Wednesday, May 2, 2012

There are two types of people ...

We've all heard some variation on the riff, where someone starts out "look, there are two types of people ... "  Some are deep and weighty: "Those who cannot do what they are told and those who can do nothing else" (Cyrus H. Curtis), frivolous "Rolling Stones people and Beatles people" (I think there was a deleted scene in Pulp Fiction where this was discussed by Mia and Vincent at some length for example) or somewhere in between like "Those who are willing to work and those who are willing to let them." (Robert Frost).  But my favourite comes from Edward A. Murphy, yes, he of 'Murphy's Law' fame, and it's "Those who divide people into two types, and those who don't."

In my little world I've noticed a clear divide amongst my legion of caring nurses here at hospice.  It's a little thing, but I think probably a telling one, and there really is no grey area on this that I have observed.

I take painkillers, and the reasons for this are mainly a) pain and b) as I have mentioned elsewhere, I value the side-effects of the opiate classes of drugs in smoothing my path and assisting me to welcome death with more grace and openness.  Some would call the later drug-seeking behaviour, and if you think that fits, I'll wear that. I in no way intend to demean or cheapen the lives and experiences of those who suffer such labelling (my many friends with gastroparesis for example for whom agonising attendances to the emergency room are too often treated with scepticism about the genuineness of their all-too-real pain, especially as they know so much about painkillers through hard-won experience) nor that of addicts living through their challenges.

I do not know what each of my many nurses thinks, of course, but there's such a clear split (and it's entirely consistent, no nurse has yet demonstrated a change in behaviour to date) that it seems to carry some meaning.

My 'PRN' (from the Latin pro re nata, 'when necessary') painkiller is charted up by my doctor as being 15-17mls PRN (it's a liquid suspension) and the nurses bring it to me in a 20 ml syringe, all ready for sending down my tube.  Exactly why it's been charted as 15-17mls remains a mystery, but there it is.  Not like there's a massive difference.  Those 2 mls though are over half a centimetre apart, two whole big lines on the side of the barrel, and it's easy to be very, very accurate with this stuff.  So here's the thing - it's always either exactly 15ml, or exactly 17mls.  Never 16, or just under 17, or a bee's dick more than 15, nor above or below the limits.

Now it surely says something that I think I have worked out that those who bring me the larger doses seem in general to more enjoy the act of giving, to be less worried about my pain, to be more accepting and trusting of me to self-manage my situation than those who bring the 15ml doses.  Totally subjective, and skewed by all manner of worldview preconditions I bring to the game, no doubt. And there's another layer.  With these heavier and potentially abusable drugs safety protocols mean that two nurses have to do the sourcing and delivery, checking my name band with my record, making sure the right patient gets the right dose etc etc.  And who those nurses turn out to be is pretty much random - 'my' nurse (usually) for the shift who answers my call bell, and whoever else has a spare minute (haha, those who work in hospitals know full well there's hardly ever such a thing).  And a rule has developed, a Law Of Nature as it were: If one of the nurses is a '17ml' nurse, the dose will be 17mls. It will only be a 15ml dose if neither nurse is ordinarily a 17ml nurse.  So the larger-dosers tend to be dominant actors, doing the preparing and being the one to hand me the syringe.

So there are two kinds of nurses - those who bring me the minimum charted dose, and those who bring the maximum.  It occurs that I could always ask for one or the other and see what happens, but I'm far more interested in seeing how it goes when I don't.  And the pain is OK. So is my sacramental progress, just btw.

Once, I would have asked them, the nurses I mean, interestedly and in a way so as not to raise any hackles, but now ... well I suppose it's a part-testament to the times I am living that I vastly prefer to leave it as something to toy with only, to allow there to be some great deep meaning and to not care whether I get it or not.  It's like having come full-circle with philosophy, in a way - I reached a while back the full understanding that nothing was ever able to be known (including the supposed fact of my own existence) with certainty, hence, philosophy as a way to get at the 'meaning of life' is hopelessly inadequate.  Now, it's become a fun pastime again.  Now there is nothing resting on the outcome, I guess.

Everything is increasingly freighted with vast and deep potential significance, yet totally random and unfathomable simultaneously.  Without the counterweight of certain mortality, I doubt we could stand the perspective for long. Like Douglas Adams' Infinite Perspective Vortex. powered by nothing deeper than a small piece of fairy cake :-)

Just a thought.

1 comment:

  1. my friend, you are in this world but no longer "of" it, if i may say so myself. i see the freedom from across the way, and it comes right on in on time (credit to van morrison. heck, go look up the lyrics for "brand new day" :-)