Monthly Archives: August 2015

Saving Happiness

Friday Fictioneers

Copyright Claire Fuller

Casey handed the death certificate to the vault matron in exchange for the safety deposit key. Baffled, her father was not the type of man to have secrets, she allowed a few tears and sorted through his memories: two sets of dog tags, an unused train ticket to Denver dated June 4, 1943, a tiny gold wedding band and a photo of her father in dress blues smiling and embracing a beautiful stranger in an Army Nurse Corps uniform. Casey smiled at his happiness, glad that there was no one left to ask. She closed the box on his past and wondered if she ever really knew her father.

For more flash fiction @Friday Fictioneers drop by the library of Rochelle Wisoff-Fields here.

When We Are Just Doctors

I write about health and wellness, life and death, and human suffering through fiction and narrative medicine but this post is profoundly personal and was painful to share. My family has suffered many losses in the last few years. Both of my parents and my oldest sister have passed away in the last three years. My parents died peacefully at home with the family at their bedside. In contrast my sister recently died in a local hospital and this is my experience in the last hours of her life. Hospitals are terrible places to die. There is no peace or dignity in a hospital death.

This is a photo taken with my dear sisters eight weeks before my oldest sister passed away.

image

When We Are Just Doctors

“I’m just the night doc,” you said. You said it with emphasis as if that explained everything and dismissed your incompetence, your lack of compassion, your failure to care. Unfortunately my sister was “just the patient”, who lay suffering hours before her death and the RN was “just the nurse” withholding the morphine that the daytime doctor had ordered for air hunger and agitation. The nurse called you in to manage me when I asked her to give my sister a touch of morphine; she was crying out in pain from her hypoxia. A civilized, yet ridiculous argument ensued about the dangers of respiratory depression in a patient who was clearly dying. You and I, physicians and colleagues, were arguing over 2 mg of morphine when you said, “I’m just the night Doc”. I’m still shaking my head over the absurdity. Instead of assessing the situation you felt the need to pass the buck until morning. Does no one die on your watch? You were so busy, not being a physician, that you must have missed the oxygen saturation in the 70’s and the flipped T waves predicting my sister’s imminent demise. The life and death stakes were not high, the end result would have been the same. We both knew that, so why did you feel the need to distance yourself from your decision to withhold medication with a just statement? “I’m just” means that you are under no obligation to act. You were telling me in essence that you were a just an overnight placeholder in the ICU. When we are just doctors we are not our best selves.

A more honest, although equally lame statement would have been, “It’s not my job”. However that declaration begs the questions as to whose job is it to orchestrate patient care after dark? Having been a doctor for three decades I can’t remember a time when my obligation to care for patients stopped at dusk. That implies that patients can only expect our best selves in the daylight hours. Did I miss the memo, has medicine gone so far away from patient care that this shift work mentality is the norm or were you “just an ass”? What if you’re only a Wednesday doctor but you’re working on Friday, will you wait until Wednesday to treat? The absurdity boggles my mind.

I don’t blame you for my sister’s death, everyone knew she was dying. She had asked for resuscitation measures to be stopped. However, in saying I don’t want extraordinary measures she never said, “I welcome a painful, oxygen starved, horrible death.” I had promised to be there with her and I had explained the likely outcome. She trusted me to watch over her as a sister, not as a physician and I couldn’t do it. My real anger is directed inward and I can’t forgive myself for leaving the hospital. I let you drive me away in the last few hours of my sister’s life, because I was angry and powerless. I couldn’t “just be a sister”. Everyone of us as healthcare professionals that night had a duty to care and we all failed due to our individual arrogance.

I used your lack of compassion as my excuse to avoid facing the last three hours of her life. We wear many hats as physicians but can we ever just be family members? The family relies on us, to translate complex medical speak, to help them understand the big picture and to act as liaisons with other healthcare providers. We usually do this willingly and in my experience, it unfortunately also allows us to keep our distance from our own very painful human experiences. I know that I am much stronger in a medical crisis when I am in “doctor mode”. You, the night doc and the night nurse wouldn’t let me be a doctor that night, thus the power struggle at the bedside. I would love to give you credit for urging me be the sister instead of the doctor, a much healthier way to grieve, but that wasn’t your intent. You made it clear that there would be no team decisions despite the fact that I had been there all night, knew my sister’s wishes intimately and had watched her oxygen saturation plummet and the T waves dip. If I hadn’t been a doc, would you have been more compassionate towards my family? Were you practicing defensive medicine because I was there? Who better to understand compassionate palliative medicine than me, your senior colleague?

As we kept our distance from death by arguing a moot point, my middle sister ignored us and kept her promise to my oldest sister. She prayed, “Hail Mary full of grace” softly in my sister’s ear, a comfort to both of these women of faith. She did not distance herself, she immersed herself in the process of helping another die. If we had set our collective arrogance aside perhaps we could have acted as a team and stayed in the moment with a suffering fellow human being.

Patients are never just patients; my sister was a vibrant and brave mother, sister, wife and friend. All of us failed to recognize what a profound privilege it would have been to assist another to die with dignity and grace. None of us were there three hours later when my sister passed away with a team that included a kind nurse, a compassion physician and my sister with faith. I can’t forgive either of us for being “just doctors”, there’s no dignity in that.

Halibut in Burst Tomato Wine Sauce

Halibut in Burst Tomato Wine Sauce

Halibut in Burst Tomato Wine Sauce

Fish is a fabulous source of low fat protein and omega 3 fatty acids. It’s perfect for a healthy lifestyle. I’ve added a vitamin rich white wine sauce of heirloom tomatoes, lemon and capers for a burst of color and incredible fresh flavor. This dish is fancy enough for company but easy for an “any night” meal. And fancy enough for my pals at FiestaFriday.net

Halibut In Burst Tomato, Wine Sauce

Ingredients:
16 ounces of Halibut cut into 4 pieces (any firm white fish would work)
2 tablespoons olive oil
1 tablespoons butter
1 cup heirloom “cherry” tomatoes
1/2 cup dry white wine
2 tablespoons capers drained
3 slices preserved lemon or fresh lemon slices
Salt and pepper to taste

Instructions:
Heat olive oil and butter in a skillet. Salt and pepper each side of the fish and add to heated oils. Sear fish 3 minutes per side, remove from pan and set aside. Deglaze the pan with wine and add the remaining ingredients. Simmer until tomatoes burst about 8 minutes. Return fish to pan and simmer 5 minutes until fish is opaque and flakes. Don’t over cook the fish.
Serve fish with sauce.

If your diet allows, serve with a glass of crisp Sauvignon Blanc.

The Gutter Sprite’s Oasis, #BlogBattle Week#23

This is a continuation of the adventures of Etoile the fairy and the Gutter Sprite.
Here’s the beginning of my flash fairy tale. I’m combining two flash fiction challenges today #BlogBattle and Sunday Photo Fiction. It isn’t Ground Hog Day, I did post the Sunday Photo Fiction story but I felt that Etoile needed a few more words to really bring out her sparkling, mischievous personality. Enjoy

Sunday Photo Fiction

Etoile urgently traced a pattern of stays and sheets with her willowy hand. The indentured firefly was bound to her index finger being made one with the artist and her masterpiece. She outlined the rigging of the great frigate, bringing it alive with sparks of luminescence, creating a mirage that appeared to sway against the rough sea.
The mural would cost Etoile dearly, for the tiny gossamer fairy had bartered with the moon and coerced the wind, risking the currency of her soul in order to raise the life-sized ship from the thin night air. With a finishing touch she spun the sounds of clanking halyards and the snap of sails.

“Let the Gutter Sprite top that,” she threw down a challenge vowing to win this year’s top prize at the Annual Fae Arts Festival. Careless to a fault, her debts would come due, but she refused to accept a hundredth defeat at this her last competition.

The Gutter Sprite’s Oasis
By Tracey Delaplain
Genre: Flash Fairy Tale

I shall pixelate you, Etoile” shouted Luna as she sunk beneath the horizon, yielding the day to the sun in defeat. “You promised,” her voice being swallowed by the mountains. “I didn’t actually promise, fairies can’t lie, I just implied that I would pay for the extra illumination,” Etoile answered and flitted beneath a rose petal where the last moonbeams couldn’t reach her. “No one will make a pixie out of me,” the tiny shimmering fairy announced with a huff of bravado.

“Firefly, come, we have but fourteen hours of sunlight and we must find a way to repay the moon. She did not much like my fairy gold and she can be so crabby at moonset. Pixelate indeed!  She wouldn’t do it, would she?” The firefly lazily buzzed out of the amulet at Etoile’s waist, “Hmm? Yes, I believe she will. You are broke and you seem to be confused as to what constitutes a truth versus a lie. I’m afraid you are the Gutter Sprite now and you’re a sore loser too.” Etiole frowned remembering her defeat at the hands of her frenemy. Not only had she lost the outdoor illumination division but she had borrowed the moonlight to fuel the illusion without permission, leaving the moon in a snit.

“You have to admit that Fleur’s art project was stunning this year. She deserved to win, again,” Firefly continued adding fuel to the fire. He loved to see Etoile seethe. Her wings would pucker and her tiny brows would furrow giving her the look of a water nymph.

“Any fairy can conjure up an oasis; a couple of palm trees, a bit of blue water and a few fish. I created a Man o’ War out of sea air.”
“Your ship sunk!”
“It was the winds fault. He promised a fresh breeze last night and delivered a squall.”
“His word is apparently at least as good as yours. Even fairies can’t control the wind. You should have adjusted your sails.”
“Whatever,” she fumed remembering Fleur’s winning entry.

The oasis had been surrounded by a legion of humans wearing swirling silk gowns and bejeweled turbans. Some sat astride strange golden animals with humped backs while others lounged on the backs of snarling ebony colored cats. Waterfalls spilled from thin air into a pool of shimmering silver. There were fish in every color of the rainbow.

Firefly interrupted her thoughts, “The fairy judges really enjoyed the feast of sugar threads spun into puffs. Kind of a dirty trick I’ll admit, but what a great idea; clouds of pink sugar.”
“You aren’t helping, Fly. I will get even with her but first we must deal with the moon.” Etoile declared.
The firefly yawned, “Let me sleep while you scheme.” Fireflies are known to lose interest quickly.
“Wake up. If I am pixelated then you, my sparkly friend, will be made a common house fly.”
“You wouldn’t dare.”
“I have a mind to do it anyway.”
“Fine, I’ll help, what’s left in our stores?”
Etoile unzipped her tiny backpack and emptied the contents onto the dew speckled grass. She picked through the bits and bobs: goose fluff, one antenna, a mouse ear, pixie snot, a tiara and a kitchen sink. Her tiny fairy brain whirled and sputtered finding no simple solution. “Hmm, we may need to borrow a few elements,” scratching her fairly tiny nose.  “What does Luna want, besides my head on a pixie’s body?” she asked.
“What does any moon want, fame, fortune, love, beauty?” he suggested, flitting around Etoile’s left ear making it twitch. Etoile batted at the firefly making him laugh and buzz away.

“The moon is cold, aloof and….. VAIN!  That’s it. We will give her the illusion of beauty, she’s so jealous of the Sun’s set. Tonight when she rises the sky will be red and we will weave the clouds, draping her in gossamer threads of gold and silver. We can borrow a few illusions from the Gutter Sprite’s oasis. She won’t notice, besides she will be off gloating at the Fairy Art Ball. The wind will help; he has a short memory and is easily fooled. We will adorn the evening sky with new constellations of panthers and camels, you can paint those.  Do you think lightening would be over the top? Does Lightening owe us any favors?”

“Uh, no but when has that every stopped you?”

“Oooh, I bet Luna would love those pink sugar clouds. I just know that all will be forgiven.”  Etoile laughed, her eyes shining with revenge, “The oasis will be destroyed and the Gutter Sprite will finally be defeated.”

Firefly sparked and sighed, “What could possibly go wrong with that plan?”

To Challenge a Gutter Sprite

Sunday Photo Fiction

Etoile urgently traced a pattern of stays and sheets with her willowy hand. The indentured firefly was bound to her index finger being made one with the artist and her masterpiece. She outlined the rigging of the great frigate, bringing it alive with sparks of luminescence, creating a mirage that appeared to sway against the rough sea. Continue reading

An Emptiness – Friday Fictioneers

Friday fictioneers

Photo credit @Madison Woods

An Emptiness

Max lie awake, restless, the campfire crackling, sending sparks towards the clouded moon. He wondered about the new kid’s story, “Idiot, nearly got his self killed falling off a west bound.”

Max gathered stories and every hobo had one, it always came down to gnawing hunger. Truth be told, an empty belly wasn’t the only hunger that put a drifter on the rails but it sure enough would stick with ya.

“A man gets starved for permanence: a warm bed, a soft woman, a kid, anything that he can call his own; leaves ya with an emptiness that no amount of grub can fill.”

For more Friday Fictioneers visit @Rochelle Wiseoff-Fields here.