Thoughts on NP Week

I hate NP week.

I didn't know that this was a thing, that we have a whole week dedicated to our entire fucking profession.  I think that celebrating a profession is silly.  What's more, the way people go about celebrating is just retarded.  Subpar cupcakes/cookies/etc diabetes inducing baked goods?  No thanks.  Cards? Going in the trash.  What I would much rather prefer is all of my patients to show up on time.  I would like very much if I had a little of the administrative time that was taken from me at the beginning of the year so I can actually get my shit done.  It'd be nice if I didn't get a new patient slid into a no-show slot with 5 minutes to spare.  What would be awesome is if someone actually did a proper gynecological exam set-up so I could just get in and get out without getting stuck in the room and being asked more inane questions about this one time she just had a little vaginal itching but it went away but what do you think it was.  

I felt the same way about Nurse's Week as a hospital staff nurse.  The people who would inform me were either a) administrators who don't really appreciate their nurses and then continue to under staff them (especially during Nurse's Week!) or b) entitled, lazy-ass nurses strutting around their obese bodies thinking that Nurse's Week gave them a pass to do even less work than they already do (meanwhile their patients are peeing themselves, on the call bell or in the process of trying to fall out of bed), demanding to be appreciated for their shit work.  And what does Nurse's Week get you at a Big Tertiary Hospital That Must Not Be Named? An ice cream service that hands out subpar ice cream bars (hey-o diabetes!) and shit cookies that are literally and liberally frosted with a reminder that "We Put Patients First."  I vaguely recall some cheaply made lunch bag that split after being stuffed with three apples. 

The fact of the matter is that people who really go into nursing or nurse practitioner-ing do it not for the recognition.  They do it because they care.  (Or in my case, cared, past tense, since it's hard to care for the large majority of my highly entitled, very misguided, uniquely retarded patient population.)  They do it because they take pride in a highly skilled, demanding profession that saps their emotional willpower, their physical strength, and will to live.  And they get up every day (or three days a week, whatever) to do it all over again.  Any health care provider with a license (and some without) who actually does their job well does the same. 

If you're going to celebrate the NP in your life, do it in a way that is relevant and useful.  Buy them lunch.  Coffee shop gift cards.  Champagne/whiskey/wine/all of the alcohols.  Listen when they are venting and try not to vomit on them when they have a gross story.  Don't attempt to one-up their experience with a story that is only tangentially related about your sister's on-again-off-again boyfriend's attending who saw this thing this one time in the hospital in a different country a decade ago.  Shut the hell up if you're going to start any sentence with "At least..."--it diminishes your NP's professional and personal experience and demeans them as a person.  Same thing for "As an NP, you should know that..." FUCK YOU AND WHAT YOU THINK WE SHOULD KNOW. Definitely stop trying to impress your NP with your infinite knowledge of the many different antibiotics you bullied a previous provider into giving you for a "sinus infection"; we are judging the SHIT out of how you were medically managed and will think you are a fucking sissy anyhow. QUIT asking for medical advice/prescriptions/"favors" from your NP-- none of us wants their friends to be their patients; they want their friends to stay friends.  Pushing it into that gray area is like friends with benefits--and no one wins in that situation. 

And if you're one of those tragic and misguided people who blithely refers to the NP in your life as "a nurse" utilize the title they worked their asses off for and deserve: it's "NURSE PRACTITIONER" you dicks!  

Vacationblog: Singapore Day 1

Day 1 in Singapore actually started 6 hours after arrival to the airport.  T!ff's family helper insisted on going to Ghim Moh Hawker center for breakfast because apparently I had told her I used to go there with my family since it was close to where we used to live.  I have no recollection of eating there but a vague idea that my mom might possibly have shopped there.  Honestly they all kind of look the same, and unlike my dad, I didn't have a "favorite stall" who knew my order.

Once I remember attending a lecture given by Anthony Bourdain where he mostly spent the hour talking shit about Paula Deen, but at the end there was a Q&A session in which someone asked him what his dream restaurant would be.  He answered that it would be a hawker's center-type place--a place where there are lots of stalls and each stall does one thing and does it well. It'd be cheap and efficient and all of these tables where you sit down and just stuff your face with this amazing food.

This is essentially what we did but first of all, how does one choose from all of the stalls?  I wasn't really sure what we were looking for as T!ff and I wound aimlessly around the tables.  She decided apparently at random to stick with one and then got in another line but explained later that the way to go is basically to find the longest line and wait in it.  Obviously the logic is that if other people are lining up for it, it's obviously worth waiting for, right? It is the Singaporean way. Anyway, the organized chaos of the hawker center, the brusque, efficient but polite way of the vendors and the astonishing speed with which food is dispensed made me appreciate how much Singaporeans love eating and how much vendors love providing the food for them.

We ended up getting two bowls of lor mee, which is an egg noodle dish in a viscous vinegar broth dotted with rando meatballs and other bits of questionable meat parts, and chee cheung fun, which is plain rice noodle rolled thinly and chopped up, smothered in hoisin sauce and sesame.  We polished both dishes off with two cups of teh tarik (literally "pulled tea" which is a black tea sweetened with condensed milk and poured between two cups at great distance to mix and give it a bit of froth.  It looks way easier than it is--T!ff's house helper/majordomo did it once and burned both her hands horribly. All of it was delicious and best of all, the lor mee was a new dish for me.

It's odd, living here for three years I spent a lot of time pursuing food from "home" or sticking to "local food" that was familiar to me, which means mostly Cantonese food or food that my mom is comfortable with.  I lament that I never felt the urge to go forth and try new things, in food and in the incredibly rich travel opportunities living in the Straits gave me.  Instead I have to fly fucking 48 hours to get back here (first world problems, yeah yeah). With all of this great hindsight to guide me I determined that the food we ate would include at least one new-to-me item on this vacation.

After this we were rather stuffed but carried on to the other side of the hawkers: the wet market. I am somewhat familiar to this aspect of Asia--when we were living in Hong Kong my mom would occasionally take us to "gai see" where we would see great hulking sides of pork, beef head and the like.  Mostly I enjoyed the soya milk treats, which is pretty much what I also did when we lived in Singapore 10 years later.  You can pass by and see all sorts of standard meat cuts in their glass cases, but ALSO interesting things like black chicken (what makes it black???), frog, all sorts of whole fish, and then the safer stuff like fruits and veggies.  It boggles my mind that even groceries here are dirt cheap.  A package of shimeji mushrooms in NYC puts you back $2.50 a pack.  IT IS 90 CENTS HERE. Same thing with other produce.  The thing that I always insist on buying in bulk is mangosteen.  Their cost is unspeakable back home but here you can buy it by the kilogram for dirt cheap.  Once T!ff and I sat with a 2 pound bag and ate the entire thing.  Inside is a delicate white meat that is juicy, sweet and succulent.  The ultimate tropical treat!

After this, we did a bit of touristy sightseeing--Singapore is always under construction and sometimes it even yield something; in this case it was the Gardens by the Bay, which is adjacent to the Marina Bay Sands, Singapore's new(?est? and possibly the first?) casino.  The Gardens themselves were lovely albeit crowded.  Lots of flora from all over the world crammed into a soaring glass dome all while being in a climate controlled environment with a skywalk that gives you a birds-eye view of the whole thing was pretty neat.  Of course we had to have lunch and here I will have to pause.

In a mall in the States or any amusement park or anything that involves the word "food court" the food will invariably be shitty.  It'll be bad for you, it'll be expensive, your options will be awful, and you'll feel robbed and one step closer to a heart attack.  In a land where people are so passionate about food, this is not the case.  Not only were there several restaurants to choose from, the food court was phenomenal!  At my insistence we ate "local" food which involved nasi lemak (fried chicken over a flavored coconut rice) and hokkien mee--both new foods.  We also had ais kachang for dessert which is shaved ice on steroids and all sorts of weird toppings--creamed corn, red bean, peanuts.  All of it was new, all of it was delicious and ALL OF IT WAS CHEAP.

Again there was a slight pang of how it could have been different had I been more... open minded?  Self-aware enough to try new things? Adventurous? At the same time there was a tiny seedling of pride in seeing how far I've come ... and also feeling emboldened to go forth and do MORE new things.  It strengthens my resolve to travel more, meet more people, eat different food, learn different cultures and learn more about myself in the process.

Vacationblog: Getting There

It's been ages since I've been on a long enough vacation that prompts introspection and enough observation to put to paper, so to speak.  This vacation I'm on now--2.5 weeks, overseas travel, stamps in my passport, and great, great friends--is a dream vacation that has been in the making for over 4 years. I have never worked at a job that allowed me to take off more than a week at a time, nor have I made enough/saved enough money to enjoy myself doing so but now that I have saved all my airline miles and money, it's happened.

I have wanted to go to Australia for a long, long time.  It's been on my top 10 for as long as I have had the desire to travel.  But a trip in that part of the world is not complete without a visit to Singapore, the country of the beginning of my formation as an adult, as a traveler, and as an international citizen of the world and all it has to offer. Also my oldest and dearest friend's family lives here and I have made a habit of freeloading off them with impunity when she's in town.

So off I went. It was over 24 hours of travel, it felt like.  But it was worth it since my mileage points basically made this jetsetting vacation free for me.  Here's something interesting about mileage with United.  It requires more mileage to fly economy on United than it does to fly business or first class on any of their partner airlines.  That's how I ended up flying business class on Air Canada.  You can tell I'm not used to it--I awkwardly ask the lady at the gate if I'm jumping the queue when she calls for first or business class passengers to start boarding. She looks at my ticket with surprise and says that of course I can board--I'm business class.  Every solicitous offer of every beverage, snack and amenity is met with surprise on my end and sort of a flustered, "Uhm.. okay, yes please!"  I get the feeling that my fellow business class riders can sense my n00b-ness at this.  They stalk imperiously down the ramp as soon as "priority boarding" is called and with the ease that is natural to people who are used to such luxuries will merely jerk their head to the side if they don't want something and then complain about the lack of slippers (whereas I feel obligated to say yes to everything; after all, who knows when the next time I'll have this opportunity is.)

What I also find interesting is that while domestic travel in business class is nice, INTERNATIONAL travel in business class is better.  The pillowcases are silkier.  The snacks are nicer. Everything is even more neat and orderly and even more amenities are offered--slippers, the travel case, a bottle of water, all of it!  My flight attendants each leg (from Toronto to Vancouver, then from Vancouver to Narita) were both male and insanely attentive but the latter leg's attendant kept calling me, "My Lady" which either is a quaint honorific from a bygone age or mildly creepy.  Either way, I was well supplied with alcohol and camomile tea so no complaints from me.  Something else that blew me away was that all of the flight attendants spoke English, French and Japanese.  HONORIFIC JAPANESE.  I was floored.  Apparently the "speaking English louder and louder at someone who clearly doesn't speak it" method employed by United is not a tactic used by other airline carriers (burn).

Let's talk about business class food, shall we?  First of all, real silverware.  Second of all, several courses.  Third of all--that shit is something I would easily pay for in New York.  Fancy shaved cucumber wrapped around microgreens, salad dressing imported from Andalucia, beef tenderloin that is actually tender, Swiss chocolates and real whipped cream with warm cake.  And let's not forget the WARM FRESH BAKED COOKIES served with gelato.  I will probably gain 5 pounds from airplane food if nothing else, especially since they kept asking if I wanted more cookies (the answer was, "Uhm... YES PLEASE.")

Arriving at Narita was unexpectedly saddening.  It's been many years since I lived there and I haven't returned, not even once.  Not for lack of trying--the one time I came close to going there was that pesky tsunami and the nuclear leakage was somewhat close to where I would be spending a majority of my time, so that was out.  All of my time I lived there came flooding back, but I appreciated it with new eyes that only a long time away could give me.  I realized that my fascination with the country and its people has not dissipated, merely dampened while I was living there and watched with sort of a weird motherly love how quintissentially Japanese its airport workers are.  I wandered the airport with a desperate sort of longing that was felt so acutely that I had vague desperate notions about coming back soon (seems unlikely). I consoled myself with buying omiyage for my friend that I'd be staying with in Singapore--the famous Tokyo banana, but now in a banana caramel custard flavor, and DYED TO LOOK LIKE GIRAFFES.  Damn those Japanese and their fabulous omiyage.

Getting back on the plane, I braced myself for disappointment since this last leg was riding on United Economy.  However when they closed the airplane doors both seats next to me were empty.  With joy I realized that while I wouldn't have my down quilt, eye mask and water served to me in fine crystal (how quickly we adjust to the life of luxury!  This explains all of the Debtor Anonymous meeting available to people on vacation at St. Barth's!) that I would be able to stretch out and get some more sleep.  The rest of the flight was pretty uneventful, save for my missing the dinner service (meh), getting up to get more water and the flight attendant--unsolitcited--admonished me to not sleep so much.  Singaporeans, so bossy.

By the time we rolled up to Changi, I was pretty tired and kind of anxious to not make my dear friend wait so long, but I had plenty of time to wait in the immigration line and look around.  They really have upgraded the place.  The art, the space, the openness of it all bespoke a kind of understated opulence that can only be Singaporean.  It's been ages since I've had to wait in the immigration line; I had a green card when I lived here during high school.  It looks like they upgraded the immigration check out line for residents and green card holders to merely swipe their passports and scan their thumbprints.  Lucky.  I had the great fortune of witnessing a very typical looking ?Singaporean/?Chinese girl make a mild fuss and promptly get whisked away by military grade beret-clad security to an unknown location.  Don't mess with immigration, people.

I have never been happier to see my friend, her face pinched with the uncertainty that comes with actually having to wait for someone in the airport (again, something from a bygone age, it feels) and watch it unfurl into a look of delighted recognition.  We were whisked away into her waiting car and while I drowsed on our way home, she detailed the next few days' adventures...

On First World Problems

I could write several [thousand] blog posts' worth of first world problems that I come across, in both my life and the insanely ridiculous patient interactions I've been privileged/burdened/cursed (depending on the day) with.  Today's involves my cell phone.

Does anyone remember their very first cell phone?  I sure do.  It was a 2x6 inch Philips hand me down when we lived in Singapore.  My friends called it "The Paddle."  In all fairness they were sort of right.  In more fairness, they were assholes, as all high schoolers are wont to be.  It couldn't hold a charge for more than 6 hours, but it was MINE and I was MOBILE, goddammit!

Fast forward to my next phone, which was that amazing Nokia that everyone seemed to have at the turn of the century.  Many games of Snake ensued and lots of bad grades in college.

I am always amazed at the Next Big Thing in cellular technology.  It fascinates me in how it shapes society, public relations, how people interact with each other over dinner (spoiler alert: they don't), how we absorb information.  I have loved every new phone I got with the same enthusiasm as the snowman Olaf from Frozen has about summer.  Everything seems shiny, impossibly fast and futuristic.

My latest is a treasure--a phone I waited months for despite being eligible for an upgrade.  I wanted it and when I got my HTC one it was shiny, blue and everything I had ever hoped for and dreamed of.  Short of doing household chores, it seemed to do everything else.

...until it got stolen.

I can't understand theft at an institution of higher learning, let alone an Ivy League.  But during a bathroom break, some punkass kid stole my phone (bypassing the work iPhone, something that still has me scratching my head) and probably made a sweet amount of cash on eBay for it.   I was angry, resigned, sad, defeated, lots of things and wanted to nail the kid to the wall.  By his balls (see: anger issues, last post).

I budgeted enough to get a new one.  My enthusiasm for technology was renewed, my hope for mankind somehow buffed to a brighter sheen and all was well for about a month.  And then my new phone crashed today.  I threw a minor tantrum, managed to see all of my patients without killing anybody, and then headed to Verizon, who offered to replace it with a "Like-New Certified" phone, which is basically "phones that people change their mind about within a few days and exchange for something else."  I pouted and tried to give the sales guy a hard time about refurbished phones.

Pause for a second.  Not only do I have a cell phone with a great albeit rigid company, I upgraded my previous smart phone, LOST the new one I got, had the money to REPLACE it, and am sulking about the FREE REPLACEMENT my cell phone company is offering not being brand new.  Also I'm totally dreading re-installing ALL my apps.  And all this time I have a totally slow but completely functional BACKUP SMART PHONE that I can still contact my loved ones with.

Sometimes it's nice when you can give yourself some perspective, even if it makes you feel like an entitled, elitist asshole.  Me and my first world problems will quietly bow out and show a little gratitude about my lot in life, which is actually immensely full of privilege and plenty. I will be happy about my new-to-me phone and be thankful that I live in a world where this is the norm.

On Not Letting the Sun Set on My Anger

Something that I've been dealing with a lot in the last few years is rage.  I have never considered myself a rage-full person and certainly people who knew me from my docile college years spent penned up in church would have a hard time believing it.  It comes in bursts.  Sometimes it actually makes it to the surface.  Usually it's my family that sees it the most.  Sometimes it's a mild flare, and sometimes it is white, white hot and I can't sit still because I want to be physically violent with... something.  

Where does it all come from?  In therapy tonight we identified that it is a conglomeration of small, tiny, injuries to myself.  Something that feels disrespectful, something that makes me feel helpless or powerless.  A slight to me or something I believe in strongly.  It all adds up into a big, poker hot ball of rage.

I hadn't realized that my coping mechanism for this in life is to deflect my anger.   My stifling Asian Christian upbringing has taught me to squelch the feelings of anger, tell myself something that will make me okay with it for the time being.  What I didn't realize is that in not acknowledging the angry, in stuffing my feelings deep down, I set myself up inevitably for an explosion.  Sometimes alcohol helps to coax it out.  Sometimes it's that one last straw that makes me lash out.

It's hard to sit with being angry.  C#arlie, in a rare show of his preacher background, quoted Ephesians 4:26 (26“In your anger do not sin”^d : Do not let the sun go down while you are still angry) (hell yes I googled that) and I had to really think what that meant, since for my whole life I have basically parroted that verse as an admonishment to tell people not to be mad in a my-hindsight-is-cringing super-preachy way.  But he pointed out that most noteworthy is that Bible doesn't tell me not to be angry.  It just tells me not to go to sleep without dealing with it (been there--really bad dreams, don't do it).  It was an interesting application of a time and again read Bible passage that I've glossed over with a "Yeah yeah yeah, don't be mad, I get it." 

I do not know how to deal with anger.  I suspect that it could potentially involve pushing back.  I guess it'll involve being comfortable with it.  I know for sure it'll involve a helluva lot of practice. 

On Being There

Tonight I had dinner with some girlfriends, of varying closeness.  It was interesting to see that at different times in my life I had been extremely close to one or the other.  I think I took for granted at the time that our friendships and closeness would last forever, but of course not very many do.  It felt bittersweet--fun to relive the past but bitter to realize that most of the conversation and interactions tonight were surfacey. Nothing serious, no real, deep, genuine soul-baring conversations.  Tonight's dinner was the kind of outing that left me feeling empty.  I'm sorry to say those happen far more than I'd like... but happy to notice that they are decreasing in number, on purpose, I think.

Right before dinner (which was right next to my old work office and still gives me PTSD every time I walk past) I stopped in to visit my favorite ex-coworker, Wallace.  I have often puzzled over how I instinctively know this to be true.  I see a lot of my old coworkers on a regular basis and I am always happy to drink with them, eat with them, share life with them, but no one inspires the same adoration in my heart more than Wallace.

Tonight I think I figured out.  In those two godawful years working at that job, everyone was a taker. Even the ones I hang out with all the time.  They liked sitting in my office, chatting it up, sucking up the little good will and positive energy I had and would ALWAYS use me as a bitchbag sound board.  I get it.  I wasn't busy. I had time.  I was nice.  I listened.  I went to lunch with them when no one else could/would. They would come in, dump, complain, and take, take, take.

But not Wallace.  When I was down he wouldn't talk about it directly but instead say something funny to take the edge off, something to help me see it in a different light.  He'd breeze into my office with these interesting tidbits he found on yahoo and share these stories he found fascinating, not really knowing if I cared at all.  Once I went to Jamaica and mentioned to him that I was going swimming with dolphins and he immediately found a youtube video of an aroused dolphin trying to rape a human woman, and had a urine drug test specially ordered and waiting for me when I got back.  The day I got back, he pantomined me smoking a lot of weed.  Not really sure why this was hilarious or particularly heart warming to me, but it has stuck with me after all this time.  Wallace was able to diagnose my relationship with a now-ex-boyfriend without knowing our history or that we were even dating as doomed from a 2 minute conversation.  He has a keen eye without being invasive or nosy or solicitous.

And when I hit rock bottom, he would say something bracing--just a phrase that would lift me out of my profound funk.  He wouldn't address my tears or pity me.  He would give me a tool to help me get past the obstacle and then breeze right back out my office.  Wallace is not a taker.  He isn't really a clear giver either, although he was probably the only person in the office who offered any guidance when bossman was out of the office (so...always).  He is Wallace.  And in merely being himself, being there, he brought such great joy to my life, enough to help me make it 2 years in that hellhole.

Which brings me to tonight.  The hour I spent sitting in his office laughing, chatting, sharing and just marveling at this thing called living life was far more soul-enriching than the 3 hours I spent laughing with these girlfriends (I suppose not all laughter is considered equal in this sense).  I think the difference is that they were not there during the most dark, fiery formative parts of myself (personally and professionally) and Wallace was not only there but gave of himself in a way that was both separate and involved with my formation.  And I'm learning to be grateful for these people, pillars of self-awareness and compassion who choose to be there for me, with me, unobtrusive yet solidly there.

That's how tonight was not a wash, but a complete blessing.  Not for the three hours of margaritas and Mexican food, but for the one hour in the very warm cramped space that is Wallace's 10th floor office.

... and maybe the pineapple infused tequlia shots.  Those were pretty tasty.

On Pushing Back

My 3-year-old niece was given a meyer lemon tree in her first week of life (outside the womb, that is).  The idea was that it would grow and be fruitful as she grew and became fruitful in her endeavors in life.  It only recently started bearing fruit in earnest. I witnessed a very full basket of meyer lemons, usually at least $3 a pop in NYC, when I was most recently home.  So rich!

This is how I feel about my journey with therapy.  It's come a long way from the sobbing, I-have-daddy-issues confessional-type sessions to something fruitful that prompts genuine introspection (rather than merely an introspective face, which was mastered in my days of faking it in college Bible study), the beginnings of capable self-analysis and--most surprisingly--action.

You'd think that this isn't really that remarkable, but I disagree.  It's far easier for me to let an off-handed slight dealt by a family member slide than to stand up for myself.  The path of least resistance is to let an ex act out with some self-pitying outburst--directed at me but fueled by life circumstance--than to call him on it.  I'd be much more comfortable if I just avoided that friend who took her love for the Packers a little too seriously and bruised our friendship. (Over football!  WHY.) People push and don't expect a fight because I've never given them one.  I am much better suited to inaction than action.

For over a year I've been toiling in therapy on this concept of pushing back. A whole life's worth of Chinese-Christian upbringing has taught me that it's NOT okay to push back. Don't argue.  Play nice.  Don't express your real opinions or you'll be rebuked.  Respect your goddamn elders even if they are absolute nut jobs in complete self denial about... themselves.  Get along with everybody, even the borderline personality guy; fake it if you have to. It's hard to fight that.  My desire to avoid conflict is deep-rooted and is directly opposed to the goals of this concept of "pushing back". I don't want to act.

But it's happening.  

It's coming out in bursts, like I don't know yet how to control it or quite how to phrase my words in the moment (versus crafting them in an email--a separate skill set I have yet to master).  I struggle with sifting through my feelings in a matter of minutes rather than days or weeks in order to verbalize adequately enough to get my point across.  But I am addressing that off-handed slight, even if it involves telling my brother to go fuck himself.  I'm making heart-wrenching, deep sobs for months in the middle of the night decisions to FINALLY cut off that ex.  I am firmly but kindly telling that friend that I don't appreciate her love for a football team ruling her decision to deride me as a person (go Niners!).  

And it feels GOOD.  It feels like I am reclaiming myself.  It feels like I'm finally giving all of those hurts and injuries I've accumulated over a lifetime a conduit to voice themselves.  I'm not super great at it.  Sometimes my attempts to protect myself end up hurting other people.  But it's a start.  It's something that needs practice.  Now that I know what it feels like, how self-saving it is, I feel encouraged to keep pushing back.  And the fruit of that labor is tart/sweet, just like a meyer lemon.