Monday, June 22, 2009

Review: A Yellow Raft in Blue Water

I first encountered Michael Dorris's writing through his non-fiction many years ago when I read The Broken Cord, about his adopted son, who lived with fetal alcohol syndrome (FAS). Dorris had a sad and controversial life; he was accused of misrepresenting himself as a Native American; later, he was accused of molesting one of his daughters. He and his wife, Louise Erdrich, were widely criticized in Native American intellectual and literacy circles for the way in which they advocated against FAS. His son, described in The Broken Cord, was hit by a car and killed at age 23; Dorris himself committed suicide in 1997. A Yellow Raft in Blue Water is a novel he wrote in 1987.

I liked the structure of the story being told backwards through time by the three narrators: Rayona, her mother Christine, and Christine's mother, Aunt Ida. On the surface, it's a story about Rayona and Christine going back from Seattle to live in Montana, but there is a lot of family backstory about why Christine stayed away for so long that emerges over the course of the book. Lots of things that seemed to be loose ends at first ended up coming together in the end. I didn't expect him to write female characters as vividly as he did; I was pleasantly surprised both by the characters and by his ear for dialogue.


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Judgment Day(s)

My last grade is in. I am happy with my grades this quarter. Not that I want to get all pre-med-competitive about it, but I am applying to very competitive programs. So I need to show that I take the pre-requisites seriously, and can do the work. I think I showed that this quarter.

I also was evaluated for practical skills in the hospital. I got "Satisfactory" on everything (on a Pass/Fail scale) except "Provides restorative care to residents" and "Applies critical thinking in clinical situations". My clinical teacher gave everyone in our cohort a grade that means essentially "Not enough information to answer the question", as it is her position that our practicum does not provide the opportunity to do either in the time we have available and under the responsibilities we are required to carry out. (UPDATE) The two specific things she said about me were that I am "eager" to take on new tasks, and that I "tend[s] to get anxious" about unfamiliar situations, a state that she expects will resolve itself with practice and experience. That sounds right; I remember visualizing all kinds of awful things, like accidentally dropping a patient, that never happened. Once I had done it successfully a couple of times, the anxiety disappeared. I got a mail today from a physician friend making the same point, "I had no doubt you will be excellent in your patient interactions. Only you doubt you, Ravensara!". Which means I need to get that experience, and sooner rather than later will be a good thing. So that's all good, too. All that remains now is passing the state certification practical exam.

Not only has this week been one of student evaluations, but the publisher of the textbook I'm writing on massage literacy got a batch of reviewers' comments back to me. Overall, they are very good (a lot of praise, which is nice, and even the not-praise is constructive and on-point), and while massage schools are unlikely to make critical thinking and massage literacy a curriculum requirement anytime soon, it looks like the book has the real potential to make a splash as the basis for an elective course. So I am happy. And sleepy. I worked very hard last quarter, and slept like 18 hours today, catching up.

On the 29th, it begins again, this time organic chemistry and biochemistry survey class, nutrition, and some intro medical classes that I need, not for the content, but housekeeping/bookkeeping/pre-requisites.


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Friday, June 19, 2009

It is finished.

Spring quarter, that is. Developmental psychology and chemistry are in the bag, and I finished my nursing assistant clinicals on Tuesday. The nursing assistant class held a potluck today to celebrate.

Since it's a state school, and has a number of restrictions on alcohol on the premises, I brought sparkling cider to raise a toast to our teachers, ourselves, and our support systems of family and friends.

I also brought special cups for the toast.

Overheard: "Claaaaaassy" and "This is so wrong!"

I think I'm going to make this my very own tradition as I go through nursing school; I started doing it when I got into grad school in the School of Medicine, and it's just so me, I think.

Here's a serving tip if you want to do the same thing--leave the cups in their intact sterile wrappers until you're actually pouring the drink, and let the guests remove the sterile wrapper for themselves. It seems to go over much better that way.

Ten more days, and then it begins again with organic chemistry/biochemistry and nutrition...

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Thursday, June 11, 2009

Old school

Ok, I know this has a real risk of coming across as a "you kids get off of my lawn" post, but still...

At 51, I'm returning to school for nursing-school prerequisites as different as chemistry, developmental psychology, statistics, and nutrition. Today in chemistry, we learned the theoretical basis of pH, and the instructor started off by introducing the concept of logarithms. Yes, introducing.

For all my complaints about high school, I have to say they gave me a good pre-calculus grounding. Logarithms, trigonometry, Boolean algebra--all these things I take for granted, until I run into college students taking classes with me who haven't been exposed to them. And I mean pre-professional students to whom these are new concepts.

Thank you, Huffman High School, and Gary Harper of the math team. I really appreciate the foundation in mathematics you saw to it that I took away with me.

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Wednesday, June 10, 2009

Thank you, Stephen Tyrone Johns

I was originally going to make a post about how nurses and nursing assistants are not paid nearly enough for the essential and physically demanding work that they (someday, we!) do. I've always intellectually agreed with that point; now that CNA clinicals are 3/4 finished for me, that assertion is also sincerely felt in every single aching myofibril in my entire body. However, I will save that post for another time, because the point is also true for security guards at high-risk targets, and current events have made that aspect of it so much more immediate today.

I went to the Holocaust Memorial Museum in DC once, skipping out on the spur of the moment while I was at a medical informatics conference there. Because it was an impulse visit, and I hadn't checked beforehand, it turned out to be closed when I got there; I forget why--a holiday, perhaps, or something of the sort--so I didn't get to go in, but I committed to going the next time I was in DC. On a normal day, like today, there may have been as many as a couple of thousands visitors inside, I heard on the press conference this morning.

Stephen Tyrone Johns died today when a white supremacist entered the Holocaust Museum with a rifle and shot him. Apparently he was stopped by security guards immediately upon entering; after he shot Mr. Johns, the other security guards shot him, critically injuring him.

I don't want this post to be about the crazies, though; although they certainly appear to be on the upswing (the Tiller murder, this shooting, the homophobic online libel of a good friend of mine in reaction to the announcement of his memorial) in response to Obama's election and his positive domestic and international actions. Orcinus and others are good sources of information on the rise of eliminationism on the right. I'll leave that coverage to them for now.

The point I want to make is that on a daily basis Mr. Johns protected as many as thousands of innocent people in a high-profile target, including children, as part of his job, and today that job cost him his life. He performed a very valuable service, one that our society does not value enough to pay well, at great personal risk. I am grateful that people such as Mr. Johns do this kind of work--living in my safe, sane, protected bubble, it is easy to forget just how many haters there are in the world, and how dangerous they are. I sincerely hope that his family finds some solace and consolation for their loss in the knowledge of his bravery and heroism in the lives he certainly saved today.

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Tuesday, June 09, 2009

You win, Granny!

(Background: it is well-known in certain circles that, of the two of us, Mr thalarctos is the domesticated one, while I am totally feral [h/t George]).

While I believe there is no afterlife, I'm certainly prepared to admit there is a possibility that I am wrong, and such a thing, however unlikely, could conceivably exist.

Should there be such a thing, and should my mother's mother be able to see me now, she is, no doubt, laughing her ass off at the rebellious 8-year-old who refused to learn to make a bed properly, and insisted that, when she grew up, she'd never make another bed in her life.

On the other hand, I'm making so many beds nowadays that my mitred corners have become something to absolutely die for (not literally, no!).

(Image from:

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Paying it forward

When I stepped out of the elevator onto the ward, suddenly it was 2002 again. All the sights, the sounds, the smells were just as I remembered them.

That year, I went to the doctor complaining of severe abdominal pain. She sent me to the ER, and the next thing I knew, I was hospitalized for what turned out to be a skosh over a month. The blood clot that took out three feet of my small intestine (and that is usually diagnosed "on autopsy", as my surgeon explained), followed by immobility-related fluid developing around my left lung, kept me there so long that I literally burst into tears when Mr thalarctos wheeled me out into the natural light on the way to the car to go home.

Now, almost 7 years later, I'm back on what may be the same ward (post-hospital-remodel and lots of pain-killing drugs, I'm kind of vague about logistics). Also, I have a memory of my instructor actually being my nurse at the time, but that may well be confabulated, given the way that memory operates and my confusion around that time.

If I can show the current patients even a fraction of the kindness, support, and competent care that the staff showed me over that month in 2002, then I will have taken a small step to repaying some of my karmic debt.

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Thursday, June 04, 2009

May 35, 1989

I remember an early-morning summer flight into Honolulu Airport. On sabbatical from Microsoft, I was en route to studying Khmer at SEASSI at the University of Hawai'i at Mānoa.

The last news about the protests in China that I had heard when I left the mainland was that a brave young man had faced down the tanks at Tienanmen Square (photograph below by Jeff Widener), and there was some optimism that the situation could be resolved peacefully.

The headlines at the airport the next morning told a different story. The government cracked down on the protests, and an unknowable number of people were killed or injured. The young man in the photo was probably executed, although that too cannot be known with certainty.

It was a shock to see the headlines in the airport that morning. Now it has been 20 years, and the Chinese government is trying to bury history by suppressing all references to "June 4" on computers it can control, leading to the euphemism "May 35" to mark that day.

I remember.

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Monday, June 01, 2009

They call me Mr. Tibia*

(* shamelessly stolen from my friend George, whose lightning wit and linguistic facility I've always admired and envied.)

Or rather, I'm very, very grateful that they *don't*.

To back up a bit and explain, I'm currently teaching anatomy, physiology, and pathology at a massage school in Tacoma. Thursday a week ago, I had introduced the skeletal system, and since I've always preferred hands-on, experiential learning to just lecturing at the students, Mr thalarctos and I combined our efforts.

The night before class, he bought a whole chicken, and prepared it in his trademark way, but before cooking it, he surgically removed an entire leg, taking care to keep the joint and ligaments intact. He then removed the meat from the bones, leaving the periosteum for the students to see. It still flexed and extended in a perfectly functional way, if not under its own power.

I took it in the next day to class, and had everyone observe the bone, the hyaline cartilage, the joint, the ligaments, the periosteum. Then, once everyone had had a chance to see how it operated intact, I gave it a third-degree sprain so that we could all have a look inside.

So after we had finished observing, and after explaining how anatomy classes in medical schools often had ceremonies to show appreciation for those who donated their bodies so that others could learn [1-6], and how some native Americans thanked their prey before the hunt for the sacrifice it would make for their benefit, we expressed gratitude for the chicken whose death had provided not only a delicious meal, but also had helped the students gain knowledge, and then we gave the bones a "burial" in the garbage can. I moved on to prepare the notes for the next week's lesson on skeletal system pathologies.

When we met again next week, one of my students handed me a baggie with a dry, dusty bone in it. Smiling, she said she had brought it so I could do a little better than chicken bones for teaching---she had taken it away from her dog, who had dug it up in the woods near her home.

I was touched by her kindness, but as I took the baggie and looked at the bone, I started to feel just the least bit uneasy---it was clearly a tibia, and although it was a little thicker than I would expect, with a groove running down the front that I didn't remember from any tibia I had ever seen, I couldn't say with certainty that it wasn't human.

So what *is* the proper etiquette when you think you may have inadvertently received human remains as a gift from a well-meaning student? Never having considered that question before, I dropped by the police station on the way home to find out their thoughts on the matter.

At the small suburban police station I stopped at, there was an older male civilian volunteer at the information desk. He greeted me in a friendly way, but his interest really ramped up when he saw what I was carrying, and he went into the back to get an officer.

Officer McIvor was very reassuring and professional, and assured me--despite my concerns that maybe I just watched way too much Law & Order, that bringing it in was the right thing to do, even though it probably was not human---like me, he was not the person to do the rule-out, but their bone guy could help. He asked me if I wanted it back, which I did, as long as it wasn't evidence or something, so he took it and gave me his card. In passing, he observed that it had been quite chewed up by something or other.

He called early the next morning, and left a message---a doc at Overlake Hospital had verified that it was, indeed, a tibia, and it was not a human one, so my bone would be waiting for me to pick it up at City Hall. They don't have a comparative osteologist on staff---once it's ruled out as human, they lose interest in it---so I don't have a species, just a rule-out as a non-human mammalian tibia. Maybe the staff at the Burke Museum has someone who can get a little closer; right now, I'm guessing "bear", but it's just an uninformed guess.

It was a relief that someone's loved ones weren't about to undergo a horror, and that I had not dragged my student into a murder investigation (and she had not dragged me into one!) just because of a spontaneous gift. And now I have a tibia to pass around for future anatomy lectures on the skeletal system.

My friend Brian, an anthropologist specializing in human osteology by training, observes that it's almost never human (and he's got tons of stories, like how people call in to report the discovery of a child's hand, only to have it turn out to be a raccoon). But I had to check.

[1] Eze O, Horgan F, Nguyen K, Sadeghpour M, Smith AL. The 2008 anatomy ceremony: voices, letter, poems. Yale J Biol Med. 2009 Mar;82(1):41-6.

[2] Elansary M, Goldberg B, Qian T, Rizzolo LJ. The 2008 anatomy ceremony: essays. Yale J Biol Med. 2009 Mar;82(1):37-40.

[3] Yale University School of Medicine Students. The 2007 anatomy ceremony: a service of gratitude: I: collected experiences. Yale J Biol Med. 2007 Jun;80(2):83-90.

[4] Kim Y, Sandoval A. The 2005 Anatomy Ceremony: a Service of Gratitude. Yale J Biol Med. 2005 Jan;78(1):83-9. No abstract available.

[5] Morris K, Turell MB, Ahmed S, Ghazi A, Vora S, Lane M, Entigar LD. The 2003 anatomy ceremony: a service of gratitude. Yale J Biol Med. 2002 Sep-Dec;75(5-6):323-9.

[6] Weeks SE, Harris EE, Kinzey WG. Human gross anatomy: a crucial time to encourage respect and compassion in students. Clin Anat. 1995;8(1):69-79.

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