Homeless Volunteering

I had my first night volunteering with a group that does homeless youth (< 25 yrs) outreach. They have a medical van that goes out and actually serves people of any age, not just youth. The medical services provided are another draw for the kids to come by and for the outreach workers to connect with them. I really enjoyed myself.

It'll be an intense learning experience as I will have to start really relying on my own assessments and plans; I won't have another person to double check it with (Usually it's one medical person, RN, NP, MD or PA volunteering at a time). Tonight I was working with a NP. I think with what I saw today, I'll be ok. If it's a true emergency, we'll call 911, which they've had to do a few times in the past. One guy I would have been nervous with as he was on heroin and coke and he was really twitchy. But I think I'll get better at gauging it.

I've been surprised at how honest the patients were. One pt. told me in the same sentence about her daughter and her heroin addiction. This will be a good exercise in learning patience and acceptance. The knowledge of her daughter makes me even more uncomfortable with her addiction. But lectures of any kind will NOT work and are completely inappropriate. I did get her info about the community health center close to where she lives and she promised to make an appointment tomorrow (CA-MRSA with two abscesses). The more connected she gets to the community and the more resources she has to depend on, the better she will be. I tell myself and I believe that it is about building support for individuals and through engagement change can occur.

Current Favorite Music

I'm always looking for new music to listen to. Here is what I'm listening to now as I work on my pharm project. If you like any of these and think that I might like someone who you listen to, please let me know.

Richard Shindell: http://www.richardshindell.com/
Patty Larkin: http://pattylarkin.com/
Peter Mulvey: http://petermulvey.com/
Naomi Sommers: http://www.naomisommers.com/

Trauma

I still can't stop thinking about the kids at the residential crisis center I interviewed at. Most are aged 4 - 12, a few 3 year olds and a few 13 years olds with developmental disabilities; they are primarily foster care kids or former foster care kids (now adopted) who had been so severely physically or sexually abused that they are in need of a crisis placement out of a home to stabilize their behavior.

I haven't worked around kids in a long time. I had forgotten how young 12 is. When I read cases of horrific abuse and the young ages of the kids, I hadn't been able to make that translation to reality. I keep seeing the babies and cannot imagine the abuse that has been done. These kids are just babies is all I can think. They are so young, so small.

Confessions of A Mormon Boy

Last night, I went to see the play Confessions of a Mormon Boy. It is a one man show and the performer is also the author of the play; it is autobiographical. He describes his agonizing attempts for him to turn himself straight, the 'help' that he got from the Mormon Church, their referral to ex-gay therapists and help paying for them. He got married, having told his fiancee that he was struggling with homosexuality. Eventually his ability to 'remain straight' failed, he was excommunicated from the church, moved to NYC, became an escort (ie., prostitute), got involved with drugs, and eventually got clean of it all. The performance was phenomenal. Riveting the entire time. I think I can say that it was one of the best performances I've seen this year (I love student rush, when I have the time, I see as many plays as I can.)

I kept thinking the entire time about how much individual pain the Mormon Church and other conservative churches have caused. The amount of individual anguish that the belief that "homosexual acts are an abomination" has caused is overwhelming. When you are connected and have grown up within your church, synagogue, mosque, meeting, place of worship, and it is your entire life, having to reject it is heartbreaking. Thank God I grew up Quaker.

Another interview

This one is at a rehab hospital 20-40 minutes away from my house. No interview is set up yet, but I interviewed on the phone with human resources and she is getting some times and dates from the nurse manager. Cross your fingers. I'd really like the pediatric one I just wrote about, but they are hoping to find someone who can stay on fulltime. But there's a chance that they won't be able to, so then they would hire a few of us on part-time for the school year.

The rehab hospital sounds interesting. Three of their units I am interested in: cardiac rehab, spinal cord injury and brain injury. I think the SCI unit would be the toughest because the patients would be the youngest. This hospital pays $7-$9 differential for evenings, which is nice too. So cross your fingers that I get an interview before I leave for Kazakhstan.

Residential setting

Today I applied for a job at a residential crisis assessment, stabilization and treatment center for kids with serious emotional disturbances (ie., predominantly foster care and former foster care kids). The director, in my interview emphasized that the rewards are sometimes hard to see because the acuity level is so high and the kids are very disturbed from the physical, sexual and emotional abuse and neglect that they have undergone. She said that they have some children who are at the center whose parents were also treated here when they were children. Talk about a cycle that hasn't been broken.

Friendship dynamics

I had a friend who was a very good study buddy of mine. We dated briefly, it didn't work, and we returned to being friends. We were good study buddies and then the dynamics got weird. I found myself being uncomfortable in our conversations and get togethers, but I wouldn't be able to pinpoint why. I just knew that I was feeling uncomfortable about it. After a while, I realized that I was feeling bullied. Part of the problem is that it is lot of small interactions. If I think enough, I can pinpoint it, but when you talk about it, it often seems like trivial encounters.

For example, I was trying to figure out how I would work up an ALTE (acute life threatening event) in an infant. With an ALTE, an infant may while feeding or at some other time, suddenly turn blue, have trouble breathing, go limp, but with stimulation, promptly revives. In our conversation, he starts talking about what follow up he would do. I try to redirect to what we would do as our initial evaluation. But he keep talking about what we'd do as follow up. I get frustrated and say, can we talk about follow up after we've talked about the initial workup? He follows up with "I think you are just being too strict in your definition of follow up," rather than just saying "actually by follow up, I mean follow up to the ALTE not follow up after the initial visit."

It's those small types of interactions that make you feel silly if you pursue them. It's the overly intense reaction and adding in the attack, rather than just assuming that I wasn't following him, he assumes that I am being purposefully dense. It sounds so silly now as I try to write about it. But I do know that I am not comfortable around him now and I need to remember that and not make plans to get together and study. It's hard to accept that things are different.