Saturday, September 27, 2014

Memorial Day, when it just isn't enough.



The boy, he was really a boy after all, looked up from the gurney. "Where am I?" he asked, rasping voice. "Back at Da Nang, marine." the corpsman said, pushing the gurney toward the makeshift ICU. It had served as a holding unit for incoming for the last 12 hours. It was New Year's eve, noon.

He had 4 hours before been in a bunker when the first wave of infiltrators had swept across the first perimeters of Da Nang airbase. He'd been manning a section facing north, towards the gate. A young man his age had tossed into his bunker a satchel charge, landing at his feet, removing most of his legs from the knees down.

The corpsman in a bunker across the street had seen the hat less black clad young man go by, toss a parcel into the narrow space in the sandbags and run on. He tracked him with the open front sights, then put the M-16 down, running across the road to the smoke pouring out of the slots.

Inside,  both legs were shredded above the knee caps, remnants of the patella, fibula in shards. Blood was spurting out from the artery just above the knee. He tied his belt around one leg, the marine's around another, and sat back. The kid's legs above the tourniquets looked larger, the vessels were damaged above the wraps.    He remembered a  package the station hospital had gotten from  Bethesda shortly before. 

In the office of the station hospital a block away was the package. MAST trousers, compression pants that would cut off circulation below the waist.

He got them on the kid, one of the legs buckled at the knee, the kid passed out, but he got them on and inflated them. Slowly the young man regained color. Two IV's were in, ringers lactate and the equivalent of today's packed cells. He regained consciousness. The corpsman watched other stretchers go by out the window, looked at his patient, measured the chances, decided he'd stay. After all, he'd seen it all go down. He started pulling the litter across the pockmarked roads to the station hospital.

Karen was there by then, a nurse, a lieutenant in the Navy nurse corps. He'd gotten the marine over to the pre-op, a long canvas tent with sandbags around.

"Hell happened, Mike?"

"Parcel I think, dunno. He's lost a quart or more, got these on him, it stopped it."

Stepping back he watches two surgeons move in, look, shake their heads and leave. He sits down on a folding chair. He'd been up 20 hours since the first blaring alarm had gone off. Most of that time he'd been in an emplacement firing over sandbags at vague shapes, not knowing who he was anymore. Who was he anyway, the guy doing the damage, or the one on the other end?

He sees the young marine regain awareness, look around, craning his neck. He asks where he is, how he is. Karen smiles down at him. "You're fine, marine. We've got you." His neck lifts up, he looks down. "My legs are gone?" Karen looks at him, the corpsman sees this from across the room. "Yes, they are gone. But you can do this, you can." His head slowly goes back, then comes up again. He sees the MAST trousers. "What are those?" he asks. Karen puts a hand on his shoulder. "Those are stopping the bleeding." she says.

Surgeons come in, look, examine. Words in huddle are exchanged. They move away. He sits there, watching. He felt like he had a year before when  he'd sat with Cary in a theater in DC, watching a Bergman film festival. He felt like that, watching. Cary had explained some of it to him afterward.

"I'm getting cold." the marine whispers. Karen goes over to him. "I know." she says, "We'll have to operate soon the doctors say."

The marine looks off, staring up. "It's weird, I've never been a man, you know?" His head turns and looks at the Navy nurse. "I've never been with, um, a woman. I'm not a man, like the other guys in my squad."

His eyes, from the side, 10 feet away, look pleading to the corpsman, sitting like there like silent Greek chorus. He's looking up at her. Then the corpsman sees that she smiles down at him.

Karen, the stocky 30-ish blonde nurse from San Diego looks down, her hand on his head, smoothing his hair back nods. "Yes, yes you are. A man." She leans down and kisses him on the forehead. He smiles. "Wow, can we have dinner?" Karen nods. "Yes."

Two surgeons come in, followed by a tech with a tray of instruments. The anesthesiologist puts a mask on the marines face, they deflate the trousers.

He walks back to his bunker, wondering if that nurse that gave him so much comfort, will remember in years to come, the boy she'd reassured, that she'd put together before he finally came apart.

In later years and decades, the boy watching became the man who took the nurses place. Sometimes he could do more, and that made him happy. He always remembered her though, the person who with nothing real to offer than herself, and the truth, eased someones way.

What else can we do, really, than ease someone's way?  


Friday, September 19, 2014

Bucket List(s)

Apparently after the movie starring Jack Nicholson and Morgan Freeman, this became quite the thing. I tend to not notice social phenomena, so it wasn't until a year or so ago I discovered this. So I looked at it a bit, and was surprised at some things.

The premise, as I understand it, is that one has X number of weeks/months to live. Were it years, we'd all be in the same boat. One then list what one would like to see/do before they leave this world.

Common things on the list are wishes to do things: ride an elephant, visit Bora Bora, flyboard (?). Others are visiting places not seen, going back to places, etc. The surprising thing to me is I can't find one that says "I'd like them to cure this cancer", or "I'd like to see my family get along better"...things like that.

So with that in mind, here's my 'bucket list".

1.  See a woman, leftist, feminist even perhaps but not mandatory, socialist President of the United States.

2.  See a really irritated 600 lb grizzly wander into my town on a Monday morning, around 9am.

3. Bring back from the dead Wm. Buckley and Gore Vidal and make them debate again. On Fox. Frost as moderator.

4. Have the guy who whacked my arm in the Redmond vs Bend basketball game in 1963 admit to it. I would have made that shot. It was a foul.

5. Simultaneously , across the world, whatever peas people had in their house would be in a blender. We would have 'world peace'.

6. One of my kids would have an epiphany in the middle of the night, or anytime really. They would realize what was needed in their life was....fly fishing. They would pick up the phone, call dad, pleasantries exchanged, bargains made, etc. Arrangements made. They would get a case of fly rods, fly tying materials and equipment, a check for lessons. Months later a blog would be started, showing large steelhead caught and released, plans for a trip to Alaska, etc.

Last one is stretching it, I realize. The rest, I'm still waiting.

Tuesday, September 16, 2014

Dinner and one other thing....

Uninterested in shopping today I ventured into the kitchen wondering what was for dinner. Around 5:30pm. Idle I was, not trying to put stress on the cupboards or fridge. But with certain expectations, that they, my cupboard, would be there for me, I opened the fridge.
 
Top shelf, little of interest. At the back there is a large cup I got 4 years ago, with aluminum foil partially covering it. I remember seeing it some years before, I ignored it.
Second shelf, a bit more promise. There's this wrapped pork chop I'd taken out of the freezer a day or so ago (don't press me for exact dates). The next three shelves showed nothing of promise.

Cupboard....I see one of those packages of oriental noodles, the microwave ones, you know what I'm talking about.

Over on the table I see some basil a neighbor had given me maybe last week...it had dried! Great. Then I see the braid of Hmong garlic I'd gotten a week ago hanging on the wall. Then I looked down and saw the Thai chili's I got from them. Red, pencil-thin, 3-4" long, menacing looking. I'm there. I remember that in the fridge was an onion and a couple peppers, red and green. I've got a plan now.

But what to serve the sliced-thin slices of pork, 30 seconds in the cast iron "14 pan, the onions, peppers, etc
with?The examination of the cupboard had revealed the revealed thatcarton of one of those 'oriental' noodle soup....microwave 3 minutes, etc.Fine.

The noodle thingy went in the microwave, the sliced pork went in the heavy pan, and 5 minutes later.....






Anyway, to the real point of the post:

To those readers who noticed, I have two daughters, grown daughters. They live in Seattle, both living their lives. I have no idea how often the fathers of daughters talk to theirs after they are grown. I feel extraordinarily lucky in that both talk to me. It's a very rare, very, that I don't talk to them at least 2 times a week. Now, this may be because they are both checking to see if I'm still compos mentis, dunno.

Anyway, I called the eldest this afternoon, I don't remember what it was that I wanted to say, but that's unimportant. When she answered I heard laughter, hilarity actually, and the sound of two voices. Both of them, in a car, going someplace.

The rest of the 3 minute conversation was listening to them cackling at everything I said.

What a joy it is, to hear your two daughters together, outside yourself, together, living their lives. I did something right maybe. These two women are friends, sisters and more. Without me, they are still there, together.

That is a great feeling. When I'm not here, they still will be....together.

Quite grand, really.

Monday, September 15, 2014

What happens when you leave your car in a parking lot

Of a yet-unopened cross-country, telemark ski hostel in Alaska, circa 1975. Had a bit of a blizzard one night, this was what greeted us the next morning.






Hatcher pass. Tom Murphy, then a hippy ski bum, now a nationally-renound avalanche expert. He plays with cannons.

Friday, September 12, 2014

The Adorable One starts school right

First day of pre-school she apparently believes in the adage "start as you intend to continue". From the first, TAO has shown an active mind that want's to be in control of whatever situation she's in. She's never been one to sit back and watch, she wants to lead. Add to that a certain craftiness and guile, an ability to plan several moves ahead of time and a methodological approach.

Evidence of that came yesterday in the form of an email from her teacher to my daughter and son-in-law.  (S&S is modernspeak for show and tell)

From: Rachel
Sent: Thu, 11/09/2014 06:56 PM
To: Kate  (Fiona) ; Drew  (Fiona)
CC:
Subject: Fiona's delightful Show and Share

I just have to share with you how Fiona's S&S went today. I wish, more than anything, I had had somebody filming it because it was PRICELESS! She completely commanded the class. Had lovely, interesting things to say, AND (I about died) kept pausing and asking the class to say together, whatever interesting fact she'd just shared... "Everybody say 'pteranodon'." AND THEY DID! and way better than they ever repeat anything for me! It was awesome.
Thank you for sharing your sweet girl with our class. I enjoy her enthusiasm so much!
-Rachel 
 
I foresee interesting times ahead for her mom and dad. 
 
Here's a pic from her first day. 
 
 
You can just hear her thinking "All this is mine. Mine."

Tuesday, September 9, 2014

Insert Ezra Pound quote here....

The weather forecast from the local rag:

...WINTER WEATHER ADVISORY IN EFFECT FROM 6 PM WEDNESDAY TO NOON
MDT THURSDAY ABOVE 5000 FEET...

THE NATIONAL WEATHER SERVICE IN MISSOULA HAS ISSUED A WINTER
WEATHER ADVISORY FOR SNOW ABOVE 5000 FEET... WHICH IS IN EFFECT
FROM 6 PM WEDNESDAY TO NOON MDT THURSDAY.

* IMPACTS/TIMING: A STRONG AND MOIST FRONT WILL IMPACT THE AREA ON
  WEDNESDAY NIGHT THROUGH THURSDAY MORNING. THIS FRONT WILL CAUSE
  SNOW LEVELS TO DROP SIGNIFICANTLY AND BRING ACCUMULATING SNOW TO
  MACDONALD AND HOMESTAKE PASSES AND ALSO HIGH ELEVATION VALLEYS BY
  MID THURSDAY MORNING.

* SNOW ACCUMULATIONS: UP TO AN INCH OF SNOW IS EXPECTED FOR
  ANACONDA, BUTTE AND GEORGETOWN LAKE. 1 TO 3 INCHES IS EXPECTED
  FOR MACDONALD AND HOMESTAKE PASSES. AREAS BETWEEN 4000 TO 5000
  FEET COULD RECEIVE SOME LIGHT ACCUMULATIONS.
 
 

Monday, September 8, 2014

Which way do you flow?

Recently I went for a drive just west of here on a secondary road that goes from near Anaconda over a pass in the Anaconda-Pintlar mountain range to the Big Hole river. The same area that I did a post about catching brookies for breakfast.

At the top of the pass a series of small springs in the mountainside form a series of beaver dams.






At this point the road above and these ponds is pointed north and south. At both ends of the series of beaver dams the ponds drain, forming small creeks. The one that flows north goes perhaps 15 miles becoming Warm Springs creek along the way.





It empties into the Clark Fork of the Columbia, then flows west and north.





Perhaps 300 miles later it joins the main stem of the Columbia.





Along the way it goes through a series of dams, mostly hydro-electric. The dams are the source of most electricity in this part of the country. If I were more poetic I'd say the water from those beaver dams are powering my laptop. Eventually the Columbia joins the Pacific at Astoria



Back to the beaver dams.....the water flowing south goes through a lovely valley, becoming larger along the way thanks to other springs and small creeks.





It joins the Big Hole river and flows generally east and south.





The Big Hole is joined by other rivers and creeks, the Beaverhead and others. These flow into the Jefferson, continuing it's journey east.





The Jefferson after many miles eventually joins the Missouri.





The Missouri at this point is crystal-clear most of the time, with some very large trout. The river wends it's way across the nation, going east and south. Along it's hundreds and hundreds of miles water is taken out for agri-business large farms, and receives water from many other rivers. Eventually it reaches St. Louis.




As you know the Missouri joins the Mississippi, and eventually the water, or at least a few drops of it, hears the music of New Orleans before it goes out into the Gulf, past the oil rigs.



All from here, east and west:


Saturday, September 6, 2014

Another dry medical post

In 1974 my wife and 3 month old girl moved to Alaska. I had a position in the ICU on a research study for GE to validate some new multipurpose cardiac catheters they were proposing. The study eventually came to naught, and dissolved into some nasty bickering of the legal sort, but we did some interesting, then cutting-edge things.






The money that poured in from GE let us equip the ICU with equipment that few hospitals in the US had, let alone a smallish one in Alaska. One thing we acquired was this:





Its a intra-aortic ballon pump. It's the second series of those built by Datascope, and it's cost in 1975 was around 100K. I'll let you do the math to figure out what that is in 2014 bucks.

The primary goal of intra-aortic balloon pump (IABP) treatment is to increase myocardial oxygen supply and decrease myocardial oxygen demand. It is used for those patients in critical condition with 'pump failure'.

To understand why it works a short review is in order.

The heart has two basic phases in it's function of delivering oxygen-enriched blood to the body, and sending the blood after being circulated back to the lungs to be re-oxygenated. The phases are systole and diastole.





The heart muscle is supplied with oxygenated blood during the diastolic cycle. The purpose of the IABP is to augment the blood delivered to the muscle, and hence reduce the workload, ergo demand.

The method used then has been considerably refined, but then a large diameter catheter was placed in the femoral artery via a cut-down in the groin, then threaded up to just below the aortic arch.





The catheter end was then attached to the tube seen on the arm above the Datascope. During diastole the balloon would inflate briefly, pushing the blood back up the aorta and into the coronary arteries, thus augmenting the supply of oxygen the heart muscle was getting.





Enlarged, the picture shows a aortic pressure waveform, and the augmentation achieved.

The tricky part then, once the placement had occurred, was timing the inflation of the balloon at the end of the catheter to match the diastolic period. It was measured in milliseconds, and had to be monitored constantly and adjusted when the heart rate changed. Since that time the device has been computerized and automated, but back then one of the 4 of us working on the project had to be there 24/7. A inflation during systole could be disastrous. It also had complications...after a period of time the constant inflation of the balloon would beat up the platelets, reducing the red cells.

It was fun, the four of us were all young turks. One is now the chair of a department at a university, another a cardiologist in Kentucky, the other was the head of anesthesia at a major southern California medical center before retiring. The last is retired, and spends his time reminiscing and fishing. 

Wednesday, September 3, 2014

September

The sun now first peeks above the mountains east of town around 7am, it's barely getting light when I get up just after 6. It's now full dark at 8:45pm. This time of year we lose around 25 minutes of light a week. A few of the older cottonwood trees are starting to turn but the lawns are still green. From my front window it still looks like summer, sort of. Ann's flowers are gone though, my bluebells are starting to shed their seeds for next year. But there's a feeling in the air, it's in the upper 30's in the morning, and while we'll probably hit 70 again, the day's of 80 are gone for several months.

While I once loved autumn...it was my favorite time of year; the promise of skiing soon, the first snow coming soon, it's now something I just like. But enough maudlin whining. Just east of town it's lovely.







Some other pics from around the area: This one was taken a week ago, the snow is gone now.
















This last one above is the statue of 'Our Lady of the Rockies', constructed in the 70's as a community project of sorts, it looms over town from the east ridge.

And, the fishing is good for the trout that have gotten fat over the summer.






So I'll enjoy it while it lasts. Hope your season is as enjoyable.




Monday, September 1, 2014

Labor Day

Labor Day came about as a holiday largely because of unions. The Seattle Times recently ran a column about a 'think tank', the Freedom Foundation, that want's to abolish the holiday. Here's an excerpt:


But to the Freedom Foundation, a business-backed Olympia think tank, the day is evidence of the power of unions, which to members equals the decline of America. Rather than stoop to taking a union-backed day off, they plan to fight the power by ... working all day Monday instead!
“I can’t think of a problem in society that can’t be traced in some way back to the abuses of organized labor, so it would be hypocritical of us to take a day off on its behalf,” said Freedom Foundation CEO Tom McCabe.

So what exactly is so bad about organized labor? Let's look.....well, they stopped this:





Pesky unions stopped child labor exploitation, at least in the US.

Other things they were largely responsible for:





So enjoy your day off unless you have to work of course.