Dear Mosquitos,
    Perhaps you have not looked at a calendar recently, but it is my duty, nay pleasure to inform you that we are rapidly approaching mid-November and, not to be indelicate, but you should be dead. Or moving on to warmer areas of the country, I hear Vegas is lovely this time of year. Regardless, the all-night blood-buffet that you have been so freely availing yourselves of at Casa Mischievium is now closed. As much fun as it has been to wake up with random itching on limbs I so carelessly left out of the blankets, or to the occasional telltale high pitched whine in my ear, our time together this year has come to an end. If you do decide you prefer the chilly environs of SF (brrrrrr, you feel that? so, chilly!), might I suggest you dine at a nearby establishment? Le Maison Du DP is also quite tasty and conveniently located right next to me. (An aside: Seriously, why do you bite me several times in one night, but never him? He has blood, too, I promise! Try it! Yum!)

Thank you for your swift attention to this matter.

Mischievium

Dear Acid Reflux,
    Ours used to be what one could call a "casual" affair. One night stands here and there, punctuated by the occasional weekend together. Sure, you'd go through lonely periods every now and then when you were more likely to stop by for a couple of weeks, but usually, you kept your distance, due no doubt to some sort of cliched fear of commitment. Then there was the drunk dialing, but I don't think we need to get into that here. While usually I would cheer on the kind of personal growth it must of taken for you to be with me everyday for about the past 3 months, I preferred our old arrangement. Actually, and I know it will hurt for you to hear this, but I'd prefer if you were out of my life altogether. Now, you may think this is a little harsh. You have been, after all, more than willing to step out for a few hours when I am entertaining "friends," but your always right there at the door as soon as they leave. And, I really hate to lay this all at your feet, but your jealousy has only driven me deeper into the arms of Zantac and Rolaids.

This must end. Please, for the sake of us both, leave while we can still remember the good times.

Mischievium

http://www.youtube.com/watch?v=Kq7JUi1lQc4

Thank you to JenniferZ for the link.

The best things about voting today, other than, you know, participating in our democracy blah, blah, blah...

1. Voting out of someone's one-car garage. I kid you not, my voting place, in the city of San Francisco, was someone's garage. It doesn't get more grass-roots than that. Sure, I had to wait in line for a ballot, then wait for a pen, then wait for a booth, then wait in line to put my completed ballot in the machine, but honestly, it was kind of fun.

2. The one-hour combined Daily Show- Colbert Report Midterm Midtacular which will be on tonight. Have you seen the Stewart/ Colbert 2008 t-shirts? Awesome.

I was going to include the vast drop in campaign related junk mail, but I'm afraid that it has already been replaced by the holiday catalog related junk mail. I seriously need to call and get off these mailing lists. Seriously.

Is it trite to say that you know that you're an adult when the thought of someone else's joy at an unexpected gift is more exciting than the thought of receiving a gift yourself?

Last year, the best part of my holidays, bar none, was participating in the MDC Holiday Helper project. During the holiday season, there is a veritable plethora of charities vying for your attention, donations, and money, but the beauty of the MDC Holiday Helper is that you directly give your money (in the form of gift cards) or your gently-used items (clothing, sheets, crockpots!) to the family in need. You see the difference you are making directly. You don't get a tax write-off, because this is not an official nonprofit, just people helping people, but I don't do it for the tax write-off anyway.

Can I tell you how exciting it was to go online and buy gift certificates to Target, Walmart, and amazon.com (or in person to Whole Foods-- you should have seen the look on the cashier's face when I handed him a fist full of gift cards ) ) and then wait with baited breath for said family to receive the help they so desperately need? Now, they sign up for the project and list their needs (this year in a fabulous searchable database, thanks to JenniferZ and her husband), so they are expecting something, but what is *really* fun is when their expectations are surpassed.

You don't have to be a member of MDC to help, just click here. Many families tell their stories, some don't (which is their right, no one has to justify to me why they need help). How heartbreaking is it to read that what some families really need most is money for groceries, or warm coats for their kids? And how great is it when you can actually directly fix a problem for someone else?

So, if you are in a position to do so, check your closets, you may have a sweater that you never wear that will keep a mom warm this winter (the families list their needs and sizes). Or if you're home puttering on the computer, how easy is it to send a gift card, big or small, to a family in need?

All you do is click on the link above, read through some families' profiles, then click on the link at the top of a profile to send an email to the organizers about how you can help (they will then send you contact info for the family) be it GUIs (gently-used items), GCs (gift cards), or whatever else.

What you get in return is good karma, usually heartfelt thank-yous (though these are not necessary), and the knowledge that you were able to make someone else's life just a tiny bit easier. And if that doesn't make you merry, well, I'm not really sure what will.

New Shows I Like:

Heroes: Normal people discovering that they have extraordinary gifts. And it has Adrian Pasdar-- an actor I've always liked, but who just couldn't seem to find his star vehicle... until now.

Studio 60 (please don't cancel it, NBC!): Smart, interesting interpersonal dynamics, interesting in general (as far as some of the behind the scenes things about how networks and TV shows run), I've always liked Matthew Perry, and I've generally never liked Amanda Peet... until now.

Ugly Betty: Catty, sweet, and funny all at the same time. You can watch back episodes on ABC.com
I was trying to think of a way to end this with "... until now" just for the sake of continuity, but I can't... until now!

You may notice that none of these shows are on CBS. Yeah, well, I'm still pissed at them for cancelling Judging Amy. It's my little one-person boycott.

So, I just got back from five days in New York. Those of you who have followed my adventures thus far will remember that I left NYC almost exactly two years ago pretty much of my own volition. DP reluctantly moved to NYC to follow me when I went to school, then he ended up liking it more than me. The decision to leave was mutual, but fueled by me. I wanted out, away, off the right coast altogether. And so we moved to SF, another city, but very different in atmosphere and attitude. I missed the people I left in NYC, but not being there.

Going back made me miss NYC. Of course, it could just be that being on vacation in NYC is more fun than living in NYC. We went and saw Spamalot and the Bodies Exhibition and saw improv at the Upright Citizens Brigade theatre.

I saw my friend T450 and a good friend of mine from nursing school. Seeing the latter was bittersweet. My friend from school, we'll call her S, continued on in the program and became a CNM. Just yesterday, she started her first job as a midwife. As you may recall, I agonized over making the decision about whether to continue on to the master's progam and become a midwife, or to stop after the RN portion. I finally decided, very practically for me, that it was too expensive and that the job prospects were way too limited. Since that time I have been working in the NICU and have seen a good majority of the things that can go wrong in fetal development, and a bit of what can go wrong in delivery-- I will spare you the details. I saw the movie version of the book "Midwives" right before I left to visit NYC and (spoiler alert) at the end, the midwife in the story is acquitted, but very soon after stops delivering babies because, as her daughter explains, she lost her confidence. In short, she had seen too much. I think I may now be in a position where I've seen too much. That said, I would be lying if I said I didn't feel a pang of sadness when she talked about getting hospital priviledges and starting her practice. I think I had so convinced myself that even if I completed the training I wouldn't be able to find a job as a new midwife that hearing that she had found one (and blocks from her house-- yay for her!), really shook my confidence in my decision. Please don't get me wrong, it wasn't easy for her, it took her a year to find a job and I am *very* happy for her, she will be a terrific midwife (she's a terrific person).

I don't think that there's anything I can say about New York that hasn't already been said. When I was there this past weekend, it struck me how hard it must be to be unique in New York. I mean, all these hundreds of thousands of people come there, creative dreams in hand (to be an actor, model, writer, animator, director, painter, musician... etc), only to be met with hundreds of thousands of others just like them. You've got to be seriously confident in your talent to stand up against that. Or you've got to make it about something other than that-- there are a happy few who do it (follow their passion) because it makes them happy, and who learn to set the end results (success, fame, employment?) aside. Maybe someday I figure out what makes me happy and just maybe I will find a way to be like them.

Part I: Living the Dream

Last Friday, DP's friend Mike was in town. We usually keep whatever things we leave in the car (cloth grocery bags, gym bags, tennis/ netball rackets) in the way back/ "trunk" area where there is a little screen that we can pull across to cover it. When DP picked his friend up from the airport, he moved his gym bag to the back seat. They came back to our apartment to drop off Mike's luggage and pick me up. We went out to meet some other people for drinks and dinner and when we parked the car, DP forgot to put his bag back into the way back. I think you can all guess what happened here. When we got back to the car after dinner, the rear passenger-side window was smashed in and the bag was gone.

So, what did the smasher-thief get? A TimBuk2 duffel bag, dirty work out clothes, some toiletries, and an old iPod Shuffle. The irony is that the thief didn't touch/ see the most valuable thing DP left in the car, his  Arc'teryx jacket.

When we got back to the car, we assessed the damage, then called the non-emergency number for the SFPD. Whoever answered gave me the three options for filing a report (online, in person, over the phone) and, while I didn't really expect that the police department was going to hunt down the man who smashed in our window and took DP's gym bag, I didn't expect her to be so upfront about it. When I murmured something about, "So, no police cruiser is going to come by?" Her answer was no, the reports are only for "insurance and statistics" purposes. Nice to know the SFPD keeps stats on the crimes they don't investigate.

Mike and I were philosophizing on the nature of the hopes and dreams of a smasher-thief. I mean, really, what was he hoping was in the bag? To borrow a phrase from TV talk show hosts, what is the ultimate "get" for a smasher-thief? It's got to be a bag full of money. That has to be the dream. Now, we all know that the chances that anyone is going to leave a big bag full of money in their car in plain sight is pretty slim, but, you know, it's like the lottery, you can't win if you don't play. Dream on, smasher-thief, dream on.

Part II: Want a Cookie?

When we arrived home in our shattered-glass filled car, there was a another car blocking half of our driveway. This is not the first time this has happened. The problem is that situated between two sets of driveways is the doorway to our building and a corresponding section of curb which is *almost* big enough for a car, but not quite-- but, MAN, do people love to try. Compounding this problem is that our garage spots are very narrow, so you really don't have a lot of space to angle the car in or out, and, actually, the last time this happened, DP ended up scraping the front of our car on the side of the garage trying to get it out.  This time, we weren't even going to try.

So, for the second time that night, we called the non-emergency number for the SFPD. Actually, we called a tow company first who explained that the cops had to come cite the vehicle first and then they would call a tow truck. We called the police and got placed in their queue, this was at about 11:30pm... on a Friday night... in the city. Yeah.

At 1:30am, when there still was no sign of the police, DP got fed up, backed the car all the way across the street and sat there for a few minutes working out the angles he would have to use to get the car in and, by some miracle of God, was able to get it in without damaging our car or theirs.

When we came out the next morning, the car was still there. No citation, nothing. This really ticked me off, not just because I wanted a little justice (or was it vengeance?), but because I fundamentally believe that I am not a lucky person and that if I had left my car in a space like that, it totally would have been cited and towed.

When DP, Mike, and I were sitting out on the stoop waiting (in vain!) for the cops, I brought down some homemade cookies for us to munch on. At one point, I told Mike that I hoped the people that owned the car would show up so I could offer them a cookie. He looked a little perplexed when I said that, so I explained...

"'Hey, would you like a cookie?' I would say and then when they said, yes, I'd say 'Yeah, well, I'd like to park my car in my garage, I guess you don't always get what you want.'" And then I'd shove the cookie in my mouth. It's more subtle than flipping them the bird, but I think it still makes the point.

Last week we went to the much anticipated (by me) HEM concert at the Great American Music Hall. Located in the heart, and by "heart" I mean the "crossing-the-street-behind-a-hooker, located-next-to-a-strip-joint" heart of the Tenderloin. The hall itself is an old fashioned dance hall and it's early 20th century decor and intimate size are especially suited to a band like HEM whose music is so intimate and, to borrow a phrase from O Brother, Whereart Thou, "old-timey." DP and I arrived in time to get ourselves a table about 30-40 feet from the stage-- that's right, we got to sit down! This was totally *my* kind of concert. Most shows I have been to the opening act was something to suffer through to get to what you really want to hear, like paying penance for the coming musical rapture*, but Ollabelle was really good, albeit a little bit less polished, but similar to HEM with little more gospel and bluesy feel.

Then HEM came on and the rapture began. They played a lot of the stuff from their new album (emerging favorites of mine include "We'll Meet Along the Way," "He Came to Meet Me," "Reservoir," and "Not California"), but also managed to squeeze in all the other songs I really wanted to hear, including "When I Was Drinking" and "Half Acre" from Rabbit Songs and "The Fire Thief," "Hollow," and "Strays" from Eveningland. Their lead singer Sally Ellison, who has to be 6-7 months pregnant, was radiant and her voice was as clear and strong as ever. I don't know if I can describe feeling of sitting in that dark room, feet from the stage, feeling the waves of music move through me, feeling connected to them and to the rest of the crowd.

You know, the older I've gotten, the more I've really distanced myself from music. From pre-teen through college, I bought a lot of music (not all of it particularly good, especially the preteen years, Debbie Gibson anyone?), spent a lot of time listening to music, singing music, feeling music. The older I've gotten, the less I find music that makes me feel much of anything and there are fewer and fewer bands that inspire fan-like devotion. Maybe it's part of the adult armor we put on to protect ourselves-- the cynicism, the playing-down of dreams lost, the letting go of possibilities, the gravity of all the life altering decisions we have to make (or maybe that's just what being an adult feels like right now). Maybe it's just become harder to reach me and that's what makes HEM all that more special, they've found a way to pierce the armor.

*Another notable exception to the opening act rule was HEM, itself. I
first saw them as an opening act for Beth Orton, whom I have a very
limited affinity for, DP was the one who wanted to see her. I mean, I
like a lot of her music, but after listening to it for awhile I want to scream "ENUNCIATE
ALREADY! Consonants are not the enemy! Use them!"

I don't often talk about work on this blog. Part of that is that I am really not at liberty to discuss too many details of my job (confidentiality and all), part of that is that when I am not at work, I don't particularly want to think about work, and part of it is that I know many people who read this blog are parents and I don't want to scare them (this is your chance to stop reading NOW). Part of the "not wanting to think about it" is the stress and pressure inherent in having a job that requires you to make life and death assessments and decisions about someone else's child and the other part of "not wanting to think about it" is knowing that a certain percentage of the parents I meet, despite our best efforts, are about to go through the worst time of their life. They are about to face the thing that breaks up some ungodly percentage of marriages. The thing that all parents fear from the minute they are told that they are going to be parents-- the death of a child. Their child.

Where I work we have what are called "primaries." They are patients that we sign up to be nurses for for the duration of their stay, either because we are asked by the parents, or because we feel moved to for whatever reason. A few months ago, I signed up for a set of twins who were a few weeks premature. My primary before them had been a baby who had been in our unit for ~6 months before she was "well enough" to go "home" (or, in her case, medical foster care). When I signed up for the twins I thought, great, this will be relatively short, they'll grow, I'll help mom learn to breastfeed them, and they'll go home. Then one of the two went from moderately unstable to critically unstable. We examined all the usual causes, but when none of them panned out, the medical team turned slowly to wondering if it was caused by a certain rare genetic disorder. A very preliminary test came back indicating that it very well could be and blood was sent from each twin to a specialized lab on the other side of the country to confirm the diagnosis. The test results were to take 3-4 weeks to come back (doesn't 3-4 weeks seem outrageous in this day and age?).

The first twin did not live to see the results come back, but his pattern of response to the one treatment that we could provide (which became less and less effective each time we used it) pretty much told us that he did, in fact, have the disorder. When it became apparent that he was not getting better and that we were just prolonging his suffering and death, his kind, incredibly loving parents made a decision I hope I never have to make, they asked us to withdraw support. After the first twin died, all eyes went to the second twin-- he had similar, but considerably less severe symptoms as his brother and, hope of hopes, they were fraternal and, therefore, not genetically identical.

I was not there when the first twin died, but I was there when the results finally came back. Despite being fraternal they both had the exact same genetic mutation, a recessive trait carried unknowingly by both of their parents (this means each child that they conceive has a 25% chance of having this disorder). Those that know me know that I am what you might call an "easy crier"-- I cry at stupid commercials, I cry watching Oprah, I cry watching stupid commercials during Oprah, you get the picture. When we sat in a crowded little room to tell the parents the results I was okay (as in not crying) until the dad started crying. In situations like that, I hate being an "easy crier" because to some it looks like I am trying to co-opt their drama, when I really just wanted to be there to support them and I have very little control over the tears. The day before, in a quiet moment just after the parents left, I had said to the baby "you're just going to have to get better, I don't think your parents can take losing you, too." I know I wasn't alone in my sentiments. The next day, before we gave them the news, there was this palpable mix of sadness and anger coming from each of the clinicians, even the ones who have been giving devastating news to parents for years. Why anger? Because this wasn't fair! Of course, losing a child never is "fair," but losing two to a disorder that each had 75% chance of NOT having seems even more unfair.

For the next several days, we watched the remaining twin carefully for the signs of deterioration we were sure would come. Then days stretched into weeks. He stayed the same, didn't get any worse, and got maybe slightly better. I say "maybe slightly" because there was a lower method of support that we didn't try for a long time because we were sure it wouldn't be enough to keep him stable, but when we finally tried it, he shocked us all and did fine. The line from Natalie Merchant's song "Wonder" where she says "And they smile as they see they can offer no explanation," still rings in my head when I think about him. As I type this, he is at home with his parents, he is still not well, but he is not suffering and from what I last heard he is no worse than when he was in the hospital and certainly has a better quality of life at home with his parents. He continues to amaze us all.

I have never been good at knowing what to say in situations where someone has lost someone they loved and, while there are certainly things you shouldn't say, I'm not naive enough to think that anything I say can make it any better or easier for them. When I saw the parents for the first time after their son had died, I gave them both a hug and said, with tears in my eyes (of course!), that I was so sorry. Later, I wrote them a little card with my memories of their son. He was only earthside for such a short time, I thought they could use all the memories they could get and I wanted them to know that I saw him as their son, as a person, and not just a patient.

I heard from a friend of mine in another state who recently suffered a miscarriage, after all that I went through with the family of the twins, it was tempting to issue a hollow "I understand." But the truth is, I don't. However sad I am for them, however much (in the case of the twins) I feared going to work each day that he was still in the hospital because I was afraid that would be the day that he took a turn for the worse, however much I still think about them and pray (in my own way) for them, it will never compare to their sadness and grief, their fear for his life, and the prayers they must silently say every minute of every day. Witnessing is not the same as experiencing. And as sad as I am for my friend, as much as I did pray for her (this is her second miscarriage), all I can do is be there to stand witness, witness that her child existed, witness that that child was loved and wanted, and witness that it can never be replaced.

I should mention that the story of my patient who, against all odds, is still alive and at home is not a complete cinderella tale, he is at home with some
"support" and he (most likely) will not survive this disease indefinitely,
but each day he does is a miracle and a gift and, as I remember my friend who just lost her unborn baby and those
that died 5 years and one day ago, I am humbled to remember that each day I live is
a miracle and a gift.

I just finished reading "About a Boy" and I have to say that this is one of the few books that has been made into a movie where the movie really is as good as the book. Maybe I'm flattering myself here, but I've often thought if I was a writer, I would be similar to Nick Hornby-- funny, but with a strong emotional under current. Now, I'm reading "High Fidelity."