Thursday, March 16, 2006

Reptiles

In The Dragons of Eden (ISBN 0-345-32508-7), Carl Sagan talks about the parts of our brain and what they do. When he describes the limbic system he refers to draqons and our reptilian nature; aggression and ritual.

I'm married to a special unit nurse who works in the PACU (post anesthetic care unit). In more sensible times it was called the Recovery Room. It's the room outside the operating suites where they take patients to recover from surgery. The nurses who work there are often not remembered at all by patients, who are still groggy with anesthetics. When the nurses and anesthetists have brought the patients to a state of normalcy, they are either sent to one of the floors, or home. The nurses who work there are paid $30.00 an hour. The recovery room is open from 7:00 a.m. to 11:00 p.m. In cases of emergency, they call in two PACU nurses, open the Recovery Room and staff it for as long as it takes to recover the patient.

It's hard to get operating room time for patients, and what with one thing and another, sometimes operations are scheduled after 11:00 p.m. as emergencies when really they aren't emergencies...... So, call in two nurses, open the PACU and pay them. Pay mileage. Pay time and a half for the first four hours. Pay double time for the next four hours. Lots of money, not to mention wear and tear on nursing staff and their families. Keep in mind that the average age of these nurses is in the late forties, so generally speaking they are an experienced, but elderly bunch.

So last night, I and the Flower of Acadie stayed up till 11:30 p.m. waiting to see if she would be called in by the last of the day staff (3:00 to 11:00 p.m. shift) to continue on into the night with a case. Shiver me timbers but there was no call and I and the Flower were off to bed by midnight. Aaaaaaaaaaaaahhhhhhhhhhhhh. Tee-hee and all that stuff. At two a.m. the cat threw up in his kennel. We hadn't combed him enough and he's changing his coat with the approach of spring. The Flower got up and cleaned up the mess (his kennel is on her side), then put the cat out of the bedroom to roam. At two thirty a.m. I got up and let him back in and put him to bed in his kennel. At three a.m. the phone rings and they tell the Flower she'll have to go in to care for a post-op laparotomy. I get up, scrape the frost from the windshield, warm up the van and put a can of diet coke and some cookies in a bag which I hand to the Flower. The Flower's hospital is a pepsi cola only hospital, about which more later.

I continue on to the den, fire up the computer, put on headphones and listen to an album while combing through EBay looking for bargains. At five a.m. a pair of headlights illuminate the back yard. The Flower is home. She tells me that she and her partner were there for fifteen minutes, by which time the surgeon had decided that his tummy operation was a serious case and needed to go the Intensive Care Unit after surgery instead of the Recovery Room. Fair enough she said. He couldn't know what he'd find in there and it was nobody's fault that she and her partner were called in needlessly. The Flower spent a bit of time pacifying me. She said that ICU beds were very expensive places to send people and doctors were loath to send someone there if it wasn't absolutely necessary. However, when cross-examined, she admitted that ICU nurses were paid the same as PACU nurses. She allowed as how the ICU was staffed and ready twenty-four hours a day, including doctors and nurses. Yes she admitted, all of the beds, equipment and monitors were already paid for, just like the PACU. Over breakfast the Flower explained hospital politics to me.

The ICU guards its position in the hospital hierarchy very jealously. They do not accept patient overflow from the PACU/Recovery Room. They do not accept patients unless they are bona fide emergency-near-deaths-door patients. This means that it's possible to have an empty Intensive Care Unit, fully staffed and waiting and still have to call in PACU nurses and pay them.

And so you wonder what it is about the Canadian medical system that's costing so much money?

Limbic thinking. Buried there under the neo-cortex is the limbic system, fully staffed with reptiles, responsible for aggression, territoriality and other political behaviour. A lot of things are done in hospitals that don't make sense unless you consider politics and reptilian thinking. Accounting and planning are functions of the neo-cortex and they should hold sway in a modern scientific establishment like a hospital; but when the reptiles come out, hissing and aggressive, homo sapiens knows enough to run like hell and take cover, because a hospital is an hierarchical entity, and here, the reptiles still rule.

What the hell, we were up anyway, so we had those delicious little breakfast sausages made by Tony's and buttermilk pancakes with good Canadian maple syrup. For us, it's going to be a pretty good day, but not for you. Not you Nova Scotia tax payers. The hospital is going to spend your money like a drunken sailor who found someone else's wallet. Good luck.

Tuesday, March 07, 2006

Birds

One for sorrow
Two for joy
Three's a girl
Four's a boy
Five for silver
Six for gold
Seven's a secret
Never to be told.

It's just past six thirty a.m. here in Nova Scotia and I'm sitting on the second floor overlooking my back yard, where the birds, rabbits and squirrels are making a breakfast of sunflower seeds, cabbage leaves, apples and potato peelings.

We've a resident family unit of five crows who are currently overseeing this morning's breakfast gathering. They are being held at bay by the chickadees, who are a contentious, noisy bunch. After full sunrise, I expect the Evening Grosbeaks to show up in all their splendor. The males are a glorious yellow, black, brown and white and I suspect they're much like baboons, as there always seems to be one large male overseer who is larger and more brightly coloured than all the others. go read Terri Windling's lore about birds.

I'm a fan of corvids and crows in particular. They keep some of the previous year's hatch around for next year to help in feeding and raising the next season's baby crows. They are noisy, nosey and opportunistic. Their verbal repertoire is nothing short of fantastic - everything from flying saucers in the woods to a musical tap tapping sound that must have given rise to John Wyndham's Triffid communications. I've no idea what they are talking about, but I have on occasion spoken to them. I'm concerned that my crows are a little on the stupid side, or else they're malicious. Here in rural Nova Scotia most folks have a garbage box to keep crows, raccoons and bears out of the garbage. We put garbage in opaque green bags and the recycling material goes in translucent blue bags. If I leave my blue bags outside the garbage box, the crows take great joy in tearing the bags to shreds and gaily decorating the landscape with plastic grocery bags and bits of paper. If I leave the recycling bags in the garbage box, the "sanitary engineers" won't put them out for the recyclers, who refuse to open the lid of the garbage box. It must be a union thing I guess. My garbage box is made of marine plywood and painted forest green and I've seen it turning and tumbling on a giant wave of snow thrown up by the snow plow during storms. It can surf a surprising distance that way - past the lilac bushes and right into the white pines. The mailbox stays where it is though. It's anchored in steel and concrete.

This has been a light winter hereabouts with often mild temperatures and not a lot of snow. I've about forty to fifty centimetres (eighteen inches) in the woods. Rabbits are plentiful and tame. They'll come right up and sniff your boots looking for food, which is kind of charming. The way they're behaving at the moment, I suspect we'll have a full crop of baby bunnies this spring. Good pickings for the owls and there are a few of them too. You can recognize an owl strike in the snow if you know what to look for: their wings whoosh the snow on either side of the talon strike and it gives a good idea of wing span. If you'd like to know more about Canadian wildlife, try Hinterland Who's Who, and if you'd like to narrow your focus to birds, try WhatBird.

The sun is now up and shining on my monitor, which makes it difficult to read. That's one of the reasons it's situated where it is: keeps me active outside instead of sitting here pounding the keyboard.