Daily Archives: July 14, 2013

This piece was previously published in Close2TheBone.

Vascular Surgery

There’s a good reason women make the best surgeons, she thought.  Quick, deft hands, single-pointed concentration, focus.  She thought of the women jet engine mechanics she had met in the Air Force.  Not that she had been in the Air Force; but in the course of her duties as a civilian surgeon under contract, she had met them.

 Now, reining in her reverie, she was intent on the task at hand.  Drat this light, she thought.  She really needed a more direct light source, but one has to work with what one has at hand.

 Slowly, painstakingly, she drew the outlines with a surgical marker:  carotid triangle; carotid vein;  carotid artery.  This, the artery, was what she wanted.

 She steadied the syringe she had readied with an oh-so-fine 27-gauge needle.  2% lidocaine with epinephrine should be enough analgesia for comfort, and enough epinephrine to ensure a relatively bloodless field.  She couldn’t help chuckling: bloodless indeed.

 Squinting in the insufficient light, she injected the layers:  first the skin, then the loose fascia of the neck; lastly, the layer surrounding the vessels of the neck, careful to avoid direct injection into the wall of the vessel, which might cause a spasm.

 Now it was time to cut.  She picked up the number 11 scalpel and steadied her hand.  Carefully, carefully she opened the delicate skin of the neck, noting with satisfaction that the epinephrine had done its job.  There was no need for the tiny hemostats she had ready in case of superficial bleeders.  The next layer, the loose fascia, pulsated bluish, overlying the great vessels of the neck.  These she would blunt dissect with the larger curved hemostats.  She injected a bit more of the anesthetic, just to be sure.  No need to cause discomfort, which might result in unwanted movement.

 At last the artery was exposed.  She marveled at its pulsations, at the tiny arteries that nourished the big one itself, and the miniscule veins that issued from it, carrying its waste into the larger system of veins, to be cleansed by the liver and kidneys downstream.

 Holding her breath, she slid the first hemostat, jaws open, under the artery.  Clamp.  The vessel, trapped in the jaws of the hemostat, stopped pulsing abruptly.  There was no going back now.  Now the second hemostat, exactly one and a half centimeters below the first: clamp.  She raised the surgical scissors, poised for the definitive cut between the clamps. 

 Tilting her head to see better in the mirror, she cursed the dim light in that bathroom again.  And then, the definitive cut!  In a single motion, she swiftly removed the two clamps and was instantly drenched in red liquid.

 A scream of agony split the night as she sat bolt upright in the bed, heart pounding, drenched in sweat, clutching the sodden bedclothes as she struggled, locked in the arms of the Angel of Death like biblical Jacob.

Clutching her throat, she rushed to the bathroom, the very same bathroom, and strained toward the mirror in the same dim light.

 Nothing.  Her throat, graceful and bluish white as ever, shone back at her from the reflection.

 Sucking in a deep gulp of air, letting it out in a sigh that brought the dog running, she splashed water on her face and neck, toweling off the sweat.

 “It’s OK, buddy,” she whispered to her whining canine companion. “Just another nightmare.”  The dog smiled anxiously, wagged his tail tentatively, and licked her calf.  She reached down and patted his faithful head. 

 “Good thing I have you, she murmured.  Stripping off her sweat-soaked nightgown, she rinsed off in the shower before throwing on a fresh one.  She sank into the recliner with a book: sleep would not visit again, not tonight.

 © Laura P. Schulman, MD, MA 2012 All Rights Reserved

Had a complete and utter tear fest Friday.

The kitten I rescued and fought so hard to save…Died Friday. And even though Castiel was only with us a week, I had grown quite attached to the little guy and his adorable little face. I am haunted by his eyes. I cried, and I cried, and I cried, to the point of ending up with a headache.

And I cursed God. Yes, I did the unthinkable.

But damn it,that little kitty didn’t do a damn thing to deserve what he went through. Abandonment, losing his littermates, having a stroke. And yeah, that’s what it was, his leg wasn’t broken, he had a stroke that wiped out that entire side. But he fought valiantly, trying to get around on his own. He was brave and he will not be forgotten.

And I am tearing up.

It’s not fucking fair. You have horrid people, serial killers, pedophiles, et al, that live on and on. But this sweet little kitty who seemed born only to suffer dies. Pardon me if that makes me doubt the existence of some benevolent being. It sucks. I hate it.

But to avoid making my kid more upset I dried the tears up yesterday and the house filled with kids, all of whom want to flock to my side rather than my kid’s. I don’t get it, I am not *that* nice. If anything, I was a little grumpy yesterday due to my sadness. And all the kids could do is ask where the kitten’s body was so they could look at it. What the fuck? That seemed so blasphemous to me, not letting the little guy rest in peace before being buried. They are just kids, but it seemed so ghoulish to me. And it hurt. And it made me sad all over again.

One of the new kids that’s been coming over asked if she could call me Aunt Niki. Her sister asked if she could call my mommy. I told her that would be disrespectful to her own mom and she could just call me Nik, or Niki. But it’s sooo sweet. It’s like these kids are just starving to death for adult interaction. And while Damiana’s parental figures don’t seem to care a whole lot, these girls have parents who care because they have to check in every hour. Maybe the parents care and don’t have time for the warm fuzzy stuff.

My kid channeled Satan, as she does when there is an audience. I can’t help but feel utterly inadequate when she completely bulldozes me, then if that fails, she manipulates and deflects. And I wonder what I did wrong. Should I have been stricter and sterner when she was smaller? How did I fuck this up? It’s said most personalities are fully developed by age five (not sure I buy it) and my kid is almost four. Have I turned her into a budding sociopath?

Stressful.

But in spite of the kids being here off and on for 9 hours, I held up pretty well. My kid was the only one other than Damiana pushing my buttons.

I miss Castiel. I really am haunted by his little eyes. He was doing so well for awhile, seeming so content and happy. And all for what? So he could die? What’s the fucking point? I am having a hard time seeing why anyone tries to live a life. No one gets out of life alive, anyway, so what’s the point?

And yeah, I know it’s not right to have more emotion for cats than people but the cats have never fucked me over.

I woke at 4:50 am. I tried to go back to sleep, but once it was light out, forget it. Now I face a long day with morning brain and I am not excited. But my mind just kept spinning round and round and it seemed brighter to get up and do something rather than lay there and let myself be driven insane.

But I feel the “woke before 7 am” burning eyes and cloudy brain and that never bodes well for a good day.

But I am in mourning for Castiel so a good day probably wasn’t in the cards either way.

My respite is today my dad is coming to get Spook to take her to this 4h fairgrounds thing to look at animals. I was invited, they offered to feed me even, but aside from not doing the crowd thing (PANIC PANIC PANIC) I could use the break. And without her here, the kids will go away or I will eat their souls.

I just feel so damned sad and hopeless. Yes, I have other cats. But I don’t subscribe to that “heir and a spare” bullshit. I bonded with Castiel in a certain way. I miss him. I was used to him sleeping on my headboard at night.

Just.

sad,

Having had a break from the drama of the shop for that one day, even though it was packed with the chaos of kids, I have gained some insight into my own behavior as well as that of those around me. I don’t like it, I don’t entirely accept it, but I am working toward the place where I can to some extent leave it alone. I am starting to see how I can be annoying. I annoy myself, so it stands to reason I would annoy others. Just because I am deeper than a kiddie pool doesn’t mean I have the right to expect those around me to be. If shallow works for them, I need to accept it.The only problem with this is it is going to breed a total sense of pity for them on my part. I just do pity shallow people who lack self awareness. But it seems to be what is called for for my own emotional survival.

So I sucked up my panic and just appeared at the shop the other day, wanted or not, because I needed the board numbers for something he wanted me to find. I ended up staying, per his request. Hey, I got smokes and lunch out of it, so not entirely a waste of my time. One thing about it, I’d have to give up all my vices were it not for R enabling them financially. I would never take from my budget for my kid for my own idiocies. But with R being a vice enabler, at least I get what I otherwise wouldn’t have. Time to start spewing sunshine myself. If I can’t get what I want, I will take what I can get. And take. And take. Because if that’s what he’s willing to give freely, I am in no position to demand more.

Besides, he kind of demonstrated both that he is mentally coming undone from all the booze, and that he does, in his own way, have a protective thing toward me. I got into that drama over calling the woman about whether she was going to pick up that TV, and mind you, I had no clue who she was…And it turned out she was my sister’s boss and I got a lot of shit from my mom because the woman complained I was rude t0o her on the phone. Well I went and asked R if I had been rude, because he was standing right there when I made the call.

Next thing I know, he is on this vendetta against this woman, as the TV had been there, done, for five weeks and the woman kept promising to come get it but never did. He finally goaded her into calling back and she went on a self righteous tirade about how “You never ever speak to me that way, no one speaks to my that way!) Because yeah, being asked to pay for your TV repair after 5 weeks of storage is totally rude. Given, when she finally did breeze in to get it, R was flippant with her, but then, she told us her check WAS going to bounce and what kind of moron does that? “Here, I’m going to openly commit a crime by bouncing a check and admit to it proudly.” STUPID.

But yeah, he hadn’t much cared about that TV until I told him the fallout I took for calling the woman. Then it got personal for him. Maybe I am flattering myself and he did it for shits and giggles for himself. Still, I’m going to humor myself by thinking he was backing me up, albeit in a way that’s probably not good for business. But then it’s his business, so if he wants to destroy it, what can I do?

And people are starting to take note that he is indeed spiraling out of control with the drinking. Making drunken calls at night, barely remembering them the next day. Coming in to work reeking of beer oozing out his pores. Wearing clothes that are dirty and holey for days at a time. Walking around with no shoes on while at work. He claims he is happy, all is well, no problems, but the rest of us see  him coming undone. For about five days, he had actually made an effort to cut back on drinking. Then boom, he’s right back to it, 80,90,100 ounces of beer every night, even when he’s had a good day.

So I am going to start considering the source on this one. Yes, to some extent, my own issues are the problem.

And I am going to make a concentrated effort to stop bitching so much in this blog. Honestly, if I can’t cope with this non job, I will never be able to get an actual job. I need to get my shit together.

But considering his downward spiral and the fact others are beginning to see it as well…

His opinion is becoming less and less valid.

Let him throw his stones about my issues.

If I am in a bad mood, I will lob the fuckers back at him and aim for his head.

Or more painful for him, his beer can.