Feed the F*cking Dog

(Disclaimer: there are a few swear words in this post.  For those of you that know me in real life, you know that I cuss enough to make a sailor blush, but I try to avoid it in writing.  In this case, I'm quoting and I felt it was necessary.  It's really not that bad, but I felt like I should warn you anyway.)

Jenn begged me to blog again, and this is one of her favorite stories.  It's a story that I wish I could tell you in person.  It requires my particular brand of snark, a little bit of interpretive dance, the happy hour setting, and the kind of wild hand gestures that would lead me to spill a beer in your lap.  Your lap, not mine.  Bear with me, runners, because just like every other thing I say and do, I manage to tie it back into running.  That seems to be the curse of marathon training.  EVERYTHING you do is somehow related to tied back into running.  For those of you that aren't runners, you might actually enjoy this anyway.

When you choose nursing as a career path, it takes a certain amount of courage to walk into that hospital every day.  You have to be brave enough to assume that you can handle whatever is thrown at you, confident enough to trust your instincts and training, and just bad-ass enough to keep your unruly patients in line in order to pass them on to the next shift.

Over the summer I had the pleasure of taking care of a particularly memorable patient.  We'll call her "Miss H."  Miss H was a total disaster.  On a scale of one to ten, with one being a "hot mess," and ten being a "train wreck," she ranked about an eleven ("it's one louder than ten").*  She belonged in the locked psych unit, but she wasn't medically stable enough to be there. She had every blood disease known to man, and if it wasn't transmitted sexually then she picked it up off a used drug needle.  Let's just say, I didn't want any of her body fluids coming anywhere near mine.

Miss H, because of her high risk of falling, had been given a bed that is very low to the ground.  Because of her delusions, she had been assigned a sitter.  The hospital employs sitters, whose only job is to sit in a patient's room and keep them from hurting themselves.  Miss H had a central line (a large IV-like catheter) in her jugular vein that she had been trying to remove on her own.  She had also attempted several times to leave the hospital. She was unsteady on her feet and was not able to stay oriented to her environment. See above: train wreck.

I confidently strolled into her room and said, in my sweetest morning voice, "good morning Miss H.  My name is Ashley, and I'll be taking care of you today. What can you tell me about your night?"  She didn't even look at me.  She was sitting on her low bed with her feet on the ground.  She cried out, as if in pain, and drew her knees up to her chest.  Concerned, I squatted by her bed and said, "Miss H, are you hurt?  What happened?" She again, failed to even glance in my direction as she said, "you know that g*d damn cat from down the street?  They're always letting that piece of shit run around.  No more."

Unsure of what to do, my body frozen in a squat, I pivoted my head to glance at the sitter who let out a combination of a grunt and a laugh.  I was acutely aware that my patient was bat-shit crazy, and it was my job to battle it out for the remainder of the shift.  This was one of those battles that was going to require a little more bravery and strength than I was accustomed to.

Keep in mind, Miss H also had a roommate.  This roommate wasn't so sane herself.  Every time I spoke to my patient, her roommate would answer.  Here was just one of the many exchanges we had:

Me: Miss H, would you like a Sprite?
Roommate: I don't want no damn Sprite.
Miss H: Ma'am, I was speaking to your roommate. If there's something you would like, I'd be happy to get that for you.
Miss H: Who let her in here?  You know she's up here smoking that shit.  Oh hell no! Not in my house.
(It should go without saying that no one was smoking in the room.  Also, Miss H seemed to have forgotten the fact that she was homeless.)
Roommate: Where's my damn Sprite?  These stupid kids...

Much of the day continued like this.

Periodically throughout the day Miss H would burst into tears, start ripping at her central line, or try and get up to leave the room.  I'm not sure if you have ever had to intervene with a person that is having drug-withdrawal hallucinations, but it's near the bottom of the list of my favorite things to do.   Several times that day, Miss H would look in the corner of the room and say something along the lines of, "I'm gonna kick his ass...that stupid mother f*cker."

With anger in her eyes, this would be the point where she would stand up and head towards the corner.  Since she was a high risk for injuring herself we had no choice but to intervene.  There was no one in the corner, but I was afraid that as soon as I stepped near her she would find me.  I'm not sure, but I was afraid that to her I might look remarkably similar to "that stupid mother f*cker."  I'm not keen on putting myself in front of a combative, hallucinating patient that's ready to spit hepatitis in my eye (that's not exactly how it works, but you get the idea), but it's also my job to keep her from hurting herself.

My day progressed from a polite "Miss H, please have a seat," to a very stern "SIT. YOUR. ASS. DOWN. NOW."  I didn't leave her room all day.  She blamed me for missing the birth of her grandchild.  She told me the sitter threw her down the stairs.  She warned me of the dangers of sharing a crack pipe because some of those people have AIDS.  This was not the time to remind her that so did she.

The day climaxed with her simultaneously swinging at me and the sitter as she tried to leave the room, and then burst into tears before taking a seat on her trash can.  After finally getting her back in bed, she started in on her rice crispy treat that was leftover from lunch.  She sat down, got a glisten in her eye as she tore off chunks of her dessert.  She fixed her gaze under her roommates bed while puckering her lips and beckoning with her hand.  She smiled and said, "see that dog?" as she began to throw pieces of her rice crispy treat under the bed while saying, "come 'ere boy!"

I roll my eyes towards the sitter and put my hands in the air.  The sitter and I exchange a brief look.  It is the look of sisters.  It was a look that can only be shared among people that have experienced an epic event.  It was as if we had survived a plane crash, natural disaster, or nuclear fallout.  We had been battle hardened and suffered.  We were at our breaking point.  In exasperation I said to the air, "feed the f*cking dog.  I don't even care anymore."

Nursing is about priorities, and after all we had been through that day, preventing my patient from making it rain cereal treats was not a concern of mine.  If she wanted to make some snap crackle pop confetti I was going to allow it.  I reached the point where I had not choice but to just carry on.  It's not how I pictured my day, and it wasn't pretty, but I knew that I had done everything I could.

"Feed the f*cking dog" has become something that I say a lot now. When I've reached the point where things are out of my hands.  If I've done everything I can, and now I'm just forced to sit back and watch.  I also say it when I just don't give a shit.

You still with me, runners?  Here's where I bring it back:

When you run you have plenty of time on your hands to think.  I think about this patient a lot.  It was such a shit-show of a day, but I can't help but laugh every time I think about it.  I know I have posts that tend to get philosophical, or motivations that can be incredibly corny.  The reality of it is, at mile twenty, I doubt that I will be saying, it's only "about an hour."  When I am miserably trying to suffer through that last .2, I don't think I'll be able to say, "remember why you run!" (<--both posts you should check out)

Just like that day, I have NO idea what to expect when I'm running a marathon.  I will be brave enough to go to the start line, confident enough that my training and rest will get me through, and just bad-ass enough to force myself to finish.  I know there will be some miraculous highs, but I'm dreading the inevitable lows.  Despite what happens, I'm sure that at least some of it will be a miserable experience.  I'm expecting it, and I accept it.  

My mind will quit on my body.  My body will quit on my mind.  Despite the training, and the support, and the motivation, I'm going to be dealt blows that I can't comprehend right now.  I will be battle worn and scarred both physically and mentally.

At that point I will have lost all shreds of arrogance.  I won't be able to turn to my sappy sentiments.  When I've done all I can, I will just have to somehow keep going and say, "Ash, feed. the. f*cking. dog."


*Sorry if you don't get the reference to "This is Spinal Tap."