes. I was smiling uncontrollably because it was kind of silly -- me with those huge candles and so much shorter than everyone else. Since I was grinning so madly, the otherwise very solemn congregation started to smile back. So as I said the blessings, we just smiled at each other, and sometimes laughed a little.
I got to just stand and make eye contact and smile with so many strangers. To me, that was the whole blessing in a way. As we handed candles back to Fr. M later he winked and said, "You know it doesn't work without the candles." And we all laughed, the veil lifted. We don't need candles or oils or waters. It's all in the people. Tradition is just a way to get everyone there at the same time. Like going to your high school football game on Thanksgiving. Being in a church where the priests think that way and understand religion in that way too is so refreshing.

Ten True Stories About Johnny Blazes

Laura did this for her brother when he turned 21,
and I liked the idea enough to steal it for today, the 25th Anniversary of the birth of my dear friend and our third roommate, Johnny Blazes!
Happy Birthday, Johnny!

1. Johnny taught me to dumpster dive. Ze and I rescued about three huge bags full of donuts and bagels from the dumpster behind Dunkin Donuts in J.P center. We brought them to Boston Latin and set them up on the sidewalk as breakfast for students the next morning. Our (former) headmaster came outside and told us we needed a vendor's permit, but we told her it was our "alumni donation" to the school and she gave up.

2. Johnny was the first "freegan," I ever knew. Hir boyfriend David was the second.

3. In between high school and college Johnny and our friend Meghan went to Nicaragua to help build a library. They learned Spanish and raised all the money themselves.

4. For fun and money, Johnny and I co-starred in an educational video series that was used to teach English to children in Spanish speaking countries. One day ze left hir microphone on backstage and the sound guy overheard us talking about a new and very private piercing Johnny had just gotten. He brought it up later and it was extremely awkward for all of us.

4. Johnny founded and directed OCircus! at Oberlin College.

5. Johnny Blazes is well known in Boston's burlesque scene as well as the drag scene. I have always known ze was talented but every time I watch hir on stage I am amazed all over again. Ze is truly one of the most talented people I know.

6. One Christmas Johnny wrote a song for me. Ze produced it with hir father and two of our friends. It's called "Me and Judy Garland," and whenever I listen to it I am still floored by how amazing it is and how much love went into it.

7. Johnny and my boyfriend Tim brought me home after my father's funeral. They were not weirded out when I requested they just stay even though I told them I probably wouldn't talk. They just stayed. They were not surprised when I fell asleep. They did not leave even then. Johnny baked cookies and told me ze would be there whenever I was ready to talk. Years later when I was finally ready to talk about it, and thought I had no one to listen, ze was still ready.

8. Johnny is not only a performer but also is a certified massage therapist, a yoga instructor and a substitute teacher. Ze charges $40 an hour for a massage, so call now!

9. Johnny was the first person I ever wrote video sketch show with. We were 15 and both dating actors named Adam. The show lineup involved a monkey in a diaper, a cooking show about toast and a segment where we ran around in public in our underwear. We never produced it, but I still have the script somewhere.

10. Johnny played Puck back at Riverside Theater in Boston in 1999 and it was the best portrayal I have ever seen. My Dad saw it and could NOT stop talking about it, and how much he wanted Johnny to perform as Peter Pan on Broadway. I still believe that I live with Peter Pan.

BONUS: When Johnny was touring with OCircus! I missed their Boston show because I was debuting with N.X.T at Improv Asylum that night. We hadn't spoken in months. When we called to fill each other in on our successes we found out we were both looking for a roommate and we ended our search that very night.

Lord, what fools these mortals be!

The first show was wonderful. A few glitches, but everything was handled with the grace and professionalism I hoped for. I loved watching everyone's characters really come to life once they realized there was an audience out there.

"You did a great job holding it together when the audience laughed at your slapping Theseus," I told one girl.
"That wasn't me," she said with genuine wonder, "it was like it was Hippolyta doing all the work."

Students who had been mumbling now projected. Students who had been phoning it in really hammed it up. "They loved it when I got into it!" exclaimed the actress who played Helena. She had been too self conscious to act "dumb," in rehearsals, but once she got her first big laugh began flipping her hair and rolling her eyes to beat the band.

Eliciting laughter from a crowd is like magic, or like a drug. Once you realize you can do it you become hooked. This is always part of my dream for my students: that they understand how they can effect people with art (and specifically comedy), and that they strive to find new and interesting ways of doing it.

We're doing the show again Monday night at 6:30pm. You are all sincerely invited. That's how proud of this I am.

Lessons Plans

I am eating lunch in the gym/theater and listening to a live recording of The Chieftains through the state of the art sound system in here. It's moments like this that I wonder if I could ever leave nursing and do this full time*. Any minute now the students will finish their own lunch and come down, ready for our invited dress rehearsal for the whole school.
The following thoughts will be familiar to anyone with Google Reader due to a publishing glitch last night, but I wanted to share them here.

It has been interesting having two vastly different groups of students working together. Yesterday before the Adolescent Program came back from skiing I met with the six Upper Elementary students to do my intro to stage directions, my safety talk, a review of the plot of AMSND and then costumes. I turned my back to speak to another teacher who entered the room and when I turned around I saw that the students had organized a game of Wah!. I couldn't believe it. When I even pause for a breath or a sip of chai the AP students begin to fight over space on the couch, or to write music on Garage Band, or else they find basketballs and begin throwing them around. (WHERE are they getting the basketballs?)

I realize this is due not only to differences in stages of development but to differences in group dynamics and in individuals within the groups. But that's expected. I have taught theater and directed shows now for eight years (not counting the time I spent as an apprentice) in various capacities for age groups from 3-5 year olds to college students . I meet the challenges gladly. Some of my standard lessons by now are "tried and true," and I hardly have to think about them, I just engage them. Many were originally created with an appreciation for various cognitive and social developmental stages. Most were just picked up along the way in my own education, and adapted as I saw fit. Because every show is different and each group is different, many of my lessons are made up and tailored on the spot. The secret to maintaining control, however, is to never let on when I'm improvising. The kids will yell, "Let's play Big Buddah!" "NO! I want to play Hey Baby!" And even as I am scanning my brain for the lesson I need to teach based on whatever their rehearsal was lacking and finding the appropriate exercise to demonstrate a point I am calmly smiling and saying, "Come on, now circle it up! You know I don't take suggestions for classtime."

Although the students are socially at various stages of development -- some of them still in Industry v Isolation and others struggling with Identity v Role Confusion (and some struggling more than others), cognitively they have all reached the formal operations stage of development. It is for this reason that I tend to treat them like small adults. This is a good thing and a bad thing. It's good because I tell them from the first day that we're all here to work and to put on the best show we can. I expect respect and professionalism and in return I will give the same. More often than not they exceed my expectations. Most of their Montessori experience is based on similar models of varying degrees of responsibility placed on them based on their development. We're honest. They tell me when they're bored. I tell them when I need them to step it up. They call me "Mischtical". I call them "ladies and gentlemen". I let them watch Monty Python in class as long as we can pause it and discuss why things are funny.

The flip side to not babying them is that sometimes they have to remind me that they need recess. But that's still a good thing, because without that reminder I wouldn't take recess either.
The Chieftains are singing North Amerikay. I love recess.

But now if you'll excuse me I need to go make sure all the fairies have wings and probably re-answer "can I have a sword in Act III?" (no) "Do I really have to hold his/her hand?" (yes) and the ever popular and unrelated "can you tell us how to make our own blood packs?" (later, definitely.)
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* Sigh. Probably not. One of my biggest flaws is that I have too many passions and I pursue them all with equal zeal.

Show Time

* Apologies to anyone using Google Reader, I deleted a draft of this post but Google Reader published it anyway so you may be getting a repeat here.

Today was the first time we ran the entire play with music, costumes and a full cast. I'm pretty pleased with the results. The Upper Elementary students we pulled in this week to learn the non speaking fairy roles are great. The set pieces all came together, and we've transformed the gym into a woodland wonderland. I stayed late today to hang all the lights myself and to do the wiring for our ancient lighting board.

One of my favorite parts in the show is when Pyramus and Thisby die in the play within a play. Originally, just having gotten off of Gorefest, I promised the kids we could use blood packs for comedic effect. Realizing the floor of the gym was just redone, I later took it back but explained why red ribbons have the potential to be even funnier. They got it right away and watching P and T dramatically die with their red ribbons (Pyramus' forgotten in his pocket until he drags on his death too long and Quince has to enter and remind him to draw it; and Thisby's tucked inside the actor's mouth) kills me every time. (Hopefully their parents have a similar sense of humor.) Meanwhile, because I talked up the blood packs so much the Adolescents have now taken a keen interest in Gorefest and during downtime ask questions like "but what was the poop made of?" and "Can we audition next year?"

Everyone has grown completely into his or her role, and as hoped, the students have taken a lot of ownership over the show. They have ad libbed lines (yes it's Shakespeare, but we decided from the beginning that nothing was sacred), and added details to the show that make it their production as opposed to some cookie cutter junior high shakespeare pageant. I tried to showcase some of their other talents as well. For example, we have a piano covered in vines on stage for the whole show and the actress playing Egeus also plays a Fairy-type wizardly presence who provides music and seems to charm the audience to sleep and then rouses them when the night is through. One of the students has been filming rehearsals and told me he is preparing to make a DVD of the show with behind the scenes bonus features. He's twelve.

Bottom line is that these kids are all amazing. They have worked really, really hard over the past two months. I only see them twice a week and usually only in their own classroom. Over the past two weeks however, we have built a set and they have mastered the volume needed in Thacher's polished wooden gym. They look great in their costumes and they have every comedic moment in the show down pat, with room for vamping. The show goes up tomorrow and they are absolutely ready for it. So ready that I wish we had a longer run. Maybe we can take it on the road.

I've been extra tired without my normal days off from work, but it's all worth it. The show is going to be wonderful. These kids and their families have a lot to be proud of.

The NCLEX-RN

Within the past two weeks Boston College nursing students have been joining us at work as part of their community rotation. Because student nurses in their fourth year are focused on the ultimate task of nursing school: passing the NCLEX-RN, I have recently been talking a lot about study tips, testing strategies and of course, my own experience with the NCLEX.

The NCLEX is a terrifying thing. Questions are asked in literally every category of nursing, even though no nurse will ever have to have quite such a broad span of knowledge once he or she starts work. This is, of course, because nursing school isn't actually a training to be a nurse so much as it's the training for the skills needed to learn to be a nurse. Once a nurse enters a specialty he or she draws upon this broad base of knowledge while going about the business of transitioning from a student to a professional. Medical/surgical, maternity, neonatal, pediatrics, mental health, and of course fundamentals (physical assessment, psychosocial development, general med or I.V administration, etc), it's all on there. And of course pharmacology, my exam weakness.

The day before my exam I did a "dry run" in the afternoon. I was staying at my family's house in W.Roxbury so I parked at Forest Hills and took the train to Downtown Crossing. I went to the building where the test would be held and even went inside. I made sure there was no way I could get lost or be late. Amy and Scott came with me and double checked my plans. I felt assured. I chose a comfortable and attractive outfit to wear and even made a mix CD full of pump-up music to listen to for the train ride. I was READY.

The morning of the test I drove to Jamaica Plain two hours early as planned. But I had neglected to take into account time of day during my dry run. There was no where to park. I kept my cool, having left time in the schedule for glitches. I drove to Green Street. No parking. As I waited to turn the corner a woman walking started screaming at me because "I know you were going to run that red light if I didn't stop you." (I wasn't.) Shaken by the unpleasant encounter, I drove to Centre Street. Nothing. I circled back around to the Park and Lock, which was full. I tried to squeeze my car in the corner, by the fence which the manager had allowed me to do in the past. But this time an angry man I had never seen approached my car yelling at the top of his lungs, "No! No No! You can NOT park there!" I tried to explain, "Sir, I really need to get downtown for this exam," but he just kept yelling. Back in the car I took a deep breath.
I had lost an entire hour so far, but still had a half hour margin to work with.

I found some on street parking with a two hour limit and decided I'd just eat the ticket. Considering that just signing up for the NCLEX-RN costs over $200 it was better than rescheduling. Congratulating myself on getting back on track, I parked with ease and grace. As I left the car I realized I had left my CD in the player. I had to turn the car back on to get it out. Trying not to get hit by oncoming traffic I extracted the CD and put it in my disc man. That was when I realized I had shut the door. With the keys in the car. And the car running.

I lost all composure and called my mother up on the brink of a compete melt down. She asked for the location of my car, told me to get on the train and not to think about it anymore. While I was in the test she found my spare keys and enlisted my aunt to drive her to the car. In case anyone was wondering, my mother is My Hero.

I arrived about 15 minutes early to the test and collected myself in the waiting room. The exam itself is a different length for every prospective nurse, but the total allotted time is six hours total. The test can be anywhere from 75 questions to 265 questions. It's a computer adaptive test (CAT). The questions get progressively harder as long as they are answered correctly. They get easier if you answer incorrectly but then get harder again as you begin to answer correctly. The machine shuts off at the point where you would stay above the minimum level of competency no matter how many more questions you got, or conversely, when no matter how many more questions you answered you could not rise above the minimum level of competency. Because of that, there is no way to know if you passed or failed based on when the computer shuts off.

Many nurses can tell you how many questions they had. I can not. They told us not to look at the numbers. I looked once, and it was past 75 and I started getting sick to my stomach, and I looked away. It felt as though over 70% of my exam was made up of obscure pharmacology questions about specific antidepressants having to do with whether or not a med should be taken with grapefruit juice and things of that nature.

When my machine shut off I was thankful and depressed. I walked outside, sat down on a brick wall amongst a flock of pigeons and began to cry. If only I hadn't had such a stressful morning, I thought, I wouldn't have failed.

Three days later I decided to make it official, and I checked the status of my exam online. The word "Pass," next to my name seemed impossible. I made a noise, "like an animal," according to my brother, who walked into the room, saw the screen and immediately began pounding me with a pillow and then his fist. "Do you know what you put us through?" he screamed, "we thought you actually failed. We felt so bad for you!" This attracted Mom's attention and she joined in the pummeling.

When I tell this story to the SNs at work the take aways are these:
-Plan as much as you can for how you want your day to go, but realize it still might not be perfect so leave room for error.
-Study as hard you want, but realize that at the end of four years, you know what you know.
- Everyone thinks they've failed. I haven't met anyone who thought he or she passed. The test is designed to make you feel horrible. Wait the three days out and be good to yourself. Your family and friends will appreciate it.

Back to Basics

This morning on the way to work I found myself annoyed by two high school girls standing next to my seat. They were having a very loud and inane conversation which mostly involved one of them telling a story and the other one saying, "I know, n****r!" I forgot all about them until the end of my shift when I walked onto a train at Mass Ave headed home and heard someone screeching, "n*****r, do I smell like tuna fish to you?" Seriously. What are the odds?
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I had a lovely weekend, kicked off with my final Faceoff show Friday night. Sunday I worked from 3pm to 7pm and was planing to then take a bus to a train and then a taxi over to Bobby and Claire's for the Superbowl. Instead I was lured astray when Caroline called work to see what I was up to. Caroline is an amazing cook and I hadn't seen her since she started moonlighting at the Pine Street Inn (plus she lives very close by) so I jumped at the opportunity. Joseph picked me up after a short train ride and within 15 minutes I was barefoot on their sofa eating spicy soup and debating Melody on the appropriate use of the verb sup*. Caroline and Joseph taught us all how to drink a Mexican Flag, and then, no sooner were the limes and salt put aside when three flavors of sorbet, a pan of warmed berries and fresh hot chocolate sauce appeared.
On Monday night it was my turn to act as a host. Laura made guacamole, and I heated up some chicken wings and one by one a motley crew arrived to watch Groundhog Day. "I can't believe it's only been a year since we watched this last," Laura complained marveled. Me neither. My brother showed up after the movie was over and I was getting ready to turn in. We stayed up and drank tea and talked about recipes for chicken and how badly we'd like to visit Mexico. (Badly.)
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If the entire weekend was categorized by spending quality time with good friends, Saturday afternoon was perhaps the pinnacle. I had lunch with Liz K., who was one of my my closest friends in high school. Liz is going through a bunch of changes in her life, and when I found out, third hand, I called her up. I was nervous as I drove to pick her up in our old neighborhood; for all I knew we had very little still in common. After all, there were reasons we both drifted from the close knit group we were once a part of. As it turns out, I had nothing to fear. We had a four hour lunch and then decided to attend church together. As I knelt beside her in the large, gothic church of our childhood I felt more at peace than I have felt in a very long time, even in prayer or meditation.

I talk a lot about mindfulness and self awareness, and have written before about how important I think it is to reevaluate your knowledge of yourself and to question yourself often. One facet of this that I can never get enough of is reconnecting with the people who knew you before you were you. When Liz and I were close enough to talk every single day and share everything from Latin translations to boyfriends, I was a different person. And just talking to her about even inconsequential things opened up a lot of insight into who I was then, who I am now and how I got here. Senses reconfigured.
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* We were both correct. It is both an archaic word meaning "to eat dinner," (my stance) as well as a more modern word used in place of "sip" when a fluid is more viscous than water but not nearly a solid (her argument).

Stand By Me/Beautiful Girls

Mental Health Rant

The more I thought about the Goldfarb the more upset I became. Watching the video over and over didn't help.

Many people who believe they do not have issues with mental health (whether they do or not is another story) consistently downplay the significance of mental illness in our society. This attitude is not often actually put into words by educated people. No one who knows better says "They should snap out of it" or "It's their own fault anyway." But we feel that way sometimes anyway.

I work with people with mental illness every day. Still with all my experience, exposure and education I sometimes catch myself transmitting the message "Why can't you just knock it off?" and even when it's not directed right at the patient (maybe it's in a venting session with a co worker) it's always a harmful stance to take. It perpetuates a myth that all people are always in control of how they behave. They are not*.

Shutting down funding for Mental Health programs is like ignoring that people have arms.
("Hello, we are a hospital that only treats anything NOT having to do directly or indirectly with your arms.")
So is the practice of insurance companies denying authorization for mental health services.
("This insurance policy does NOT cover your arms. Sign on the line.")
What would you think if you went to a country where that was the case? You'd probably come to the conclusion that arms are not valued. They are considered expendable. People in that country for some reason just really don't need to worry about arms. For some people, it's because they have never had problems with their arms. So there'd be a lot of fine, two armed people. But then there'd be a ton of people with one or no arms just from minor injuries like broken fingers or infected lacerations.
Denying mental health services sends the message that this entire branch of medicine is less legitimate or important than others.

This is a dangerous message for health care companies and the state government to send because American society in general these days already sends very mixed messages about mental health. On one hand, we are more educated and comfortable about mental health than ever. Characters on popular TV shows have therapists, women are no longer diagnosed with 'hysteria,' when they cry, and men are encouraged to share their feelings with their wives**. On the other hand, women and men alike are feeling the pressure to save face. Think about how much the media harped on Hilary for crying when her polls were down. No one wants to see you break down when times are tough. People are expected to power through and write a book about it, produce some angry music, or create a stand up routine. Anything less is unacceptable. And yet... Oprah continues to have a tv show.

Depression, personality disorders, mood disorders, it's all neurological. It's physiological. It's very, very real. Whether the help is medication or therapy or a group or a program help is needed.
Providing mental health services is imperative for successful preventative health care. People who feel safe and happy drink less, smoke less, do fewer drugs, commit fewer crimes, and reach higher levels of self actualization. To go back to the arm analogy, what do you think will happen to all those people with disabled or missing arms? They will have to be supported even more by the people who do have arms.

I know you can't fix this. You can't re open the Goldfarb. And the money is just not there. But please try to be aware of how you view mental health. Our minds are amazing. I love my brain. If you are blessed with one that works well for your purposes please don't pollute it with bias against minds that need some help. And maybe do some thinking about how to fix these problems.

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* If you want to fight me on this I will probably ask you to meet me at 10 Shattuck Street in Boston. We can stand next to the preserved skull of Phineas Gage and have it out.
** Ugh. Ugh. Ugh. I apologize to my queer readers for this incredibly hetero sentence, but my writing is limited by my scope of experience. I would definitely welcome some guest writing on the subject of Mental Health in the Queer Community if you have some thoughts to share.

One Step Forward, Two Steps back for low income Mental Health

A short time ago I wrote about MGH's decision to put a substantial amount of funding towards a collaboration between the Department of Mental Health and Boston Healthcare for the Homeless.

This article today in the Globe brought some disheartening news: because of the state's budget cuts the Goldfarb is shutting down. Surely some of the clients from the Goldfarb will be able to get mental health services from BHCHP, but not all of them. This is terrible news for those clients, but also for society in general. Crime rates WILL go up, and public morale will continue to fail.