Hidden Falls: The Musical

Everybody! Everybody! I'm in this, so you should come check it out! 

When you go to Improv Boston's website click on the Comedy Lab schedule to buy tickets.

Hidden Falls: The Musical

Wednesday Nights in March*

8pm at Improv Boston

In this 40 minute long improvised musical, actors will create the town of 

"Hidden Falls," anew based on audience input at the top of each show.

Through song and scene we'll discover the people who make up the town, 

and the dreams and desires that make up those people.

Because it's completely improvised, no two shows will be alike!

Buy tickets online for one or more performances.

 Part of Improv Boston's Wednesday night Comedy Lab series.

Director: Steve Gilbane

Piano: Steve Gilbane

Percussion: Jeff Greenwald

Featuring: Jaime Church, Mat Gagne, Don Schuerman, Ben Scurria,  Monica Shea, Deanna Tolliver, and Misch Whitaker

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* Except March 9th due to programming for the Women in Comedy Festival.

 Which you should also come see. 

Not The Doctor

Patient: Why can't I have Flexeril? It's all just pain medication.
RN: Not really. See, Flexeril works in the brain stem and sends signals to your muscles to unclench. You told me your head hurts, which is probably not due to muscle spasms.  Tylenol stops your cells from creating these things called prostaglandins. Prostaglandins are protective, your body forms them when there's a problem, but they also cause pain. By stopping them from being created, Tylenol reverses the pain you feel. Like in a headache.
Patient: You're not a doctor.
RN:  You're right. I'm a nurse.

(stare down)

Patient: I think I'm having a muscle spasm now. Can I have my flexeril?
RN: (sigh).

The Effect of Ferrets on Blood Pressure

It is a widely over-cited fact that "pets decrease blood pressure," however before I wrote an entry making any recommendations to switch out a ferret for HCTZ I decided to check my facts. When I searched some online journal databases for studies on animals and BP, the results were disheartening. All of the studies were older than five years ago, and none of them mentioned ferrets.

In the past few minutes, on a related note, I have had to stop typing and put my laptop down in order to prevent Rascal from eating the following things:

1. My leather bound copy of  The GLOBE Illustrated Complete Works of William Shakespeare
2. A roll of duct tape
3. My left foot
4. The other ferret ¹

So, I can now tell you from my own qualitative data, that ferrets have a negative effect on hypertension in acute stress situations. Which is fine. I don't need lower blood pressure anyway.³


 I haven't been a pet owner in years.  And being a ferret owner is a very, very specific type of pet owner. ⁴ 
Ferrets are simpler than frogs or dogs but way harder than say, my Mom's beta fish, Ceviche. (Although come to think of it, my Mom has never claimed the title of "pet owner" per se, but she technically has been ever since that fateful Mother's Day when Brian and I decided a Japanese fighting fish would be an excellent gift. ⁵ )

I get up early and go to bed late so I have time to clean their cage before I leave and when I get home. Ferrets need exercise but you can't walk them or go jogging with them at Fresh Pond, so they have to be allowed to run around and play. Playtime has to be supervised though. Unless you happen to enjoy the types of games that my college roommate's ferrets taught me: What's the Ferret Choking on Now?,  How Did The Ferret Get Behind the Shower Wall? and my least favorite - Find the Poop With Your Bare Feet at 2am.
All this supervised exercise time means skipping the gym, dashing home between work and evening commitments, and coming home a little early. Sometimes it even means staying up way later than you expected to, writing a rather pointless blog entry so that the ferrets can play.

But now as I sit on the couch watching Weasel and Rascal slowly curl into one giant ball of Ferret and fall asleep, I do feel my heart rate normalize and my breathing become regular.

Having an excuse to come home has actually been really nice. Having a justification for hours spent relaxing instead of running around from place to place has resulted in some seriously peaceful evenings recently. I actually made dinner one night. And watching them play, and trying to get them to play with me makes me laugh out loud like a crazy person in a really good way.

So although I am (obviously) allergic to them, and although they smell like the locker rooms at the MDC skating rink where I used to hang out as a kid, ⁶ the little monsters have taught me some valuable lessons about taking a step back from the grind.

My amazing friends are returning home from their two weeks of saving lives in the Dominican Republic. And Weasel and Rascal will get bundled up and get to go back to their triple decker ferret condo. I'm going to really miss them. I'll miss the weird noises they make when I come home, and the way they jump up and down to get my attention when I'm reading. I'll miss playing fetch and tug of war and watching them scratch their backs on the carpet like landlocked otters.  I'll miss Weasel curling up in my lap for a nap and Rascal climbing up the wall and dive bombing pillows just to give me a heart attack.

I will not, however, miss them enough to agree to keep them. Don't you even start, Amy.


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1.Seriously, where is the other ferret? ²
2. Just kidding. Weasal is inside an old Hawaiian shirt in the closet. Duh.
3. Last time I checked it was 109/70. The next time I touch a therapy dog I'm going to need IV fluids STAT.
4. Keep the D&D and Comicon jokes to yourself please. I'm just a ferret babysitter.
5. Sorry, Mom. We like to drink together.
6. Keeping it classy, West Roxbury. Actually, I prefer the smell of ferrets. Sorry, Parkway Youth Hockey.

Rennovations

Mom: But they do have problems. At the beginning of the movie he wouldn't help her pick out the new tile.
Me: That's not a big deal. If he doesn't care she should just pick it out. No one cares about tile. I don't want to marry someone who cares about tile.
Brian: There is a ninety percent chance that the guy you end up with is going to care a LOT about tile.
Me: Just watch the movie.

What Was That Sound?

I can't believe I dropped the pill.

I am furious.

There is nothing else in this moment besides my fury, because a patient needs that pill and I knocked the medicine cup over and I can't find  that pill and it was the last pill in the bottle and the pharmacy is down
                                                                                                                                                           two  

floors

and the elevator is soooooo slllllooooooow and I have had to pee for over an hour but I have not been given the chance to pee because I have been movingnonstop since the shift started.  I am starting to sweat. The hallway is one million degrees. Where the hell is that pill?

I am on the ground, and hidden behind a row of cabinets but above me I can hear the chaos in the hallway. A patient near the elevator bank is demanding to see a case manager. A call bell rings, coinciding with a phone. The bells are discordant. The coffee pot is broken and sounds like a vacuum cleaner choking on a piece of carpet.  Mentally I am ticking off at least four other things I need to prioritize before I can leave the unit to visit the rest room. And the highest priority is THIS PILL which I can't find. So do I go to pharmacy now and skip the other three tasks until this one is completed? Or do I move the other three tasks up the queue before leaving the floor to get a replacement for THIS STUPID LITTLE TINY PILL that is so important. So very important  and I am a dumb, dumb idiot for spilling the cup.

"Excuse me." There is a patient peering over the cabinet at me.  I know him very well.

"Can you open this can?"

He gently lowers the soft drink can onto the counter top using his wrists. I stand and smile before popping the tab and helping him put the can back between his wrists.

"I had good luck today," he says smiling, "I put my money in the machine and instead of just one ginger ale, I got two!"

"I love when that happens!" I say, genuinely. Because, who doesn't love that?

"Well, something was meant to go right!"  

He walks away, can between his wrists, earnestly pleased at his good fortune. Because he may not have use of his hands but he has two sodas. In fact, he may never be able to use his fingers again, but he is practically whistling down the hallway because he found something positive to latch onto this morning.
 And amongst all the other sounds in the hallway I thought I could hear a new one. It was the sound of my own heart breaking.

 I found the pill. And the patients all got their medications. And everything got quiet. And I went to the restroom. And in his bed by the window, a thin man in mismatched pajamas sipped ginger ale through a very long straw and smiled serenely at his fortune.

the cleanest ferret video you'll see today*

I am ferret-sitting for one of my friends. Weasel and Rascal arrived last Friday in a travel kennel. Amy and I set up their temporary cage, which is a lot smaller than their multi-level home in Amy's house.

She fretted as she unpacked their belongings, "do you think they'll be too cramped?"

"Don't worry," I said with assurance. "They'll have free reign of the living room when I'm home."

I shampooed the ferrets later that day to keep them fresh. Bathing them can't happen too often, but should also not be too infrequent. I remembered that from living with ferrets for part of college.

I did not remember how adorable a ferret's attempts to get dry are.

I also forgot how quickly I bleed when scratched by an angry, wet, animal.

No more baths.

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*Maybe. I guess I shouldn't make too many assumptions about your taste in ferret videos. Sorry, dude.

Allergies

This is via Nurse Sassy Lionheart, who has now made an appearance on the blog three days in a row,* talking about a patient at her other job:

NSL: It says here you have an allergy to morphine. What kind of reaction have you had in the past?
Walk-In Patient: Well, last time I was in the hospital they gave me morphine and I felt really funny.
NSL: Well that's -
WIP:  (completely in earnest) But right after I took it I also smoked a bag of angel dust.
NSL: Excuse me? You smoked a bag of angel dust in the hospital?
WIP: My friends brought it to me, with some booze. But I was on a PCA pump too. So I don't know if it was a true allergy to morphine or not.

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* Really, she should just start her own blog at this point.

Navigating the Labyrinth

Why is so much of the health care system set up for consumer failure?

My doctor referred me to see another doctor. She made an e-referral, "shared" my e- Medical records, and told me all I had to do was set up an appointment. Technology is great, I thought happily. I had no idea that I was about to enter the scheduling Twilight Zone.
Consider this sentence in a message left on my voice-mail hours after I initially called to set up an appointment:

 "Then we'll mail you a questionnaire and when you fill it out and mail it back we will review it and then call you to make an appointment. So call back and let me know if I should send it."

First of all, you'll mail a what?  I'm not taking the Pepsi Challenge. I'm going to see a doctor. Second of all, I had already called and left a message in the "scheduling" box. Which I was only allowed to do after I did an intake over the phone with someone from Registration. Clearly, I want an appointment. Send the questionnaire if that's a real thing. Why do I need to call back a third time?

Surely I had misunderstood the voice-mail.

The next day when I called I was told the questionnaire had not even been sent to me yet since they had not heard from me. I asked  why I needed to fill out a questionnaire and was told "so we can determine which practitioner you should see." At this point I reiterated that my doctor had submitted a referral for a specific doctor in their practice. "That is the practitioner I should see," I pointed out. The secretary told me I still needed to answer the questions and mail it back. There is no way to fill out the form online. I need to receive it, fill it out, mail it back, and wait for it to be reviewed before I can schedule an appointment.

This is insanity to me. In an age where robots perform surgeries,  where computers can play Jeopardy,  and where I can have ice cream delivered to my door UNTIL 4AM and pay for it with a credit card, why am I watching my mailbox? Don't they know I am rarely home? That I have two jobs? That I just ran out of stamps? Am I being referred to see Dr. Quinn, Medicine Woman? *

As I stood in the hallway at work, trying to let the anger go,  it made me think of my patients.

- If I can barely navigate this ridiculous back and forth of voice mails, phone calls and paperwork, how hard must it be for someone without a home? A phone? A voice mailbox? A mail box?   Even if a homeless man or woman has a mailing address (and many do), often it is not accessible  to them 24/7.
- Add on the fact that seeking help for anything other than acute injury is not going to be a priority for someone on the street, and you have a real barrier to compliance for appointments related to chronic life threatening problems such as diabetes, cancer and AIDs.
- Forget appointments to screen for early signs of disease, such as yearly pap smears for females or colonoscopies for people over the age of 50.
- Plus, when I finally get an appointment I am likely to write it down somewhere, be able to take a (paid) day off from my job and I will drive my car to see the doctor. A homeless man or woman is likely to forget the appointment, or just blow it off due to lack of transportation or the need to be somewhere else at that time  (taking care of an infant, standing in line for a bed or food) or in some sad cases, abusing substances to mask physical or emotional pain).

That's why Healthcare For the Homeless programs are so important nation-wide. It's not about cheaper access to services or free care. It's about access to services at all. It's about organizations that can offer rides to the disabled war veterans to get to appointments, or who will help an illiterate woman  fill out pages and pages of complicated forms in order to get social security benefits. It's about teams of people who will meet with folks who have been through too much trauma to deal with the type of rejection sometimes faced by patients waiting for care. Just think, I've had to call this woman's office three times so far since my PCP made the referral for me. People with mental health issues, social phobias and histories of being abused probably would not have made the second call, if they made the first one at all.

So as I continue to try to get in touch with Dr. Mike** I am thankful for the structures in place in my life that I often take for granted that will assist in me eventually getting an appointment. And I vow, not for the first time, to do my best every day to address every patient issue that I can, or to put the patient in direct touch with someone who can help them. It can't always happen. Things get busy. Patients get blown off. Especially ones with minor complaints. We triage, we prioritize. But I can try my best.
Because unless I create the care I wish to receive, the system is going to stay broken.

In the meantime, Nurse Sassy Lionheart suggested I just get on my horse and gallop the questionnaire back to the office. You know, to speed things up.

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* Gosh I hope so. And I hope Sully is there. mmmm.. Joe Lando circa 1996.. That helps. No more anger. Only wild and free "courtship feelings." ****
**  Not her real name, obv, but I am assuming she, like the real Dr. Mike, will be bold, outspoken and have all kind of new ideas she learned at the Women's Medical College of Pennsylvania.***
*** If not, this was so not worth it.
**** No disrespect, of course, to Joe Lando's current wife and children. I am glad it worked out for you all.

Flattery Going Nowhere

Sassy Lionheart: That's the patient that called Night Nurse No Nonsense 'exquisite.'

Me: Wait what?

Sassy: Yeah, he told her she was exquisite and asked her name.

Me: Ha! You know what he said to me?

Sassy: What?

Me: He told me if it weren't for my stethoscope he would have thought I was a patient.

Sassy: Ha! What did you say?

Me: That we don't have a pediatric department. Do you think he meant I look sick or... homeless?

Nurse Bestie: Your hair is a bit -

Me: Enough.

Housing for Labor

My role as a provider of health services to homeless men and women does not end the cycle of homelessness. My mission is to provide the best quality health care I can offer to people during a vulnerable time in their lives, whether their non-housed status is chronic or temporary.

Still, my hope for all of my patients is for them to attain safe, stable housing situations. Housing is a huge part of homeless healthcare.

There are many different reasons people become displaced or homeless. Which is why there is no good, solve-all resolution for the problem. But there may be a few approaches that will work on large pockets of homelessness in the US.

An interesting article came my way via Twitter yesterday from the National Coalition for the Homeless.

The full article can be found here. In case you don't have time to read it I'll sum it all up:
In San Jose, there is a community of otherwise homeless people who live intermittently in a tent city near Coyote Creek. They are often asked to clear out. The city organizes a clean up effort (for example, in conjunction with the county jail). Then... they move back in.
But if the US Environmental Protection Agency funds a grant proposed by the city's Environmental Services Department, the Santa Clara Valley Water District and a non profit called Destination: Home, then the creek dwellers may be able to do the clean up work themselves this time, earning housing and job training in the process.
Since my visit to St. Mungo's Nightingale House in London last spring, I have often thought about how important job training and social services are for ending the cycle of homelessness.

The Downtown Streets team, mentioned in the article, has used a similar model to get men and women off the streets of Gilroy, Palo Alto and Daytona Beach in Florida.

Again, because homelessness has so many different causes, the same treatment isn't going to work for all of them. What about elders who can not work? Those who are homeless due to illness or physical disabilities?

Both Richardson and Liccardo say they are fully aware that the program will not end the problem of chronic homelessness, especially for the severely drug addicted and mentally ill.

"We don't pretend that we can save everyone,'' Liccardo said. "But this could be an effective tool in the toolbox."

And I think this is an important thing to note. It's easy to reject ideas because we can see that they don't hold the entire solution within their limits. But when a problem is as multifaceted as homelessness... an entire toolbox full of approaches is going to be absolutely necessary.

Well done, San Jose!

Happy Valentine's Day!

I know I've mentioned this song before but I can't help it reposting today.

I first heard this song in 2002 at my very first Ed In the Refrigerators show. Actually, I'm fairly sure that first show I saw them do was the release party for the album It Could Happen to You. 
Annnd... for those of you who don't know this already, I was a senior in high school and the two guys from Ed In The Refrigerators (Joe and Andrew) were.... 10 and 11 years old respectively.

These two middle school kids playing all their own instruments and singing this little love song made me giggle so much that night that I bought the album. And I still love it. This particular tune has a sticky (almost cloying)  melody and laughably straightforward lyrics. (Check out the bridge for both a great example of list-song writing and an impressively aimless knowledge of anatomy).
Above all else, the sentiment is actually rather clever  - but you gotta listen all the way to the end to catch the twist.

So... here it is, for your Valentine's Day delight:  Heart of Blood.

Audition Notice!

Improv Asylum is having auditions for their NXT cast!

You can read all the details about it on the website.

I auditioned onto the NXT cast in 2007 with Stephanie Jones while we were still seniors in college performing with Mission:IMPROVable at UMass Amherst. I met some great people, performed with really talented comedians and worked under fabulous directors. After just under two years I was invited to join the mainstage company, where I continue to perform today. If you want, you can contact me to talk to me more about my experience before or after you email Stacey and book an audition slot.

Do it. You know you want to. Do it.

My Job is Weirder Than Yours

This morning one of the nursing students approached me as I was settling in at the nurses station.

-"Hey - this morning I had a sandwich just like that."

-"It's good," I told him in between bites.

-"So I was eating the sandwich and I found a dead body."

-"You what? where?"

-"I was eating the exact same sandwich, Dunkin Donuts, sausage, egg and cheese -"

-" - this one has bacon."

-"Nice - but,- "

- "I hate frozen sausage patties."

- "Whatever. But as I was walking near ---------and I saw it, the paramedics were stepping away, they were done with him."

- "Oh. So it was attended."

- "Well yeah. But it was so cool because I knew I was a real nurse because I just kept eating my sandwich, you know?"


I stared at him. And finished my sandwich.

Woo and Bieber: Roommates - Episode 4

Justin doesn't want to use his comp tickets on Woo