Most Memorable Moments in the Emergency Department Part 3/5…The Blizzard.

At some point during my tenure in the ED there was an epic blizzard that covered our state in roughly four feet of snow and ice.

I of course was at my first shift of three in a row twelve hour day shifts.

The hospital made it clear that we were all expected to make it to work. We were essential personnel and we could sleep in the cafeteria on cots if it meant we’d be there in the morning for our shift.

Another nurse and myself ended up splitting the cost of a hotel room that was about a five minute drive from the hospital. The hospital shuttle driver assured us he would grab us in the morning, he told us there were chains on the shuttle and no matter what he’d make it to the hotel and get us. There were about three dozen of us that stayed there that night, not all from the emergency department.

I only had one change of clothes with me because we had never seen a storm bad enough that I wouldn’t be able to make it home the second night.

We woke up in the morning and we could see the highway from our hotel room window. There was a tractor trailer truck jackknifed blocking all three lanes and other dots of cars stuck on the highway in mountains of snow. We knew this was going to be bad.

We went downstairs and met up with our other nurses and waited. And waited. We called the hospital. The shuttle was stuck. The bed manager told us to stay put that her husband would get us. We looked miserably outside thinking we were all going to be fired…as the hospital had threatened to do just that if we didn’t make it back.

We would later find out that all the plows were broken down at one point so there was literally four feet of snow on the roads, minimally if plowed at all, some tire marks to follow here and there, and cars just stopped in the middle of the road stuck in piles of snow.

We all were contemplating walking there when a white suburban roared up to the hotel. I swear to you it slid in front of the double doors. The window rolled down and a guy in his pajamas yelled, “You guys for the children’s hospital? GET IN!” I’m not religious but I crossed myself. I also put my seatbelt on and pulled it tight.

That man got all of us to the hospital. We literally slid all over the capital city and avoided hitting cop cars multiple times, during which he would roll his window down and yell at the cops to get out of his way because he was carrying nurses and the cops would look at him like he was nuts trying to decide if they should stop him or not.

He made about four trips back and forth and God knows how he even got into the city from his house, but he did. The day shift made it in. Nights was relieved. Some night shift people took day shift people’s hotel room keys and crashed there during the day. A lot of OR scrubs went missing because none of us had clothes.

So we all showed up for day shift and people who hadn’t stayed at the hotel were helped by strangers when they got stuck on on-ramps and off-ramps and one person’s neighbor even drove them in because he didn’t want her in her little car and he had a truck. It restored my faith that day in good samaritans and in people helping people in the cold and snow, helping nurses get to work.

It was a slow day but not as slow as you might think.

My two most memorable encounters were one patient and one staff member.

There was a car that pulled up to the ambulance bay doors. A Father got out and opened the back door and pulled out a young child bundled up from the cold. We let them in. The Father was humble and quiet and his child had cancer, was on chemotherapy, and spiked a fever that morning. He knew he had to take them in. He told me where he lived, and I knew it was a solid hour without four feet of snow. I asked him how the hell he made it here!

He put his child on a sled under blankets to get to a main road. He walked two miles through thigh high  snow. Neighbors saw him, some who knew him and some who didn’t, and they all came out to help him- taking turns pulling the sled and making sure his child was comfortable.

His sister and her husband showed up at the main road and piled them into their truck and drove them the rest of the way. He said they got stuck many times and each time he and his sister and his brother-in-law would shovel out the truck and he said every time other cars stopped to help. I said something like “That’s amazing. You are a great Dad.” He smiled and said,

“She’s my daughter. She had to come in. I’m not great. I’m just her Dad.”

Later in the day an ambulance came in and I had seen the EMT a few times. She looked haggard. I asked if she was okay, her eyes welled up and she said, “We couldn’t get to a call in time. Heart attack. We got the stretcher out, the road wasn’t plowed, it took us forty-five minutes to walk to the house with the stretcher. He was dead. We should have been there, we should have saved him,” She cried then.

I’m not a hugger. But I gave her a hug. Eventually she wiped away her tears and her partner sorta slapped her on the shoulder in an awkward, please God stop crying before we go back to the ambulance type of way, and then they went back out into the snow.

I have to be honest. The third day shift after my second night in the hotel I didn’t wear any underwear. I only had enough for one overnight not two. And twelve hour shifts don’t leave a lot of time to get laundry done. I had to choose….sleep or clean underwear. I chose no underwear and doubled up on the OR scrub bottoms.

Couple things about this whole experience. The hospital never offered to help pay for the hotel fees; not even partially. I think they gave us a 5$ voucher for lunch. They sure as hell didn’t have clean underwear on hand. But they expected their staff to eat/sleep/live at the hospital as long as they needed to in order to make it to our shifts. They just didn’t want to help fund it. I would have had far less of an issue paying for all my meals, a hotel room for two nights, and scrounging for food and clothes if I knew my employer was 1- grateful 2- going to take some sort of financial responsibility.

But they didn’t. The people who took it upon themselves to help us were strangers who dug out our cars and in some cases drove us to work.

I don’t know why it takes a natural disaster for people to show their true good colors. But it does sometimes. It also takes a natural disaster for a hospital built as a corporation to also show it’s true colors. We were told that we could be fired if we didn’t show up, yet the hospital shuttle never came to get us and the hospital never gave us a viable solution that would allow us to spend the night and actually sleep and shower and eat.

Instead a maniac in his pajamas who didn’t know us at all, who only knew his wife was a bed manager who also barely knew us, but called him forty minutes earlier and said, “Honey, I need your help,” showed up when we needed a miracle.

He never asked any questions. He swore at cops and buses to get out of his damn way and yelled that he had some nurses to deliver…he saved our jobs and the night shift nurses from being stuck there.

It takes a lot for me to admire people and a lot for me to judge them. I had already started to realize hospital systems are about the bottom line and not actually about supporting nurses. That day was another nail in the coffin for my view of my employer.

I came to admire the Father who would not take praise for doing the right thing. He was freezing still when he came in but he was only concerned for his child. He played it down like it was no big deal to get there. We all knew it was. His child was admitted inpatient because unfortunately they were very ill.

The EMT and her partner who trekked through four feet of snow carrying a heavy stretcher and gear only to find their patient dead. Then shedding silent tears as they trekked back with a body instead of a person. I felt true admiration for the people I encountered that day and  pride to be working beside them. I also had never been so incredibly thankful for all the strangers who stopped and helped all the nurses get to and from work that weekend. As essential employees it was another way in which our bonds were strengthened. We all were there for each other in so many ways that weekend and that’s part of what makes working in acute care so incredibly powerful.

p.s. because if I don’t mention this my friend will freak out…I also appreciate the nurse who lived in my hometown (literally the hardest hit in the state with 4-5 feet everywhere) who with my wife shoveled out a spot in her apartment complex so after my third shift I could finally go home. I zigzagged down the highway and slid off the exit ramp and I parked in her complex and she dropped us at the end of our unplowed street where my wife and I trekked through waist high snow (Yes I did not have underwear on and still only two scrub pants on no snow pants, so yeah I was cold) to get to our house. Thanks dude;)

p.p.s. The benefit to staying in the hotel instead of on a cot was they served wine at the hotel. And because there were a bunch of nurses there…they served a lot of it that weekend.

Top Five Most Memorable Emergency Department Nurse Moments 2/5…

Night shift changes a person.

Not only because it permanently messes with your sleep schedule and actually takes years off your life (Yes that is scientifically proven) but because, well at least for me, it made me a nurse. Not just an average nurse. But an I can handle mostly anything you throw my way kind of nurse.

Night shift is when shit hits the fan. Sometimes literally. Or maybe the wall.

I switched to nights from evenings after I had been working for roughly two years on evenings. In ED terms that’s still relatively new. I was just starting to work in triage, which significantly honed my assessment skills, and had never truly been on my own. Because in the ED you really shouldn’t be. It’s a team setting. So people don’t die.

But nursing is always a shit show. So while there are patient/nurse ratios they are more of a guideline not a hard and fast rule.

So a few months into night shift I already learned that I needed to get good at IV’s fast. I was decent but night shift made me one of the best. Because if I missed there literally might not be anyone else who could do it if there were enough call outs. And trust me, people get pissed if you stick them with a needle more than three times. Especially when it’s their kid.

Eventually I would put an IV into a child’s pinky. Literally. And the mom would request I do the IV every time they came in. She knew I could get it even if all I had was her child’s fingers.

But my most memorable night shift didn’t revolve around IVs. Shockingly. It was a night with a lot of call outs and no one would be coming in at midnight when evening shift left. Myself and two other nurses were covering a full floor of for once, medically ill, not psychiatrically ill, kids. Overnight there was only one Attending and one resident.

Midnight rolled around. Evening shift was antsy to go, so they left. The second Attending hung around charting. Thank God. It had been busy, but nothing life threatening. Until twelve thirty AM when evening shift was gone and it was me and two other nurses. For a packed floor and full triage bays.

I like being busy so it wasn’t horrible. Until I walked in the room of one of my patient’s and they weren’t breathing. It was a baby. The mom was asleep. I started bagging the baby while trying to flip the brakes off the stretcher and yelling at the mom to wake up.

Luckily our Attending was walking by and saw me bagging a patient, said, “OH!” and my team was there. Unfortunately that left the rest of the department manned with only one nurse and one attending (for some perspective day shift could have up to 14 nurses on at once). For awhile.

We had to intubate the baby and admit it to the ICU. By the time I made it to my next patient’s room an hour had passed and I walked in, it was a teenager, and for fuck’s sake they weren’t breathing. We had already diagnosed a double pneumonia. Apparently they decompensated in the last hour.

I started bagging my patient. Fumbling with the damn brakes on the stretcher again, yelling at the damn parents to wake up, and who should walk by but my Attending. She did a double take. I think she thought I was pranking her at first. But I wasn’t. We intubated a second patient.

I walked into my third patient’s room an hour later. The parent’s were pissed. I hadn’t been in for two hours. The one nurse on the floor had hung some IV antibiotics an hour ago though. I didn’t blame them but thus far he was my only patient that was breathing so he had to wait. They didn’t really care though.

I checked his blood pressure and it was wicked low. Tachycardic. Somewhat delirious. Fuck. I shook my head. Unlocked the brakes and rolled him to our resuscitation room and called a medical alert overhead. My other nurse and my Attending whom we had just intubated two patient’s together rounded the corner looking haggard and pissed even though it seriously wasn’t my fault that all my patient’s tanked that night.

He was in septic shock. Perforated bowl. Went to emergency surgery.

Now I don’t remember that night because all my patient’s were close to death. I remember that night because myself, two other nurses, and one Attending were all that stood between them and death. If that’s not absolutely terrifying and amazing and awful and awe inspiring…I don’t know what is.

That’s when I felt it. I knew I wouldn’t forget that night. I wouldn’t forget the teamwork with those two nurses and the Attending. We forged bonds in a battlefield of dying sick children that cannot be described fully.

The most fucked up part about that is how much money I was making. I was getting paid roughly 29$/hour that night plus maybe 7$ night shift differential. To save children’s lives.

Obviously it’s more than minimum wage. But is that what a life is worth to us? My work that night was solid. But in my “yearly review” my manager never brought up that night. She brought up the ED’s budget and nonsense that I had no control over. I was never thanked by management for working my ass off that night understaffed and underpaid and saving lives.

In fact I wasn’t given a full raise that year because the ED had failed to meet some of it’s budget requirements. That never made sense to me. My raises were based on objective financial data. Not the number of lives I saved or who I saved them with or perhaps more importantly who I saved them without.

Nursing makes a person jaded. It certainly made me very cynical. I saw the value large corporations place on human life. Because hospitals are just that: corporations, and it didn’t add up to me.

That night I breathed air in the lungs of patients who couldn’t breathe on their own. I sounded the alarm and helped stop them from dying. That night shaped me as a nurse. I saw the limitations to nursing and I saw my full potential starting to shine.

I didn’t feel new anymore after that night. I felt like I could handle kids not breathing. I felt like I earned the trust and respect of the nurses and Attending that night as they earned mine. I felt simultaneously like the coolest person alive and also the most underpaid.

I remember thinking this is it. This is why I became a nurse. To save some lives. And there I was doing it.

p.s. on non-busy nights when we didn’t have patients trying to die left and right…we did prank the shit out of each other certain pranks involved moving peoples cars in the parking garage pretending they were stolen while others involved body bags. As I said night shift changes people…makes you a little darker.

 

Top Five Most Memorable Nurse Moments From The Emergency Department…Part 1/5

The most memorable moment for me in the emergency department was unfortunately not a happy one and it haunts me to this day. In fact I avoided writing this for awhile as I just didn’t want to. But it’s a story that needs to be told. Over and over. Because I don’t sweep bad stuff under the rug. I broadcast it.

I was in triage. The panic alarm went off, which meant something was happening with the psychiatric patients. I work in mental health now. I love it. However, it was the reason I left the emergency department. In the ED it’s containment, not treatment. It’s dangerous. I had been kicked in the ribs already, and had friends punched and kicked and bitten. But nothing could have prepared me for that night.

I turned the corner and two nurses who I knew very well, one of them who I had helped train, were bleeding, screaming, crying, in the hallway outside a psychiatric patient’s room. They had been horribly physically assaulted.

I worked in pediatric emergency, but a pediatric patient can still be over two hundred pounds and over 6 ft tall. There were too many people watching, patients, families, staff. I grabbed them and put them in a big walk in closet near by with an Attending who was trying to comfort and assess them.

Then I called a nurse manager I knew was in the office, I told her to go to the ortho closet now. She did. They thanked me later for doing that. Getting them out of the craziness and into a closet. It felt wrong to shove them in there so I was grateful later to learn that they appreciated it.

With my heart pumping I walked into the room of the patient. There were about six security guards holding the patient down. The patient was still straining and fighting. There was blood on the faces of at least two security guards. One had his glasses broken and hanging off his face. These were all people I had worked with for over five years.

With tears brimming in my eyes I used gauze to dab at the blood so it wouldn’t drip down their faces onto the patient. I tried with all my might to ignore the clumps of hair and scalp on the floor from my friends now in the ortho closet. There was blood spatter on the walls.

The worst part. The ultimate horror of that night was seeing the fear in my all of my co-worker’s eyes. Fear and anger and hurt and knowing there was not a damn thing we could do about it.

The patient was under eighteen. And with documented mental health diagnoses. No one would press charges against them. We had been down this road before. This horrific crime that left two nurses injured for months with neck injuries from being thrown around the room by their hair, punched in the neck, and more…it would go unpunished. Forever.

All the nurses that were there that night; we all quit within six months.

It was too brutal. Too real. Too fucked up for us to forgive and forget and brush under the rug. It also showed how the hospital would never have our backs if assaulted in the line of duty. It showed how the system just lets that go.

I can tell you the patient was in their right mind. Not psychotic. I can tell you that though every single person who worked in our department wanted revenge we swallowed our rage and took excellent care of that patient for the next week they were in our department waiting for an inpatient bed.

I never had to wipe the blood off my co-workers before, and while I have unfortunately, had to do it again during my career in inpatient psychiatry it was never quite so traumatizing as that night in the ED.

I returned to work the next day. There was another nurse standing outside the ambulance bay doors. Just standing there staring. She had been there with me last night. We stood there together for several minutes. Not talking. Building up the courage to swipe our badges to go inside. We never spoke. We didn’t need to. Eventually she swiped her badge. We went inside.

I realized in the days following that it reached a point where I was scared to go to work. Every time I heard the panic button I saw the image of them sitting screaming and bleeding. We were all more cautious, more jittery, more likely to give a PRN (as needed medication) for agitation much faster than we ever had before.

Eventually they came back to work and I was incredibly awed by their strength and bravery. Balls of steel was my actual thought. I don’t think I could have done it. Come back from that.

It shouldn’t be this way. Nurses should not be assaulted/attacked/abused. But we are. On a daily basis.

That day should not be my most memorable. I have fantastic memories of so many funny times and good friends and good talks and pranks on night shift and moments of absolute teamwork that can only be done in an acute care setting. Moments when everyone comes together like a well oiled machine to save the lives of children who were dying. Those moments were breathtaking.

I remember when I was new in inpatient psychiatry. There was a medical emergency. I yelled out what I needed and held my hands out and waited…and nothing. I looked up and there were psychiatric nurses staring back at me like I was nuts. I realized then I missed the ED. I wouldn’t have even had to speak in the ED. We all just would have done our thing. It’s a security blanket I didn’t realize I had until it was gone.

Yet the night I remember most wasn’t saving a life. It was watching lives being shattered. Watching my co-workers and friends broken with their blood on my hands. Literally.

When you ask some one what’s the craziest thing they’ve seen as a nurse. They won’t tell you these traumatic memories. But it’s what we are thinking.

I didn’t leave the emergency department because I didn’t love it. I did. I didn’t leave it because I even wanted to. I would have stayed forever. But not after that night. That night changed something inside of me. Changed my perspective of nursing and how our society treats nurses. That night broke me a little.

To all my fellow emergency department nurses out there. I see you. I know you. I value you. You are epic.

Conversations With A Three Year Old. About Fathers. When He Has Two Moms.

I’ve been watching “Tidying Up” on Netflix. I like her style. I took her method to my son’s closet and dresser. I took all the clothes out. Packed up two massive garbage bags for goodwill and one plastic container for Summer stuff that will still fit them. Then refolded all their shirts, Tidy style, and I was feeling very proud of myself putting all the shirts neatly folded into their dresser. Declan was in the room with me, chatting with me and playing intermittently.

He took a toy and pretended it was a phone, he was whispering, “Hi, is Mama there?” he wasn’t looking at me. I was chuckling to myself still putting clothes away, “Okay, bye,”. The one sided dialogue was cute, and I turned to look at him when it was over, “Who were you calling baby?” I asked. Thinking I already knew the answer. Me. Mama.

His answer floored me.

“My Father,” (But it sounded like My Fawder because he’s three and talks funny).

Me (trying to act very casual and not freak out): “Who?”

Declan: “My Fawder,” he smiled.

Me: “Oh, uh, who’s your Father baby?”

Declan (takes a moment to ponder this question): “Uhhh, Mommy!”

Mommy is my wife. Who was not home at the moment. Declan was all smiles, glad he figured out who his Father is and resumed playing.

I sorta sat there for a minute with my perfectly folded shirts and wondered how or if I should pursue this line of thinking. Then I thought. Fuck it. At least he knows I’m not his Father. I mean sheesh. I’m Mama. My wife has short hair and no boobs hence I’m sure the confusion. Three year old’s don’t get gender and he probably just thinks she’s the male-ish figure.

I know other lesbian couples where the kids call one partner (generally a more butch-y partner) Daddy and they just let it ride. So that’s what I do.

I told my wife when she got home. She thought it was hilarious. She asked Dec who his Father was, and he smiled shyly and said, “Mommy,” and she smiled and gave him a hug.

Declan is wicked smart. I’m not just saying that because I’m his Mom. I’m brutally honest. Trust me I would say if my kid wasn’t smart. His brother, Jackson, also wicked smart, but lazy. He can do as much and say as much as Declan he just chooses not to unless or until it benefits him. Potty training. Didn’t do it for M&M’s or chocolate chips. Wasn’t the right motivator.

He did it when we started not allowing him to watch any movies until he went on the potty.

Jackson is a cuddle bug. That boy will cuddle with me at any time of day or night that I sit down. He’s attached to me. Declan will snuggle occasionally. And it’s not because he doesn’t like to snuggle. It’s because he’s so damn busy. He’s always taking toys apart and putting them back together. The other day I went into the other room and he had half of a jumbo 24 piece puzzle together. It was hard. It was the jungle. It all looks the same. The kid did it by himself. I’ve never even shown him how to do a puzzle and he wasn’t looking at the picture on the box to guide him.

But I digress.

My point is that he figured out kids have Moms and Dads. Mothers and Fathers. Then he tried to fit his family into that social construct. Mama is a girl obviously. I have long hair and I breastfed him for a year. I wear necklaces and he’s always touching my hair telling me he loves it.

But Mommy, that’s debatable in his eyes. Short hair. Dresses like she works at a paint store (because she does) and wears work boots and no jewelry.

So there you go. She fit the Father mold a little better than Mama (which is fine but for real I’m the one that uses the power tools). Then he assimilated that into a fact in his head and bingo bango a Father is born.

My wife doesn’t care. In fact we’ve talked about utilizing Father’s Day as her day and Mother’s Day as my day so we have separate days to celebrate one another. My kids sure don’t care. But there’s something niggling at me (yes that’s a word).

Why are society’s constructs so rigid that a three year old gets them better than he does his own family composition?

Sometimes people get mad when I reference heterosexual privilege. But I’m going to do it. Because hetero’s have privilege. EVERY movie in existence that is mainstream and three year old appropriate has hetero families and love interests. The boys love Disney movies. Guess what. All male/female. Everywhere. And when, God forbid Disney had Lafou dance with a man, there was moral outrage from every homophobic twat in existence. It was a dance. Not even a long dance. I wouldn’t even have recognized it as a gay moment if I hadn’t been looking for it.

Our society makes a two mom family seem less than, unequal by not giving my sons the same opportunities to see two mom families as hetero families in everything from the media to books to magazines to movies to filling out forms for freaking vaccinations. It’s always Mother/Father. What about Parent/Parent?

My three year old shouldn’t think he’s supposed to have a Father. But he does.

He’s just also smart enough to realize he has two parents who love him, and one of them obviously would fill the Father role better than the other one. Touche Dec-man.

(The picture is Dec reading to all of his doggies. I heard chairs scraping and came into the foyer to find the dogs lined up and him reading. He is defying gender stereotypes by reading from the Disney Princess Encyclopedia)

Not Your Typical “Facebook Happy” New Years Post.

I’m quite realistic. It’s something people either love or hate about me. When I see the sappy posts on facebook about how perfect everyone’s 2018 was…yeah that’s not how I roll.

I don’t ignore bad things. I face them. I won’t say 2018 was a great year for myself or my family. Because in all honesty it wasn’t. But it could have been worse. And scattered through hard times were good times.

Between the screaming three year olds who fight sleep like it’s the plague, there were hugs and cuddles and the first time they said “I wuv you Mama.” Between watching my dad battle a chronic illness that is stealing him away piece by piece, there were lucid conversations; actual conversations where I spoke and he answered and it was rational and normal and I realized how precious the ability to converse with loved ones truly is.

We’ve had struggles within our marriage that are painful and challenging. But I’ve learned to have empathy for my clients who feel shamed by the struggles within their own marriage, who feel they can’t talk to anyone about it except for me because they know I am outside their circle of perfect married couple friends. I’ve heard, “You must think I’m crazy for staying,” through tears more times than I can count.

I learned a new response, “No, I think you have a decade or more with this person, children, good memories, not just bad, and it seems like you’re not ready to give up on it yet. That’s okay. You have to do everything in your own time.” I preach acceptance to individuals struggling silently in their marriages. Because I know that feeling and I wouldn’t dare to judge anyone else’s decisions within their marriages.

At some point in December we got bookshelves. I’ve been waiting a year and a half since we moved in to get them. My books are like my babies. Yes. I’m one of those weirdo’s who has piles of books around her house. Except for the last few years they have been in boxes. It has been killing me.

So we unpacked them into the bookshelves that I put together in our foyer while I swore a lot because seriously we can never just get a piece of furniture to put together where all the pieces fit perfectly. I always have to pull out my drill and make my own damn holes to finish it off.

Anyway I came across my favorite books. I always come across them when I need them.  It’s the Fever Series by Karen Marie Moning. And I read my favorite quotes and cried through my favorite parts. Usually late at night after everyone was asleep.

“Some people bring out the worst in you, others bring out the best, and then there are those remarkably rare, addictive ones who just bring out the most. Of everything. They make you feel so alive that you’d follow them straight into hell, just to keep getting your fix.”
Karen Marie Moning, Shadowfever

“Although it may not seem like it, this isn’t a story about darkness. It’s about light. Kahlil Gibran says Your joy can fill you only as deeply your sorrow has carved you. If you’ve never tasted bitterness, sweet is just another pleasant flavor on your tongue. One day I’m going to hold a lot of joy.”
Karen Marie Moning, Bloodfever

“I’m sorry your pretty little world got all screwed up, but everybody’s does, and you go on. It’s how you go on that defines you.”
Karen Marie Moning, Bloodfever

When I feel like I’m brought to my knees in my life I am reminded that every one is at some point or another in life. That it is how I get up and go on that defines my life.

In 2018 I am grateful for the pieces of joy that overcame the spaces of darkness. I am grateful for my sons even though they drive me insane. Literally. I am grateful for my marriage because it does make me stronger, better, and there are times I just have to be reminded that we started out addicted to one another and it’s still there. It just gets buried under twins and bills and everything else about adulting that sucks.

I am grateful for my house and the life we have built together. I am grateful for my business which is thriving. I am grateful for my dear friends  who have seen my through so much in the past year. I hated making two trips to the emergency department one for my son and one for my Dad, but I am incredibly grateful that both times there were people who I knew taking care of my family members because I worked with them in the past in the emergency department.

I love that Blue Planet II came out. I hate that I showed my sons who were scarred by the whales tearing apart the bird. Mom fail. I miss the arrogance and freedom of my twenties, but am grateful to have lived to 33 as I have now seen too many young people die from heroin overdoses by 25.

I hate watching my Dad decline but I loved the conversations I got to have with him when he seemed back to his old self. One at my dining room table, one in the emergency department, and one sitting in his backyard on his birthday.

I hate the state of our country. But I have hope that 2019 will bring change. I hate that my Lesbian Gay Bisexual Transgender Non-binary Queer clients/friends/family live in fear. I have hope that we won’t one day. I hate that hetero-cis individuals belittle our fear when they have not felt the sting of discrimination ever.

I hate that Ellen D. came out with an awful stand-up routine that did not in the least address the issues the Queer community faces today. I love Hannah Gadsby’s Nanette and I applaud her for facing the tough issues.

I hate hard times in my marriage but I love coming out the other end stronger for it.

“I wish you a marriage peppered with bad days in order to make the good days even sweeter. I wish you the best marriage filled with love in all forms- so powerful that it hurts, and so pure and good that even on the hard days you know you will make it through and come out maybe a little stronger, a little darker, and with a love so strong you can’t live without it.” (me to my sister at her wedding in 2012)

I’m bracing myself for 2019. But as I said. I face shit. So bring it.