Cranky

I am, as my freshman roommate would say, fussy.

So, these are things that are making me laugh - I offer them in a selfish attempt to shake my mood.

1. The Office episode with Prison Mike and Andy singing Rainbow Connection to Pam with Pig Latin sprinkled in.

2. This, and the fact that my sister and I have chatted about it via Facebook with an aside comment from one of long lost SLP friends...



3. The Sookie Stackhouse books from Charlaine Harris - Sookie is being courted by a werewolf, tiger shape shifter, and no fewer than 2 vampires. Good times.

4. The fact that the Tuesday night trivia team had 2 new members who are ridiculously smart and we still ended up as 1st place losers and proud owners of 30 free chicken wings next week. I guess just because you can save the world from terror threats while explaining quarks doesn't mean you know that "hoi paloi" is a Greek phrase.

5. Some Girl Scout troops sell their cookies in November but the housekeepers at work ate mine. Better them than me, in the long run.

6. I spent a day earlier in the week being told by more than one patient that I am not only a horrible therapist but a horrible person only to have a lovely session with someone later in the week in which a patient, in the midst of working on a math problem, told me she liked my nail color and was it the same as what's on my toes (she has some attentional issues)then was told by another patient at the close of an hour-long session "You're a very good person", then followed up with "Who are you again?".

I feel a little better. Thanks for indulging me.

Norming

So maybe I have Bruce Tuckerman to blame to for the cone of semi-silence within which my class has been operating.

In 1965 Mr. T. invented the stages of group dynamics -- "forming" where the group starts to get to know each other, "storming" where there is jockeying for leadership positions, "norming" where the group essentially finds its stride, and "performing" where the group starts actually doing what it came together to do (apparently several years later he added "adjourning" - must have been a slow moving group).

Yes, I know it's more accurate to say he described them rather then invented them, but that seems to somehow absolve him of responsibility. No no no.

The first week of class we did basic intros. This is me, this is you, this is what we're going to talk about. No, we won't have class the night before Thanksgiving, thanks for asking. Forming, check.

Commence storming.

Subsequent weeks started the review of why adults sometimes need communication systems other than speech, and how to figure out what that system should be. I'd review a Power Point slide and hear the "click click click" of notetaking on a lap top and not much else. Thoughts? No? Okay, moving on.

As the 2nd and 3rd weeks went buy I tried to bribe them into interaction with by forcing them to do interactive things (here, collobrate the eye gaze system for each other; hey, let's have a relay race to see which team can construct a sentence on a speech generating device using a switch.... whee!). I get a questions that have the undertone of "are you for real?". Other than that - crickets.

Weeks 4 and 5 come and go with a f e w talkers - a couple who have immediate concerns based on what they're doing in their clinical practicum and maybe, just maybe, a few who are starting to find all this stuff interesting. They have to talk to each other to present brief research projects and they mostly seem to be listening. A fun conversation about how icky trach care can be. A
few more questions emerge from new talkers. Hmmm.... maybe we're getting somewhere.

And then, tonight, boom. EVERYONE either asked a question, answered a question, or shared a thought. Woot. I think we're norming.

It's sooooo much more fun than the other junk.

Membership has its...

When doctors are permitted to see patients in a given hospital, they "have privileges" there.

In the past few weeks I have:

-- heard a person with ALS say "I have hope now" when shown that even though they can no longer move their hands or arms that they can still surf the internet

-- hung out with someone who has the same disease the Elephant Man had, and helped figure out some strategies for him to successfully interview for the job position he wants instead of the job position he has

-- seen someone who had a stroke several months ago realize that he didn't need therapy as much as he needed people to talk to

-- gotten the good news that a former patient who was fired from his job because of his speech impairment, now, over a year later, has a job offer in hand

-- watched graduate students start to put the pieces together that what we do is actually pretty cool and is so much more than working with autistic kids (though that is certainly noble work)

-- had colleagues in my office in tears, laughing hysterically over the things our patients do and say, and thinking through big professional changes

-- breathed a sigh of relief that a long-time patient is 4 short hours away from returning to work full-time

-- comforted a colleague I was observing when her patient told her that her fly was down, and it was

-- met a woman who listed "alpaca farming" as her primary leisure activity

-- heard someone from Columbus, Ohio sound like they were from the West Indies because of their stroke

-- talked with doctors, lawyers, judges, auto mechanics, housewives, office managers, people with fancy homes in Potomac and people with no homes at all

For all the days I want to put my pencil down and walk away from it all, most of the time I have a crazy, wonderful job.

Clearly I too have privileges.

Motivation

Looking for inspiration to get myself going on some stuff for class... You Tube is not helping...

INTJ

Guess what I have in common with Ayn Rand, Rudy Guiliani, and Chevy Chase. Guess. Come on, guess.

Fine, I'll just tell you.

We share the same Myers-Briggs personality profile, which is, according to its authors, 75% accurate. Wikipedia describes it thusly:

I – Introversion preferred to Extraversion: INTJs tend to be quiet and reserved. They generally prefer interacting with a few close friends rather than a wide circle of acquaintances, and they expend energy in social situations (whereas extraverts gain energy).

N – iNtuition preferred to Sensing: INTJs tend to be more abstract than concrete. They focus their attention on the big picture rather than the details and on future possibilities rather than immediate realities.

T – Thinking preferred to Feeling: INTJs tend to value objective criteria above personal preference. When making decisions they generally give more weight to logic than to social considerations.

J – Judgment preferred to Perception: INTJs tend to plan their activities and make decisions early. They derive a sense of control through predictability, which to perceptive types may seem limiting.

I never really put much stock in this, but I was feeling every inch of my type last weekend during an end-of-season beach trip with 5/6ths of the girls from Dinner Club. We spent almost all of our time together in group conversation, hanging out on a deck wtih books or knitting on our laps, cocktails in hand, chatting about anything and nothing (though after several bottles of wine one night the conversation would have been deemed offensive in a NFL locker room).

From previous bigger group weekends at my friend's place on a ski resort I knew I had a tendancy to remove myself from the core group at times, even if just for a few minutes to clean up the kitchen or flip through a magazine. But I noticed I was really tired at the end of the first day, and would feel truly relaxed only in the times when a group of 3 would go shoe shopping, or a group of 2 would go on a beer run, or everyone was taking a mid-afternoon nap except for one other person.

I love these women, each of them, and there were moments where I was cognizant of the fact that I was so happy to be a part of this as I know it's a rare and special thing to have good women friends. I'm just wired the way I'm wired, and I can feel myself burning energy to stay involved in a group conversation.

It makes me think that professionally it would help to know the cognitive functioning style of our patients, as I can't imagine that these basic tendancies change post injury. The whole point of communication is to enter into exchanges that connect you to someone - to meet a basic need, draw someone close to you, exchange information. Successful communication is a spiritual process, in my humble opinion, and if it is a situation that fits our profile, then it feeds us and gives us energy that we continue to shower back onto those around us. I wonder how often we press patients into communication situations that don't feed them because we're using our own models of what feels good.

There definitely seems to be something to this personality style business. My sister recently took the test and in four letters explained the reasons we wanted to kill each other for the majority of our teenage years under the same roof - ESFP, the exact opposite of INTJ. Nature, not nurture.

Fallout

On September 11th this year, many of my "friends" updated their Facebook status to describe what they remember from that day eight years ago, as in "WP, who was in the capitol that day, remembers", or "RR: I was in my dorm room asleep when a friend called to tell me to turn on the TV. 'What channel?' I asked. 'It doesn't matter' he said." Many people said where they were when they first heard the news, others wondered what we'd learned in the time that has followed. Others just looked forward to the OSU game on Saturday.

I remember being on the unit when I overheard someone say a plane had crashed into the World Trade Center. The medical resident standing beside me said, "I've been in that place, it's a fortress. That building isn't coming down". At that point most assumed it was an accident. Patient care went on.

I stopped by the TV in the atrium just in time to see the 2nd plane crash, confirming this was no accident. But patient care went on.

Then my long time supervisor and friend, J., saw me in the hall and said, "Did you hear they hit the Pentagon?". "Who is they?" I said. "Terrorists. They're coming for the Capitol". But patient care went on.

There was a brief time where I thought I was personally in danger. Silly now looking back on it, but powerful in the moment.

Patient care that day involved business as usual for our inpatients, who for the most part didn't have the awareness to understand what was going on given their injuries, and prepping for the admissions from the acute care hospital as they were sending anyone who was medically stable over to us to make room for burn or other trauma victims from the Pentagon scene. They never came, as people either survived unscathed or were incinerated on the spot (a friend who worked the recovery later told me that they found people still sitting at their desks doing whatever it was they were doing on impact, only they were no longer people but piles of ash).

Where I work is in the northwest quadrant of the city, and to get to Virginia you have to go over a bridge leaving the city unless you want to go into Maryland and around. We were hearing that people had simply walked home in order to evacuate downtown DC before they knew all the planes had been grounded, and there were rumors flying that there were no open roads into VA. After the single longest day of my life, it was finally time to go home but no one knew how to do it. One of the guys in the Rehab Engineering department went first and called within 10 minutes of leaving to say that roads were not only open, they were wide open.

I made my way home and didn't see a single other car on the road for the whole trip, which was the most disturbing part of it all to me as this route was usually a traffic snarled nightmare. As I came out of the 3rd St. tunnel to merge on to 395 I could see the smoke plume from the smoldering Pentagon, and as I drove by it alone on the freeway, expecting at any moment to get stopped by military police or the National Guard or the Secret Service or something, I could see the giant hole that used to be a wing of a building and people who loved their country. It was horrifying.

When I got home, pictures had been knocked off the wall from the impact of the plane hitting many miles away.

It was simply a surreal day, and these things I remember.

But what I remember more strongly and spend more time thinking about is the fallout.

Today's sermon was about Noah, which is what got me thinking about this. Noah, the first winemaker, after being back on dry land got drunk and took off all his clothes in what was likely a response to the total devastation he had witnessed. This lead to the cursing of his son who found him, which lead to a whole mess of hurt.

I worked with a man a month later who after years of controlling his drinking had fallen off the wagon when his friends were killed at the Pentagon, and crashed down a flight of stairs in a drunken stupor. The hospital's international program which housed primarily people from Arab countries immediately shut down, and some relationships that were really meaningful for me were lost.

But just as the story of Noah is really a story of love, there were so many amazing acts of love the day of and the days that followed all of this awfulness. Having a moment, even if only a moment, where you feel like the world is probably ending as you know it makes subtlety seem ridiculous. Strangers all over the world gave money, and blood, and time to help people they'd never met before in places they'd only seen on TV. I took risks and told people I loved them, and I meant it, just because I thought they should know. There was no such thing as small talk - every exchange was meaningful for awhile.

But just like patient care, life went on.

Though God promised to never again destroy the earth there is no guarantee that some other force won't. As horrific as that day was, I'm thankful to have at least one time a year that reminds me of how rich love can be when boldly professed and shown to friends, family, and strangers.

The image, the antithesis of the warm-fuzzy feeling of cute animals on the ark, depicts the destruction that Noah saw from his view high and dry in the ark. I can't find the artist's reference, but thanks to J. for mentioning it this morning in the sermon. It would surely drive a man to drink.

Labor Day

I've spent this Labor Day weekend laboring Saturday and today (I was surprised when I walked into a patient room and they said, "What are you doing here today? Don't you have today off?" - it would have been a good sign but they actually thought it was Christmas..ah well).

I did get to see a few movies (Extract to satisfy my Jason Bateman crush and Cold Souls, with more on that later), watched Mad Men, finished one book (Absurdistan by Gerry Shytengart) and started another (the first of the books that True Blood is based on, beginning my scheduled run of vampire lit). I took a pass at the fantasy roster for Sunday, posted my class lecture for Wednesday, and almost worked the crossword. I ripped out my knitting, again (I'm switching back to a baby blanket to save my sanity). I was a nosy neighbor (more on that soon too). I chased the cat to trim her nails. I made a bad decision when something unusual was leaning up against my car and feel kind of bad about it. I got to spend a few minutes with people I really like who have moved away. I didn't clean the kitchen.

I am done laboring for the day and am looking forward to dinner with K. I also spent a lot of time giggling over this website, so I thought I'd share it with you. Now I'm going to take a nap in honor of all those still laboring.