Archive for the Uncategorized Category

No man, no nation..

Posted in Political Commentary, The Flow and Rhythm of Life, Uncategorized with tags , , , , , , , , , , , , , on 06/26/2017 by Angel D. Vargas

So much in our world has changed since the purported “election” of Donald Trump as the President of the United States. The hard-earned civil rights gains for women, homosexuals, black Americans and other marginalized people all appear to be on the verge of destruction. Our understanding of global warming and the impact of humanity on the planet is muddied by the interests of corporate fat cats who sacrifice the fate of the lower classes for increased profit margins. World War 3 may be close at hand, as those with a Christian bent are becoming edgier and edgier regarding the fate of an increasingly bombed-out Damascus. People lose faith in our government as our now limited news media coverage bombards us with headlines regarding the latest gaff, appalling remark, or tweet made by the leader of the free world. Mere months of this man’s presidency have felt like years to many weary Americans.

 

And life was hard before this farce of American government began eating the last crumbs left to us of the American dream. Full time work for the average adult living in the United States is needed for most of us to survive. Yet the promise of higher education is met with a shrinking job market and staggering student loans for many college graduates, more and more of whom are forced to compete for part time jobs that offer no insurance benefits. Some college graduates turn to the armed forces or civil service work to try to make up the difference, but for various reasons, that is not an option for most. Those of us lucky enough to attain full time work struggle for the time and energy to do anything else on the side, and we are met with stoic advice from the older generations who tell us “this is life,” and who welcome us to adulthood with sardonic smiles and knowing head nods. Baby Boomers get older, and they expect us generation X kids to take on the immense burden of their care with such limited resources that we can barely support ourselves. Yeah, thanks but no thanks.

 

I am often forced to make tough choices regarding my dream to become a fiction writer. And because of the nature of my own full time employment, less and less of these decisions ever seem to lead to my sitting down and enjoying the process of writing a manuscript, let alone having the time to research potential publishers for the manuscript I’ve already completed. Real life problems, depression and a sense of loss further complicate things, and I am left wondering if there is a light at the end of this increasingly long and dark tunnel.

 

But the thing that seems to help the least is technology. The Internet has all but destroyed real communication; It allows bullies to employ the cloak of anonymity to troll and abuse other users. Political discourse becomes little more than obsessive fact checking and online name calling, and people would rather “unfriend” one another on Facebook rather than meet face to face to come up with real life solutions to the growing problems in inequity in Western Culture. Finally, the Internet allows users to accept accolades for which they never worked, to claim false kinship to others with whom they’ve never spoken, or to attain misleading or false information about important subject matters that lead to more questions than there will ever be answers. In this increasingly relativist culture, we’ve allowed technology to take away our ability to even look one another in the eye rather than at our mobile phone screens.

 

We’ve allowed quickness of our fingers to outshine the profundity of rational thought. Want proof? Why don’t you look up Donald Trump’s latest tweet. I’ll wait.

 

Where do we go from here, kiddies? I’m typing this now both as an exercise in catharsis, and as a chance to let certain people know both where I stand on some of the issues of modern living, and why I’ve been so out of touch with my Internet “chums.” We’ve seen history being made with this latest president and his impulsive, often reckless decisions. As Americans, we’ve also had a chance to put things right. But we don’t understand the laws that govern this nation. We’ve lost track of what our government officials do to us behind closed doors because we let this buffoon shut most of the media out of his very public office. We’ve forgotten who we are as a nation, and as human beings. Because I love this country, I am terrified that the United States of America will no longer be the great nation that it once was. I’m already not the man I thought I’d be. It would be a shame to see this nation follow suit.

Rules of Engagement

Posted in Uncategorized on 01/30/2017 by Angel D. Vargas

-Friday, January 27th, 2017 “President” Donald Trump signs an executive order re: immigration at 4:42 pm Eastern Standard time. This order “indefinitely barrs” Syrian immigr…

Source: Rules of Engagement

Rules of Engagement

Posted in Political Commentary, Uncategorized with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on 01/30/2017 by Angel D. Vargas

-Friday, January 27th, 2017

“President” Donald Trump signs an executive order re: immigration at 4:42 pm Eastern Standard time. This order “indefinitely barrs” Syrian immigrants from entering our borders. The order also suspends all refugee admission for 120 days, and blocks citizens from seven Majority Muslim countries from entering the US for approximately three months.

The order takes effect. Almost immediately, chaos ensues. At airports around the country, hundreds are detained and questioned. Thousands more are left wondering about friends and family, stranded or turned away before they could reunite with loved ones who were simply traveling abroad. Across the world, millions are outraged.

I am outraged. Aside from the Anti-Muslim bigotry inherent in such a ridiculous order, there is more to be concerned about here. This is in direct violation of the US Constitution’s first amendment. For those who’ve forgotten it, here it is in bold print.

Amendment I. Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances.

Federal judge Anne M. Donnelly, who used to serve in New York as a Manhattan Supreme Court Judge, challenges Trump’s executive order, granting a temporary stay for refugees and others. In her words “irreparable harm” would be caused by sending the travelers home.

Irreparable harm. Those are tough words. But we are living in tough times. As such, I’ve had to look at those two words and wonder if Judge Donnelly’s countermand was too late not to have caused irreparable harm to the way American citizens must now view their own country. Trust issues, anyone?

If I want proof about how bad things have gotten within Trump’s first ten days in public office, I only need to remember how recent conversations with friends, coworkers, and strangers have gone. Walking down the streets of Harlem these days, it seems that the tension is thick enough to cut with a chainsaw. People don’t look me in the eye here, which isn’t surprising given that it’s New York City, but many of the ones who do look wary or fearful. Many more appear angry.

Words are also a problem. Now it seems, everyone must be careful what they say. The media is being slowly silenced by a man so hell-bent in preserving his fragile little ego, that nothing bad can be said about him without consequence. Kellyannne Conway promises that journalists who say anything pejorative regarding Trump “will be fired.” Trump continues to malign CNN and other networks that express concern over his heavy handedness or his apparent inability to comprehend the consequences of his own actions.

And now, it seems, citizens don’t know how to talk to one another. I know I’m having trouble. I square my shoulders now when I engage in political discussions at work, for there is a good chance that emotions will erupt like Mount Etna. My home life has been invaded by tense discussions regarding Trump’s latest gaff or executive order. My personal life has ceased to be about the pursuit of happiness. Once again, I am pressed into making the choice between taking in the news of the day, or ignoring it for the sake of my sanity.

As a Hispanic American, I know it won’t be long before I am asked to produce “proof of citizenship.” I won’t deny the temptation to smash the face of the person who will inevitably do so, but there is no doubt that person will be an officer of the law. My father was one of those. I will never besmirch the honor of his service. Yet despite my father’s exemplary career, he has already come under scrutiny for being “the other” since Trump’s election. Now, it seems, the closet bigot is free to come out and play among us all, like a demonic bully child on a playground primed to be “great again” as it gets whitewashed with hatred and ignorance.

I cannot allow that.

But there is something else I cannot permit. I will not permit the others who oppose Trump to judge me for the confidence (or lack thereof) with which I pursue resistance. I’m still unsure what form this sort of resistance is supposed to take in the face of such tyranny. I say tyranny because I am sure that this is the monster with which we are faced. An emboldened idiot has taken office, blindly signing away the liberty and happiness of American citizens and immigrants, appointing self-serving bigots with seemingly corrupt agendas to surround him and shower him with inane praise. “Good job, Putin Puppet. Now, let’s release the hounds on these peasants.”

But what will happen when Trump goes so far that there is no turning back? Has he already gone that far? It’s not even been two weeks, and I am already terrified at the prospect of what’s to come. Will there be a KKK rally here in my home city? How many more hate crimes will be committed around the world that mimic senseless Mosque attack in Quebec?

When will I have to consider obtaining a conceal and carry permit?

That’s right. I’m considering it. Some of you same idiots that fight tooth and nail to defend the second amendment while threatening to shoot yourself some beaners are forgetting one simple truth. Not all liberals and Trump opponents are pacifists.

Think on that.

I’m not into marching or rallies. I never was. But mark my words. The true patriots of America have often been the dissenters. Without dissent, people will not have reason to rethink their potential ignorance of gravely important matters.

I wonder if those who voted for Trump are starting to understand how bad this might get. When will they scream to the stars in penance for what they’ve done? I’d invite these fools to wait for the inevitable “I told you so,”but that would be my own hypocrisy shining through. I am deeply sorrowful for the sharp decline of our Nation’s values. International friends and acquaintances are asking me “what happened?” to my own country. I can’t even give an honest answer. The truth is more horrible than any horror fiction I can concoct. Yet I know I mustn’t give into the sorrow. And neither must anyone else. The moment we the people give up our desire to do the right thing, I’ll know to look for the mushroom cloud on the horizon..

State Certification Exams, and the End of Certified Nursing Assistant Training.

Posted in Uncategorized with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on 03/05/2014 by Angel D. Vargas

3/5/14

My Nursing Assistant training is put to the test during a four day externship to a long term care facility. The adventure begins with the scheduling and organization of the entire affair, but by the time the dust settles, I’m decidedly chagrined with the end result. I somehow have it in my head that we are supposed to get our choice between two facilities. Furthermore, I’ve deduced that those of us who get the required medical forms filled out the earliest are supposed to have first choice in where we want to go, as in a “first come, first serve” basis. I seem to be the only member of the class that got this taken care of early. Since home for me is at my girlfriend’s apartment in Harlem, I am hoping to be placed in what appears to be the only Manhattan location affiliated with my particular training program. Given the living situations of my classmates, they are all more or less hoping for the same placement. I am silently confident that I am going to go exactly where I wish.

Before I even set foot in a Program Administrator’s office for what feels like an official debriefing, my hopes are dashed. Our professor has come back to the classroom and dispersed our assignments to us. Not only has everyone been sent to the same facility, but its “way-the-fuck-out-in- Brooklyn” location staggers us all, as though, like some distant star, its light would take billions of years to reach our planet. Our one student who hails from New Jersey looks at me as though she wants to throw something. Another female pupil lowers her eyes to the ground, a defiant “Hell no” escaping pursed lips.  I cross my arms over my chest and turn my head, disgusted. Once again, I feel as though I’m being backed into a corner and forced to accept yet another arbitrary set of rule changes. Moments of frustration comprise my patchwork quilt of experiences with this school’s administrative communication. This nasty realization comes in the middle of my preparations for state certification tests which suddenly seem to loom like Servants of Darkness on the periphery of my life, waiting. Now I find myself wondering if those rules will change too, or if I will be handed the wrong exam without my knowledge. I vow to be extra vigilant on the first of two scheduled exam dates.

Sure enough, exam day creeps up on me like a stalking burglar. Contrary to the other two of my classmates who will be with me this day, I no longer feel as though I need to do any last minute studying, or partake in any hurried, whispered discussions of what it might be like. Our maternal professor wishes us all luck, marches her “children” into the CNA state exam room for one hour of focused study, and closes the door. The three of us sit at a large table and go over a practice exam, but I just can’t bring myself to care during “the Zero hour.”

It takes no time at all for any of the three of us to complete the Patient Care Technician exam. Sure enough, one of us is handed the wrong test, I am handed the wrong identification number for my test, and the last of my classmates has her name spelled wrong on the official roster. Despite all this, panic blossoms in the middle of my chest, and I forget to be indignant. Once the test begins, however, I feel as though I am in my element, dispatching each question with brutal efficiency. My fabulous progression sends a thrill through my body. Post test, my confidence begins to manifest in a warrior’s swagger. As I calmly stride over to the proctor to take my Phlebotomy exam on little more than a whim, I might as well have the flat of Masamune’s legendary blade resting against my shoulder. My classmates look at me as though I’ve grown an extra head, but then they nod. One of them pats me on the back as I begin the second exam.

“I know you got this,” she whispers before exiting the exam room for the day.

The externship is set to begin shortly after the test on a Monday, the 24th of February. As the day looms closer, tensions rise in the classroom. Some students begin to express doubt about travel time and cost. Others seem to lose their focus, chatting with each other or texting on their phones when they are supposed to be practicing skills for the yet unscheduled C.N.A. practical exam. One exhausted student who also works retail becomes so testy that others begin to express concern.

I become a knot of anxiety and resentment. I will have to wake up at the ass-crack of Dawn and be on a D train headed toward Coney Island for more than a hour each morning. I need to buy new white scrub pants and new white sneakers in order to follow the official facility attire standard. Meanwhile, I get the grim news that I am being laid off “until further notice” thanks to the cold calculations of a regional manager with whom I’ve only exchanged two words in almost as many years. I am still grading the test papers of nearly all my classmates, and our teacher has not stopped handing us paper after paper for our folders, all of which seem to be bursting at the seams like the bellies of expectant mothers.

None of this adds up to anything with which I would want to deal. In fact, the discussion I have with my girlfriend less than a week before the externship’s inception includes both the news of my lay off and the news about my new “wake-up” time.

I won’t bore you all with how awkward the words were as they came tumbling out of my mouth, but I will say that there is a reason to celebrate the love, understanding, and companionship of someone special. Without fail, she arranges for a couple’s massage treatment at a midtown Manhattan spa, a late one-year anniversary gift that comes just at the heels of my surprise dinner reservations for two at the Thai restaurant where we first met. There could be no better time for something like this. The treatment is so lovely and enjoyable that I almost cry when my girlfriend dashes off to a stage management assignment while I go home to melt into a puddle on our futon.

I settle in for the weekend. The fact that I’ve had my last official class in school settles on me like a spring dew. I smile, albeit wearily. It doesn’t take long to map out the walk I need to take once I get off the D train somewhere near Coney Island. I am forced to buy a pair of pants one size too large for me, and without any pockets. It’s all I can afford, and after an exhaustive search in the city, I am lucky to have found that much. My sneakers are cleaned and ready to go. I am as prepared as I am going to be, and I try to take the time to rest.

Monday

It seems, however, that the weekend passes within the blink of my burning, wearied eye. Church bells cut through the night,  and I sit up in a panic until I remember that this is the phone alarm that we’d agreed upon since my schooling began. My girlfriend jokes about wedding bells, but she can’t bring herself to climb out of bed before the sun begins its game of “peek-a-boo” with the clouds. I don’t blame her, and I don’t ask her to go through any more trouble than she already has. Until now, she’s made my breakfast at close to 6 in the morning for almost two months. It would be madness for her to wake up even earlier without a damned good reason. Love and emotional support can only go so far for those of us who are not Mother Theresa.

Without sufficient cause to travel on the D train, I might avoid the aggressive aura from the 125th street stop in Harlem. Still, the train arrives at about ten minutes to seven in the morning. I trundle on, aware that I’m already feeling stand offish. Fellow straphangers can make me feel as though I’m about to enter an arena rather than a public transit vehicle. Getting from point A to point B can be tiresome on such mornings. I don’t manage to attain a seat until about 34th street, but that is still at the very beginning of my journey. I’ve not traveled toward Coney Island for more than a decade, and I forget how long a ride it can be.

I also forget the cold. And this isn’t just any kind of cold. It’s the frigid, carve-a-hole-in-your bones-and-leave-a-wet-mildew-on-your-soul kind of arctic blast you can only  find near the water in the middle of the winter. A coastal city like New York will make you pay for any gaps in winter attire. I chose to wear my white uniform pants without a thought to long underwear. I also chose to don my winter coat without a sweatshirt beneath. The wind howls, and my teeth rattle as though I am a baby being shaken by a mother in the throw of alcoholic rage.

I still manage to get to my assigned Long Term Care facility in once piece. Many of my classmates are already there, dressed from head to toe in white. I find myself torn, wanting to either turn around and walk away, or look for the hospital identification band around my wrist. Everyone except our instructor for the day sports the raised eyebrows and hunched shoulders of apprehension. I forget to be hungry for a few minutes while we settle ourselves in, and our instructor for the week explains the importance of following the facility’s rules for attire, for conduct, and for the treatment of patient information. HIPPA is a big deal, and yet there seem to be so many different ways to violate it. By the time speeches are made and questions are answered, I’d rather like to become a deaf mute.

Receiving our assignments is fraught with nervous tension. We go to our assigned floor, and we receive a warm welcome from the charge nurse. However, the C.N.A.’s under her command are already busy. They arrive an hour earlier than we did, and it appears as though a good portion of their morning duties have been accomplished. Just when I begin to feel like a fifth, white-walled wheel, I, along with the only other man in the class, am assigned to a Nursing Assistant. She takes us to the male patients on the floor, and we set to work right away.

Our first assignment is breakfast. We get to feed a male resident who cannot even hold a spoon in his hand. Nerves mount once more as my partner steps in, meal-tray in hand, to begin. The first few spoons of hot cereal dribble down the man’s chin in embarrassing rivulets. After some nervous titters, we clean the detritus from his face and attempt to find a rhythm to the rest of the meal. I’ve hung back, surprised that my partner feels more comfort with this than I do. Our instructor finds us, nods in approval at our progress, watches my classmate feed the older gentleman, and then tells us to switch places. I don’t know why, but this takes me by surprise. In the end, I remember the classroom training, and I begin by offering the resident his apple juice. “Three sips, three spoons, three sips, three spoons.” This becomes a silent mantra in my head as I calm the shaking of my spoon-hand and proceed to offer encouragement.

The meal is soon taken from my hands by a smiling Nursing Assistant. My confused expression prompts the N.A. to tell us that the man’s wife will be visiting later in order to feed him a lunch. I am almost mollified by this explanation until I hear the bedbound man’s teeth grind against each other so hard, I’m afraid he’ll tear one of them from his gums.

“Does he do that often?” I ask.

I find out, of course, that this is regular behavior for him. It makes me curious, but something in the N.A.’s light, but insistent tone tells me we’d better get going with the rest of our morning duties. Sure enough, there is plenty to do. By the time all is said and done for the morning, my partner and I have made no less than six beds, participated in three bed baths, and learned why bedsores are not something to be taken lightly.

After a lunch and a debriefing with our instructor, our afternoon looks to be more or less the same. The morning’s activities make three hours fly by in a cosmic blur, yet the afternoon seems to drag as though someone pressed the “slow motion” button on my life. Still, things seem to be going rather smoothly. We’ve learned the scope of a Nursing Assistant’s hands on duties, and we are soon taken back to the employee break room. It’s only one o’clock in the afternoon, and our assignment keeps us here until four p.m. for each of our four days.

Our class doesn’t return to the floor. Nor are we released early. Our instructor, a registered nurse, has to go over so much paperwork and administrative procedure with us that I, along with all my other fellow pupils, become slack-jawed and bleary-eyed. Once the end of the first day arrives and we are released to our respective destinations, I find myself hoping that the next three days are just as easy. Yet I am also certain that they won’t be.

Tuesday

When I arrive the following morning, the only apparent difference between Monday and Tuesday for me is that I am now following a male Nursing Assistant instead of a woman. I am sure there will be differences in the male assistant’s approach to the male residents. I am right of course, but that doesn’t stop the work from getting done. He moves quickly, allocating duties for me and my fellow male classmate without missing a beat. Things appear to be the same as the day before, right down to our first task of feeding the same man his breakfast.

Just as we begin to find the rhythm to how to week might progress, another C.N.A passes by the room door and utters something to the effect of “the state is here,” and my stomach almost drops. Just to clarify, our class was taught that the State will often do inspections of long term care facilities in order to document procedure, look out for resident safety, and “ensure the quality of all the employees.” Facilities can be fined for evidence of resident neglect or abuse, and some have even been closed down and the staff arrested and charged with various crimes against the elderly and otherwise vulnerable. In theory, we should all be thankful that State regulators have arrived to oversee our stay at this facility.

The staff’s reaction to a state visit could not be further from one of gratitude. A frantic energy begins to build in the facility. It affects the way we handle the rest of breakfast. It alters the speed with which we attend to the other residents. The sheer volume of cleaning seems to climb exponentially. Even the charge nurse seems apprehensive, and I don’t know why until I recall our visual lesson regarding bedsores. Now I wonder what the State will observe in its tour, and why it seems that we as students are doing three times the work that we were doing just the day before.

Then I think back to my work at a major metropolitan hospital in Minnesota, and I sigh. I’ve dealt with important inspectors before in a healthcare setting. JCAHO (Joint Commission for Accreditation of Healthcare Organizations) sends their own investigative officials to hospitals and clinics. I’ve met with and spoken to these people during my time as a nightshift Psychiatric Associate at a major Midwest Metropolitan hospital. The entire affair ceased to intimidate me the moment I realized I always did what I was supposed to do and did right by the psych patients with whom I was in contact. There was never a real need for me to worry.

Wednesday

Still, the state inspectors give off an aura of self importance. During our Wednesday afternoon repose in the employee lounge, our guiding instructor leaves to run an errand, and no less than three state officials open the double doors and stand there, their roaming eyes calculating, their postures tall and aloof. I glance around, quickly noting the varied expressions on my classmates’ faces. Undaunted, I turn my attention back to the interlopers and nod. After another long day, the smile on my face is small, and I can feel my facial muscles tighten. The self-appointed State Official leader and I exchange pleasant remarks, and I exhale as my fellow pupils chime in with their own greetings. I am well aware that we can’t forget the function of State Inspectors, but I refuse to think of them as above me in any way. It does help my case that I recognize the leader of the group, a tall man wearing what appears to be an ornate yamaka. I only recognize him because we bumped into one another in the men’s restroom just that morning. A chance meeting of that nature has a way of humbling both participants.

After a tense few seconds, the double doors close, and I feel like a gunfighter that just bluffed his way out of a Spaghetti Western Standoff. I want a piece of tumbleweed to roll across the floor. Our instructor returns from her apparent disappearance, and we regale her with the sordid details of what feels like a clandestine waltz with fate.

Thursday

We finally come to the last day of our externship. All of us are tired. At this point, we’ve been told so many things to do and NOT to do because of the State visitors, I’m growing increasingly paranoid. I’ve washed my hands so many times using “state mandated technique,” that my fingers are beginning to dry, and a painful crack has erupted like a tiny fault line along the outside of my pinkie’s knuckle joint. Staring into the faces of my classmates doesn’t provide much consolation. Many appear to have grown sick of the commute, the bags beneath their eyes telling more stories than I can ever truly record. Our instructor reminds us to remain grateful for the opportunity, but I’m sure we’re all more glad that our time here is up in less than eight hours.

My final day at this facility proves to be the most challenging. As adept as my partner and I have become at feeding a particular male resident, we are denied this opportunity because we refuse to allow ourselves to be left alone as students without another employee’s supervision. This continues to be a frustration for us all, as the Nursing assistants all appear to be anxious to get things moving, yet none of the residents seem to be having an easy time of it. At our instructor’s behest, students are forced to stick like glue to their assigned C.N.A.’s. Our C.N.A. is not annoyed with us, but he does appear a bit more distant, as though his morning coffee hasn’t quite kicked in. I don’t blame him. I feel much worse for wear just having contended with this added stress for four straight mornings. I try to remind myself that my C.N.A. has chosen to do this for a living, yet this is when the existential questions begin to manifest like apparitions at the foggy cemetery of my mind.

Did I ever tell you I think too much?

In the middle of handling a struggling male resident who refuses to allow us to clean him, another male resident who can’t seem to eat his hot cereal without coughing up a lung, and a final male whose condition appears to have deteriorated so badly this week that he proceeds to vomit and defecate in the same moment, I ask myself the one question I thought I would save for a lonely walk in the park.

“Why would anyone do this for a living?”

Much to the credit of the staff, they answer me without my having to ask. One female Nursing Assistant reminds me that she chose this occupation because she feels for the elderly and vulnerable of our world, and wants do as much as she can to provide care and comfort. Another employee tells me her grandmother was in such a place, and was treated well by her caregivers, which inspired the Nursing Assistant to pursue this line of work. My C.N.A. doesn’t offer us a tale of woe or of courage, but he simply does his thing. A sparkle does seem to come to his eye as he assigns me and my partner certain rooms where multiple beds need to be made, confident that we will both do a good job. At this point, my partner and I each make our own beds, and I am encouraged by our individual progress.

We also learn to chart on resident cares on the computer. I am surprised at how little one actually gets to comment on their individual impressions of resident progress, and I don’t like being left out of the equation, so to speak. Visual icons represent the various items on a patient’s care plan itinerary. A bedpan, a toilet, or a commode icon speak for themselves. Just point with a mouse, click, and a patient’s abilities with toileting have been recorded for the day. After watching a Nursing Assistant do this with a series of activities for one resident, I realize that this can become rather mundane. I wonder if we’ve made a mistake depersonalizing patient charting, ultimately removing ourselves from the empathy needed for such undertakings. For me, the act of writing something down elicits emotion, for good or for ill. I suppose that’s why I am pursuing professional level fiction writing. Being able to talk with others about what has transpired also matters. As a former mental health worker, I am all too aware of how subtleties in body language and tonal voice changes can comfort, alarm, or galvanize an individual. This new way of charting comes off as cold and impersonal, and leaves me feeling as though my accomplishments were just not that important. Nobody should feel this way about such an important job.

This proves to be the longest feeling day this week. By the time I sit my aching body down on the most comfortable chair in the employee lounge, I find myself unable to process much of anything. My thoughts shift uncomfortably, as though they are a series of songs on a malfunctioning ipod that won’t do anything but shuffle. To make matters worse, during our lunch break, we spy snow falling outside our window, as though we are sitting inside a gigantic snow-globe. As we eat our way through our three dollar meal tickets, the wind outside intensifies until I’m sure I’m looking at the beginnings of a blizzard. This year’s winter has worn New Yorkers down, and I groan as though I’ve been asked trek through the tundra and procure snacks for everyone in the cafeteria.

The afternoon seems to fly by us like a flock of snowy owls. The storm passes quickly, and my mood lifts almost as fast. My partner and I rush around at the beck and call of our Nursing Assistant/mentor, fully aware that this will be the last time we make a bed or dispose of unpleasant human biological deposits in such a setting for a time. Finally, when the last piece of electric assistive equipment has been put away, the last bed has been made and the last resident have waved a frail but warm goodbye to us both, my partner and I head back to the employee lounge for the last of our debriefings. More paperwork followed by words of encouragement and pride seems to hover just in front of me. I think back on my experience, and I can’t help but note one ultimate truth.

This is not the work I will pursue once I graduate the program.

My conclusion has less to do with the residents than I thought it would. But, as always, one is forced to think of the big picture when undergoing such things as internships or externships. And why shouldn’t this be the case? As shaky as the economy still feels, I didn’t go back to school just to feel as though I have to take yet another job I don’t want. School is a risky investment of time as well as money. For this to feel like a success, there must be a true reward for the work I’ve put in. Gainful and meaningful employment was the goal here. Even when the idea of volunteering here is presented as an option to our group, I shudder. The location is just too far for it to be worth an unpaid opportunity.

I am the brave soul who volunteers his reluctance to pursue this line of work. I am also forced to accept another reality for which I was not prepared. The elderly and infirmed force me to face my own mortality in the simplest of terms, in the most direct line of sight. There is no escaping the ravages of time. The human body ages and dies. I may not have been alone in my awareness of this phenomenon, but I admitted it to my class. It depresses me almost unutterably.

The externship is ultimately a humbling experience for me and for so many others. Our goodbyes are short, and the Nursing Assistants can’t seem to let us go without words of advice or encouragement. I don’t give away my true feelings about the work they do, but I understand the meaning of caring for another person in the twilight of their lives. I can’t begin to imagine where I will be at that age, or what society will become in regard to its elders. I can only hope that I am surrounded by warmth and compassion, even when I forget the spelling and meaning of such words.

 

Last Leg of the Journey

Posted in Uncategorized with tags , , , , , , , , , , , , , , , , , , on 02/17/2014 by Angel D. Vargas

2/17/2014

EKG is over. I am aware, even before the class ends, that I will get an “A” on the final exam for the course. My practical goes very well for me because I’ve helped so many others pass theirs. I remember the concern from my girlfriend about “wasting my energy on others who don’t deserve it,” and my insides squirm a little. Have I stretched myself too thin again for my fellow students? Why continue to go above and beyond to make sure that others pass? Did they put forth the same effort that I did? How many hours did I spend on crowded trains with rude passengers trying to go over class notes while reading a pocket guide to EKG? How many times did I have to go over the placement of electrodes and sensors with fellow students who’d forgotten the color order, and couldn’t even define what an “intercostal space” is?

How often did I tell other participants to “just breathe” even when they were prepared to give up on themselves?

Pride and contentment at my own success flow through my veins. But a throbbing soreness in my neck and a stabbing pain behind my right eye remind me of the costs of my accomplishments.

For the Certified Nursing Assistant portion of my training, we get a different teacher with a new approach to her subject matter. From the beginning, this older Caribbean woman drops all the notions of a stoic barrier between herself and her students. Her sense of humor hits home right away, and pupils are instantly at ease. I like this nurse, who happens to be much older than our last instructor, and clearly uses her vast breadth of experience to inform and encourage us.

Despite how refreshing her demeanor is, I suspect that this spells a certain kind of trouble for which I am not fully prepared. The day that she hands me the first quiz taken by another student and asks me to grade it, I know I’m screwed. She’s not only set me up to take extra responsibility that I didn’t ask for, she’s made me an easier target for unwelcome scrutiny from my fellow peers. It feels like a repeat of the last class, and I don’t like the feelings that resurface as a result.

What I don’t anticipate is that our instructor has given the green light for the slackers of the group to take full advantage of a decidedly more relaxed situation. People seek patterns to behavior as in all else, and in this regard, I prove no exception. I can identify the three leaders of the class because I am one of them. I can also identify the silent but deadly achievers who seek to fly in under the radar. However, I am less than impressed to discover that there are those among our small group who would sooner brush this class off than put forth a solid effort. I cannot judge the reasons for such foolishness, but these are the same people who look to me for comfort whenever they decide to shut down their phones and tune in to perform a patient care skill.

And it is the practice of patient care skills that truly separates this class from all others. No amount of academic achievement can substitute for the effort placed into such practice. Despite the fact that I may be the only student to have read the rather boring text book from cover to cover, I know full well that skills and desire are the great equalizers here. More to the point, my training program is almost over. All of us will have to go our separate ways and find our own roads to travel. I will walk my road without most of my peers when I get my certificates.

I’ve just celebrated Valentine’s Day and my one year anniversary with the most wonderful of girlfriends. I’ve tried to make both days special for her, and she has done the same for me. Exhaustion has derailed some of our individual efforts, and the stresses of my schooling and her freelance work have manifested despite the best of intentions. To make matters more interesting, my job has summarily cancelled my weekly hours for an unspecified period of time. However, due to a set of carefully chosen words from my boss, I’ve decided not to pursue unemployment for fear of legal reprisal down the road. Still, I am thankful. The time off has provided me with a means of preparing for two certification tests, both of which I took on the same day despite my initial hesitation. The effort has proven exhausting. Like a Samurai weary of war and bloodshed, I want to lay down my sword, strip off my armor, and just hold my loved ones close.

The next adventure will be an externship at a long term care center. The notion of a four day assignment at an unknown location worries me a for a great many reasons, not the least of which is the harsh winter that has done little but dump snow on our city. Wearing a white uniform in such conditions has done little to improve my patience with the winter season. Having to purchase white sneakers before the assignment makes my stomach churn a little. The thought of traveling with increasingly irate straphangers will, at times, cause me to imagine homicide with a slight smirk on my tired face. Despite all my misgivings, I will be ready. This is among the last of my challenges. I will face it and find my way home.

EKG and Living my Complicated Life

Posted in Uncategorized with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on 01/25/2014 by Angel D. Vargas

EKG – 1/20/2014

The fun doesn’t end when I get a 97 on my final exam in Phlebotomy. Teaching the material to the rest of the class ultimately works to my advantage. With EKG beginning after a weekend long respite, I don’t see my new role as an unpaid substitute teacher emerge until it, along with life outside of school, slaps me dead in the face.

Before the EKG unit even begins, life becomes complicated. A plumbing problem emerges at home just after my girlfriend and I get back from a holiday vacation. Before we know it, my girlfriend has to call the building manager. A plumber is summoned. Of course, the plumber’s “booked solid” thanks to pipes that have frozen all over the building due to the recent cold snap in New York City. Not knowing when they’ll actually show up, I’m surprised to find no less than two plumbers knocking at our front door at close to seven on a cold Tuesday morning, just minutes before I’m due to leave for my morning classes. Two men stand outside my open door clad in full construction gear. Rather than leave my girlfriend alone to contend with the demands of supervising a sink repair, I decide to stay and observe. Call it an old fashioned hunch.

The plumbers don’t take that long to fix the reported leak, but I am still late for class. With EKG still just over the horizon, no less than three students who’ve already taken the course have warned me that missing even an hour of class will leave me as lost as a buffalo on a New York City subway train. I’m already touchy about being late. I find myself hoping household problems are finally settled. Didn’t we already have a pest control issue just over a month ago?

Little do I know what’s coming next.

The Monday after my final phlebotomy exam arrives. I’m tired, but things are more or less progressing as normal. The material is dense, but interesting. It’s nice not to have to memorize the order blood draw for a certain procedure, keeping in mind the various unseen additives in a bunch of plastic tubes. Now I’m set to learn about the heart’s function as it pumps blood through the human body. I’m eager to understand how it works, and what can go wrong with it. More to the point, I want to know what I will be able to say and do about it when complications arise for patients. How, after all, am I going to make money with this knowledge?

Monday’s class is pretty tough. I’ve begun to realize how complex and important an organ the heart really is. EKG, for those who don’t know, is a procedure that allows us to measure the electrical activity of the heart. Simple as that sounds, an EKG provides us with a plethora of information regarding the heart’s condition. There is a great deal of knowledge that needs to be obtained before one can practice an EKG with any degree of proficiency and understanding.

But the universe doesn’t care about that, and it decides to drive the point home by having my girlfriend’s lovely cat wake us up at two the next morning with a plaintive, albeit adorable “meow.” At this point, neither I nor my girlfriend believe that anything is wrong. Perhaps that’s because it’s two in the fucking morning and we’re both desperate to keep sleeping before the alarm wakes us in about four hours. Regardless, a tapping sound begins in the hallway just outside the bedroom door. My girlfriend is the first to stir in response to the noise, sitting up next to me. I grumble because she’s moved my portion of the sheets and now my feet are cold.

“Whaddefuuuuck?” I whine

But then I hear it too. “Tap. Tap-tap. Tap!”

Shit.

There’s no doubt about it. My tired mind already knows what the sound is. For some reason, as my girlfriend scrambles from the bed to fetch buckets and pans, an Edgar Allen Poe passage bursts to the fore of my mind.

-suddenly there came a tapping, as of someone gently rapping. Rapping at my chamber door.

However, one bucket proves to be inadequate for the task at hand. Multiple leaks emerge, poking their way through our ceiling as though it is a dam about to burst. Worse, one of the holes has appeared within the light fixture directly above our heads, and the light within is starting to flicker ominously. In a panic, I try to slap my sleep-oppressed brain into forming some plan of action. The only thing I can think to do is to grab my keys, head out the apartment door, and try to figure out if my upstairs neighbor has a clue what the fuck is going on.

The roar I hear outside the neighbor’s apartment door reminds me of the commercials I’ve seen about Niagara falls. At best, this is intolerable. But my work in mental health and my budding career as a horror writer both leave me with an incredible ability to imagine the worst case scenario. Standing outside the door, I find myself picturing the grisly scene of a murder or a suicide, and my heart begins to beat a violent tattoo against my rib cage. A mangled, bloody corpse floats in the bathtub of my twisted internal vignette, and I try not to cringe as I ball up my shaking right fist and knock three times.

When no one answers, I have to fight the mingled feeling of anger and panic warring within my churning stomach. I pound on the door this time, straining my ears for signs of life on the other side. Yet I am consumed with the notion that a mobster or an axe murderer may suddenly throw the door open and proceed to make me their next victim.  I slam my fist into the door as though the pounding will banish the creeping shadows and haunting nightmares from my already exhausted mind.

“Hello? Who is it?”

Presently my soul grew stronger; Hesitating then no longer, ‘Sir,’ said I, ‘or Madam, truly your forgiveness I implore; But the fact is I was napping, and so gently you came rapping, and so faintly you came tapping, tapping at my chamber door.’

Eventually the door opens. I choose to dispense with the formalities, and before long, my female neighbor is in a slight panic. I can scarcely think what to do next, and in my own altered state, I begin to fuss with a pair of knobs in the bathroom until we both realize that the roar of water is coming from a geyser shooting through the fixture of her faucet just above the sink basin.

Damn.

At least we both know we’re not hearing things. After a few minutes of forced calm and conversation, my neighbor proceeds to place buckets beneath the sink, hoping to catch some of flowing water. Her efforts, however, are akin to trying to empty an ocean with a dump truck, or at least it feels that way. Thinking of the knobs beneath the bathroom sink, I wade through what looks and feels like a pooling lake of warm water. Utterly clueless, I kneel at the foot of her kitchen sink, wrench a pair of buckets out of the way, and set to work trying to twist a rusted hot water knob to the right. The damned thing doesn’t budge a micron, and after a few minutes and layers of skin, I get my hands on the only tool that my neighbor appears to possess.

“Dink-dink-dink-dink-dink.” That is the sound of a small hammer against the side of a rusted metal knob beneath someone’s sink. Just thought you ought to know that. That being said, I finally manage to yank the thing closed, and the torrent of water that must have been gushing like blood from a stab wound for more than two hours ceases to exist.

That’s when I hear the blare of a fire-truck’s siren. Thinking that there’s probably some cross town apartment going up in a massive blaze, I shake my head and go to get my glasses. I talk with my visibly nervous neighbor for a few minutes. This is when I realize that she never saw this coming. I would later come to understand that nobody else did either.

Minutes later, I am leaving her apartment when I hear the unmistakable “thump thump” of multiple, boot clad feet on the hallway staircase. Turning to my right, I see no less than six men, each more than six feet tall, clad from head to toe in protective, fire retardant battle gear. For some reason, this doesn’t register as odd to me until I realize that the shortest man in the group is still at least four inches taller than me, and he is carrying a crowbar that appears to be as tall as he is. The five other men now walking with him down the hallway toward me all have serious looks on their faces. Two of them are carrying hatchets. One of them is speaking into a shoulder-mounted radio. As soon as they see me, all of them do a double take.

For some reason still unknown to me, I hitch my chin in their direction and jab my right thumb over my shoulder. “She’s in there,” I say, as though I wasn’t about to wet myself just moments ago when I realized I couldn’t stop the lake from pooling on my neighbor’s floor, and eventually, my ceiling.

The fireman with the crowbar points the tip at me and says, eyes narrowed, “I bet he took care of it already. Look at his pants!”

Only then to I look down and realize that my pants are sopping wet up to my knees. Who says I can’t have a hot tub experience on a Monday night?.. even when I don’t want to?

Watching the firemen advance toward me, I am reminded of an armored band of Elves closing in on a weaponless Hobbit, and I immediately wonder if I should renounce Sauron and all his fiendish deeds before I realize that these men, perhaps used to saving real lives, may not be in the mood for Middle Earth jokes.

Words are funny. They come from the thoughts that form somehow in my brain, and they are are emitted through a complex physiological process that produces sounds. These noises come blasting, humming, or otherwise buzzing out of my mouth. The thought that this is possible strikes me as a minor miracle on some days. Other days, I often wonder why the universe has granted the gift of human speech to the most abysmally foolish of people. In the presence of these massive firefighters, I suddenly feel like such a fool. Words have come hurtling past my teeth. I only know this because. I can taste the copper seeping from the fault lines of an arid strip of earth otherwise known as my upper lip. The ‘clop clopping’ sound of six pairs of thick, heavy boots rears up behind me like an angry pair of mustangs. I almost feel the frustrated puff of a wild stallion just at the tip of my shoulder blades, driving the meaning of my useless words from my numb mind. Before I know it, I’m walking down the hallway toward my apartment, and I feel as though I am leading a group of Gladiators behind me, weapons drawn, muscles bunching beneath hot and heavy battle armaments.

And I don’t remember why they’re behind me.

Open here I flung the shutter, when, with many a flirt and flutter, In there stepped a stately raven of the saintly days of yore. Not the least obeisance made he; not a minute stopped or stayed he; But, with mien of lord or lady, perched above my chamber door –

I open my front door to find my poor girlfriend struggling to keep no less than five ceiling leaks in check with pots and buckets. She turns her head to the sound of the opening door.. She wants to smile when she sees me. Then I step into the apartment. I almost feel the shadow of the first towering firefighter eclipse me as I escort him inside. My girlfriend’s smile never becomes more than a surprised grimace. Her eyes bulge, and I grit my teeth in sympathy. The reason we’re all standing around looking at the damaged inside of the apartment clunks into place in my brain.

“These guys want to look at the light fixture, hon.”

It takes a long time to explain what’s transpired to the firefighters. From behind me, I swear I hear one of the men suck their teeth. I clench my jaw so hard that the strain makes my muscles throb. My awe of the firefighters’ presence suddenly becomes annoyance, but I hold my tongue. They want action, and I consider telling them why they didn’t get any. Yet my wet and ragged karate man pajamas scream what my croaky, Elmer Fudd, three-o’-clock-in-the-damned-morning voice never could. “I am the one who stopped the flood. It is me whom you seek!”

But who the fuck am I, anyway? You won’t find evidence of fame or profit to my credit, even if you google my name. I’m going to school. filling my brain with information that could either save or improve lives because I need a better-paying job. I didn’t ask to be dragged into this newest drama.

The firefighters call the “man of the house” over to watch as they turn off the switch on our circuit breaker that leads to the compromised light fixture. The epilepsy-inducing yellow flicker above our heads abates, but the struggle has just begun. More people need to be called, and neither I nor my girlfriend desire more repair people in our Harlem apartment. The cat hasn’t yet forgiven us for the hullabaloo of the holiday season, nor for her recent vet visit or the visitation of the last repair crew. Frustration begins to sprout in my mind like annoying weeds. I know this little furry creature doesn’t understand how much it hurt for her mother to spend four hundred dollars of hard earned money just to have the vet tell us that cats can exhibit “psychosomatic behavior.” As a former mental health worker, I understand full well what psychosomatic really means in the medical profession. I’ve had to resist the urge to call the veterinarian myself and thank her for ripping off my girlfriend and putting us all at risk for not having the rent payment for next month.

It is only at that moment that I realize how much I’ve sacrificed already to go back to school. What if I’d been able to be with her and the cat that morning instead of learning about needles and lancets? Would the vet have dared to look into my tired, stubbled face and say the same things she said to my worried girlfriend? I’m not saying I’m any more shrewd at business dealings, but there is still a systemic chauvinism at play when it come to sales, house repairs, or all sorts of other everyday transactions. The firefighters already demonstrated that much just moments ago. “Man of the house?” Please. I can’t even afford to pay my share of the rent in this place.

The building manager reassures us that a plumber will be out to visit our upstairs neighbor and to “assess damage and make repairs.” The humans of the household already know that nobody is making house calls at four o-clock in the morning, so we eventually try to sleep. However, as my heartrate finally slows and I begin to drift off, resting my head on my girlfriend’s shoulder, a “crack” rips through the uneasy silence of the night. I sit, bolt upright like a half-sized Frankenstein struck by a fateful bolt of lightning. I’m alive, but I don’t want to be. Once again,. I know what the strange sound means, and I am out of bed, flashlight in hand before I even think to tell my bed partner what is going on.

Staring at the circular beam of light on our ceiling, I almost groan in pure anguish. A jagged chasm has ruptured the ceiling just behind the compromised light fixture. Soon, my girlfriend comes to inspect the damage. and we both agree that this spells imminent danger. Another phone call is made. More reassurances are granted, but our bodies are not prepared to honor swords.  Adrenaline and paranoia make the worst bedmates, but they push themselves in amongst the sheets. Neither of us can sleep now, for we’re both anticipating another “creak” or snap before the ceiling (or our wearied bodies) burst from the pressure.

Chauvinism and bad attitudes replay themselves like an annoying, broken record throughout the course of the next day. The building manager shows her face, inspects our buckling ceiling, and almost demands that I step up on a ladder to remove the cover to the light fixture to allow the thing to drain. I stare at her in exhausted incredulity, wondering why she expects me to take responsibility in a potentially dangerous situation that I never caused, with a ladder that we never had the time or money to procure in anticipation of this apparent catastrophe.

Then this ebony bird beguiling my sad fancy into smiling, By the grave and stern decorum of the countenance it wore,`Though thy crest be shorn and shaven, thou,’ I said, `art sure no craven. Ghastly grim and ancient raven wandering from the nightly shore – Tell me what thy lordly name is on the Night’s Plutonian shore!’

It’s now 7 in the morning. I haven’t slept a wink, and neither has my sweetheart. We each have had to excuse ourselves from normal daily obligations and opportunities. I try to cover all my bases with my school, making phone calls and writing appropriate emails, but I already know the score. I’m going to have to play a nasty game of catch up, and I don’t like it. I’ve already heard the building manager on the phone with a audibly angry man who seems to give her a ready-made excuse for not having “the time to drop by” and find us. I want to set the mobile phone on fire with my glare, but it occurs to me that if nobody anticipated this accident, the handyman was just as surprised as we were. I try to plays Devil’s Advocate in my tired mind, but it doesn’t work. My right hand twitches as though it wants to ball itself into a quaking fist.

Fucker.

Eight hours later, a plumber shows his face. As he paces in our apartment, the look of incredulous askance on his heavy-lidded eyes sours my joy at his arrival. Relief turns to resentment when my burning eyes lock with his. My girlfriend and I find ourselves desperately trying to explain the situation to him, and I a leaden feeling in the pit of my stomach. The Ronin of the toilet won’t draw his sword without a reason. Instead. He seeks unknown recompense for this waste of his time and energy. Meanwhile, my wakizashi is still hiding up the sleeve of my tattered and stained kimono, and I suddenly want nothing more than to draw it against the flesh of his exposed carotid as he stares at our ceiling, shaking his head in surly resentment for what feels like the nineteenth time in ten minutes. Finally, he shrugs his shoulders at us, practically yelling at us in a thick accent for not understanding that there is nothing he can do. Frustration builds until my girlfriend and I decided to comfort him, reassuring him that we understand his inability to help us. I ask him pointedly what sort of mercenary we should seek in his stead.

“Get an electrician,” he answers as though we asked him a stupid question.

Much I marvelled this ungainly fowl to hear discourse so plainly, Though its answer little meaning – little relevancy bore;

The frustrated plumber leaves. I throw up my hands. My girlfriend, clearly a mistress of infinite patience, makes another call.

Four hours later, when we both are at the brink of utter despair, a knock rattles our door and sends our cat scampering for a hiding place. To my utter disbelief, the same plumber that showed his face a week ago to fix our leak stands at our door. He is hunched over. his hand pressed against one side of our doorframe. His chest heaves, and I wonder if his knees are about to give. I almost empathize until I see him shake his head, an ardent refusal etched on his olive-skinned countenance.

My patience begins to escape through the very pores of my greasy skin. My eyes widen. Are you fucking kidding me?

His eyes twitch in my direction. He’s seen the look on my face, and he almost sneers in indifference.

Fighting the urge to lift my heel and slam it squarely in his sternum with bone-breaking force, I hitch my thumb behind me, daring him to refuse my invitation to do his fucking job. My jaw is set. I can feel a heat set into my steely gaze. For every ounce of disbelief he can send our way by shaking his head, the fire of my will rises, swelling my chest and setting my shoulder back. I didn’t wait here, allowing my life to be turned completely upside down for an entire day for some idiot to stand there and tell me that this absurd story will not come to a satisfactory conclusion.

Say something, pendejo. Go on, pa que tu vea, maricon!

He goes on to be the most dismissive of our concerns. He pulls on the string to the light fixture with a force that I expect will send the thing crashing upon his obnoxious head. He explains that plaster is incredibly strong, but that it has a weakness when it comes into contact with water. With no leak continuing to seep through our ceiling, we are expected to believe that the thing will not collapse under the weight of the water that still seems to be trapped above our light fixture.

He finally looks at me and asks why we didn’t use a ladder to take the fixture apart ourselves. The sarcasm that oozes through his tired words sends me over the edge. I grit my teeth for a split second. I want to say, “Go get your ladder before I kick your lazy Puerto Rican ass and report you to the building manager for insubordination,” but instead, I merely nod and ask him to go get his ladder so we can get this done. Being Puerto Rican myself, I realize that I just succumbed to a massive stereotyping exercise that I’d railed against most of my adult life. Now along with pure adrenaline, shame burns runnels through my veins like an acid. This man, a reminder of my own cultural dissonance, couldn’t leave my sight soon enough.

Minutes later, when he stands on his ladder and literally slaps the ceiling just beyond the fixture, I  expect a chunk of plaster to fall into his open mouth. I almost wish for it, but I know that such an event will only prolong the agony of our long day. His reassurance that all is well mollifies me, and we both thank him for his time. Despite my growing concern that I will kick the ladder out from under this man’s feet and proceed to beat the ever-loving shit out of him, I join my girlfriend in her attempt to reassure him that we appreciate his less than courteous assistance with our plight.

Quoth the raven, ‘Nevermore.’

We manage to salvage what remains of our day with a dinner out, smiles and laughter. I know the worst may be over, but it will take some time to return to any semblance of normalcy. Little do I know how accurate (or should I say ‘prophetic’) my statement really is.

Life goes on. The next day, I am back in school. To my utter shock, any semblance of jealousy from my fellow students seems to have dissipated, replaced with utter satisfaction at my arrival. The relief etched on the faces of my peers is mirrored in the unusually high pitched voice of my instructor, who normally insists on keeping a professional emotional barrier between herself and the class. I am taken off balance by this outpouring of emotion, and I am torn between gratitude and caution.  The lesson ensues, and in the end, I reclaim my role as class leader, finding ways to reteach the day’s material to my classmates.. In the back of my mind, I wonder what will happen when our training program concludes and we are all thrown back into the vicissitudes of life outside training. Will we all remember our time together in this place, learning from one another in the face of life’s unwavering difficulty?

I shake my head, already painfully aware of the the truth.

Just as I begin to think that things may be returning to normal, the following Thursday unnerves me in ways that I could not have predicted. I feel myself responding to unwanted visual scrutiny from fellow straphangers on a crowded subway platform. This cold snap hasn’t quite gone away, and public transit has been riddled with overcrowding and service challenges since the last snowfall. I step onto a crowded A train and feel my world close in on me like a steel trap. A woman begins to prosthelytize in a slight accent, and I roll my eyes. But she beings the same lecture in Spanish, and I almost lose my cool, aware that I haven’t quite gotten over the slight from my classmates just weeks before.

I stomp off the train, make my way to class, and finish out the day with a class review that I can’t lead this time. The class is going over the material that I missed, and I let them teach me for once. It puts a smile on my face that I don’t think the other students notice. However, the Dr. nods at me and winks, and I know that she is aware of how badly I want to succeed in class. Perhaps she’s saying something more with her gesture, but I don’t take the time to think on it. I absorb what I can from the lesson, leave the classroom and head back home to my girlfriend’s Harlem apartment.

I make my way back home, drop off my backpack full of clothing, books and papers, and head out to a local Subway restaurant. Things seem to be going well enough. I order my sandwich and watch a rather busy set of clerks do what they need to do for me and for several other adult patrons. My turn comes to finish having my sandwich assembled and pay for it when another fateful encounter with rudeness ensues. Before I can remove my wallet from my coat pocket, a black teenager saunters into the store at the head of a cadre of middle school students who seem hell bent on getting what they came for. Rather then head to the back of the line like everyone else, this teenager sashays to the front counter, her lips pursed, her eyes half closed as though she has all the time in the world to own this place and everyone in it. Her cornrows almost float behind her diminutive shoulder blades ensconced beneath a slim. black coat. She might almost be slightly cocky picture of youthful black beauty, but she spoils the effect as she opens her large-lipped mouth to speak.

“Can I get a chocolate chip cookie?” she asks, but not in a way that would make me want to help her. Instead, the shrieking tone of her voice and the sneer on her lips connote nothing less than utter entitlement, a twisted expectation rather than an acceptance that customer service is a privilege to be paid for and lent the dignity and respect it deserves.

My current work as a bookseller springs to mind. In seething chagrin, I watch as the other adults in the establishment turn their heads away from the spectacle unfolding before them.

Unfortunately, the clerk that answers her request has a pair of eyes that cross above the bridge of her nose. The look works against her in social circumstances, but it doesn’t appear to interfere with her understanding of basic customer service. She moves with a speed and grace that belies her experience with this exact situation, except that she forgets something very important as she hands the arrogant customer her bagged chocolate chip cookie.

The girl is quick to hone in on the cosmic injustice that has just befallen her. “Can’t you heat this up? Can’t the man next to you heat this up? I always get my cookie heat up.” The sound of her sucking her teeth and stomping her foot makes my right hand twitch. “What’s the matter with choo?” she continues. “Are you retarded?”

`Get thee back into the tempest and the Night’s Plutonian shore! Leave no black plume as a token of that lie thy soul hath spoken! Leave my loneliness unbroken! – quit the bust above my door! Take thy beak from out my heart, and take thy form from off my door!’

The sound of my teeth grinding rings out like a gunshot in the sudden silence. Furious, I turn back to the girl, prepared to make her pay dearly for her transgression. My brother, who falls under the umbrella label of “extreme autism” wouldn’t know the insult that was just bandied about, but I do. And I want to slap the impunity from this little bitch’s face.

But nobody else even stirs. Not one other adult in the room seems to notice the rudeness. Unfortunately for me, it means I have no support in my temptation to correct this child’s behavior, nor would I get any satisfaction from delivering a backhand of decapitating force. Still, my right hand becomes a gloved wrecking ball, hidden in my pocket.

Quoth the raven, ‘Nevermore.’

Holding out her hand and rolling her eyes as though she’s been crucified like a little Jesus, the teenager awaits her reward. Other members of her cadre pipe up with their insipid little requests. Before I know it, another fifteen minutes pass before I can finally pay for my sandwich, head back home, and do an impression of the girl before my shocked and laughing girlfriend who, like me, desperately needs to find the humor in life again.

 

First Month of Patient Care Technician Training.

Posted in Uncategorized on 01/12/2014 by Angel D. Vargas

1/12/2014 PCT Training. 

 

Phlebotomy. It literally means “puncturing the vein.” It was also the starting unit of a Patient Care Technician training program that I began on the 16th of December, last year. Now that the new year has arrived and I’ve been through the first part of training, I can tell you all the names of the three most commonly used veins for “venipuncture.” Without missing a beat, I can illuminate the complications associated with both venipuncture and “dermal punctures,” why healthcare workers and visitors want to wear n-95 respirator masks in the presence of a patient suffering from TB, or how to locate a temporal, brachial, femoral, and a” posterior tibialis” pulse.

However, the things that really concern me about this fascinating, grueling, and ultimately rewarding learning experience are psychosocial in nature. The deepest impressions made by this training have more to do with people’s motivations and worldviews than anything medically related. For example, the reasons that students chose to put themselves through this schooling are fraught with controversial political, cultural and economic implications. People’s attitudes toward class participation seem to mimic the same ones I encountered throughout my high school experience. Finally, my own patterns of learning and interaction with others say plenty about the ways that I have evolved, and the many other ways in which I have remained the same throughout most of my adult life.

Inspiration is a term tossed around like a hackey-sack among hippies, especially when it comes to what to do with one’s adult life. Career seminars are replete with motivational speeches and pamphlets that discuss the notion of “following one’s dreams,” and “finding your passion.” But when it really comes down to it, there are many adults who would argue that for one reason or another, the notion of an “American Dream” has become more of an American Myth. Some of the program participants I’ve talked to on this matter are simply trying to raise a family, and they appear to have put aside what they consider the lofty delusions of their youth and the dreams that came with it.

Others have had trouble adjusting to the growing disparities between the rich and the poor. Even on a cold winter morning, the disenfranchisement and indignation that burns like an invisible fire through inner city urban neighborhoods just slaps me in the face. I have found some students for whom the numerous training options here simply represent an opportunity to become more marketable in a society where a job search has become a nightmare, and gainful employment seems to be as hard to attain as a buried pirate treasure. Still others tell me that they were convinced to make themselves more “employable” by seeking out more training in various skills. But the ones who advise these students in such a fashion are the Admissions officers for the training program. Fear drives the point home to us all. I secretly cringe at these reasons for participating in such accelerated education, but the Samurai in me can’t deny that I’ve squared off against this same specter of poverty and frustration.

Relating this bit of information to my wonderful and supportive girlfriend reveals another scary possibility that patient care has been forever changed by this type of training. Who, after all, would want to be treated by someone on whom the very meaning of patient care has been lost in the struggle simply to survive? Is there room in that healthcare worker’s heart for the empathy and thoughtfulness needed to provide the best quality of care to patients? Or would they have been just as likely to reap the same internal reward in another industry?

Is it really that easy to exchange one cog in the machine for another?

But the meaning of “why” deepens the more I explore the motivations of all involved, including myself. Another older classmate speaks to me with an almost paternal air, seeking to understand my motivations for undertaking this challenge. The discussion comes the day before our final class exam for phlebotomy.

“You should study,” he says.

“I do study.”

“No No. Some people sacrifice their time and their families to pursue a higher education.”

At this point, I know what he’s getting at, and I have to fight not to roll my eyes. I happen to be among the top students in the small class, and I am always called upon to lead group discussions of the material. But there are some things this man clearly doesn’t know about me, and I don’t know how to go about explaining them without  reliving some of the more bitter parts of my adult past. But I am also not one to shy away from truth. Ever.

“My friend, I have a degree already. It happens to be a Bachelor of Arts in Psychology.”

“You do?” he asks, his eyes sparkling with wonder and what I can only guess is dawning comprehension.

However, this is the moment when I decide to drive the knife in and twist. “How easy do you think this has made my job search in the years since my graduation from college?”

“Oh …”

“Oh,” I mimic, almost sneering with the power of my statement. I find my head spinning at the reminder of how the promise of higher education has settled like lead into my stomach. It’s one thing to reap the benefits of both graduating with a lucrative degree and forming powerful social connections. It’s quite another to realize that your life is forever altered by the realities of balancing a checkbook and having to pay rent while utilizing your marketable skills in an underfunded and oft misunderstood field of study. Philosophy students might have gone through this pain in the eighties and nineties. Psych students who weren’t willing or able to become researchers, professors, or professional emotional scratching posts went through it with me in the 21st century.

Yet it wasn’t just psych degree holders who underwent a fundamental shift in their higher education paradigms. I can scarcely think of five friends of mine from the same alma mater who have jobs that relate remotely to their fields of study. Most, in fact, are still trying to figure out what it means to be middle class.

I’ll have to get back to you on that one when I finally get there. I’ve been trying for more than ten years.

The older student’s comments, however, may also reveal deep cultural divides, even among those who share a common ethnic background. Picture the same conversation in your head somewhere in a small cafeteria area of a small training program. This time, instead of two faceless people who’ve left their ethnic and cultural backgrounds and perspectives at the elevator door, imagine two Hispanic men with very different ideas of what it means to succeed and adjust to the perils of a shaky US economy. If you’re still wondering why this matters, you’ve never been shamed into admitting that you’re a Puerto Rican man who doesn’t speak Spanish as well as he would like. Moreover, the perpetrators of this blame and shame game have never been “your people.”

Case in point. The same man with whom I’ve had the elucidating cafeteria conversation is part of a yet another study group I’m asked to lead in preparation for the final. The group happens to be made of other Hispanic students as well. The fundamental difference between myself and the others becomes clear when my cafeteria colleague and another group member begin to have a fluid conversation in Spanish. Then, the oft dreaded question of my professional and social adult life comes not from the group itself, but from the teacher behind me.

“Do you speak Spanish, Angel?”

“Not as well as I would like. ”

“Yeah, maybe,” says the young woman in front of me, but you understand it, don’t you?”

Now at this time, I’m forced to sound a bit like Bruce Campbell in the Army of Darkness movie when he talks about not having said “every single tiny syllable,” but basically saying the secret incantation to stop the Army of Darkness. To test my “basic” understanding, the bespectacled young lady rattles off something in Spanish so rapid that I only hear about two thirds of what she’s said.

Naturally, a little something called “orgullo” kicks in. “Orgullo” (or-goo-yo) for those who neither speak nor read the language translates into “pride.” In Hispanic culture, “orgullo” is rather large and in charge. Me llena de orgullo ser Latino, pero when you ask me to speak Spanish, something like what I just typed might happen. “Spanglish,” a broken form of what some would call the “original” language that is becoming more and more common with each passing generation.  And like a growing number of second, third and fourth generation Hispanics in this country, la idioma del Español has had to take a back seat to English for educational reasons.

This program proves no exception to me in that regard. It is taught in English by a Russian doctor who has taken command of Western medical terminology, proudly pronouncing the terms with an accent thick enough to make me think of Bond villains.

Yet when I go to translate what the lady has said back to her as proof of my membership in the Hispanic lion pride, I don’t pass the sniff test. To further punctuate the point, the paternal Hispanic man leans toward the rest of the group and says “Pero el no entiende Español.”

“Que carajo cree, maricón? Que soy estupido?”

This is what I want to yell at the group at large, not just to the kind, yet painfully unaware man before me. I’ll leave you to your Google translators to figure out the meaning of those bitter words. Regardless, the gauntlet has been thrown down, and the judgments have already been made, fair or otherwise. I know enough to understand that he said “but he doesn’t understand Spanish.” That’s bad enough, but the group suddenly begins to look at me like a lost puppy dog, and now I want nothing more than to flip my desk over, and scream two words at them in perfect Spanish.

“Unidad Latina!”

Ears burning, face flushing faster than the toilet I used moments before this useless conversation began, I continue to help the group, but the damage has already been done. I didn’t rise to “mi hermano’s” bait, but I’ve continued to help “my people” through their constant frustration with medical terminology and the concepts behind certain procedures. It’s bad enough not to fit in, but now I’m helping my rejecters not to become the “rejected” when it comes to seeking employment with bosses who need them to understand how not to infect or possibly kill the patients with whom they will work. to gain this understanding, they need a command of the English language.

They need me to help them, and they’ve already judged me as unworthy to be among them.

I admit all this to a concerned girlfriend one night after a few too many drinks. It’s not enough to make it right. The situation seems more like a setup to me. But if I’m to believe what another Hispanic student said to me weeks before when I told her I don’t speak the language as well as I want to, “all Puerto Ricans are like that.”

I’d like to meet those Puerto Ricans. It seems that in my family, I’m the only one who has to endure this ridiculous public shaming ritual every time the issue of speaking Spanish even comes up. It’s an utter insult to be belittled by people who have not had to learn the English language in order not to be considered “remedial” in a public school system that still has difficulty with their Hispanic students. My personal life story might leave these judgmental fools suddenly breathless. But if I have to stop and reveal my history to everyone who shakes their heads in my general direction, I won’t get anywhere in life.

I’ve got better things to do.

Needless to say, after some coaxing from my girlfriend, I decide to save my energy during the next few in-class study sessions by ignoring my peers and reviewing my own notes.

The day of the final, I am the first to finish the exam. My grade is a 97. My overall grade for the class is an “A.”

Soy Americano. Soy de la raza humana. Si no le gusta, vete al infierno.

http://www.youtube.com/watch?v=A0HUcSBiI-I

%d bloggers like this: