Tuesday, January 20, 2009

The End of an Error

It's 12:27 on Tuesday, January 20th, 2009. In just a little less than 12 hours, the presidency of George W. Bush will come to an end.

I did not come up with the idea for making a blog post about the end of Bush's presidency until about two minutes ago. So what I will say here is simply off the cuff, a collection of thoughts about the last 8 years.

During the presidential election year of 2000, M and I were married but still childless, living in a 2-room Residential Director apartment inside a fraternity house at our alma mater. M was finishing her second degree and working part time, and I was working full time in middle management and moonlighting as the RD for the fraternity that had been the rival of my own fraternity while in college.

Having long since discarded the more conservative leanings of my teenage years, I was a strong supporter of Al Gore. I recognized that Gore was not the best presidential candidate in history, but I felt that he was adequate for the job because of his intelligence and experience.

During the primary season, I had hoped to see John McCain pull out a victory. I believe that if McCain had won the nomination that year, I would likely have voted for him. I felt that McCain was clearly the better choice for Republicans, even though I was not myself a Republican.

I was dismayed when the Republicans chose Bush to be their candidate. My parents live in Texas, so I knew a little bit about W. I knew, through the lens of my parents, about what he had done as governor of Texas, and I more or less thought he was a clown, puppet, and fool.

I felt that he did not have the qualifications to be president. I felt that he was an overprivileged little jerk who had ridden his Daddy's coat tails his entire life. I felt that he was, at best, of average intelligence and that he came off like a remarkably stupid idiot when speaking. Practically every business venture he had tried during his adulthood had failed, and I believed this was a fairly good sign for how a Bush presidency would pan out. I felt like if Bush won that year, it would signal a major victory for an increasingly powerful extreme right wing that had spent the entire 8 years of Clinton's presidency poisoning the minds of Americans against "liberal" politics.

I remember on election night in 2000 feeling very nervous. I remember watching the numbers come through in that little living room inside our RD apartment. At first, the numbers were good for Gore. Major swing states were called for Gore, and at one point I remember talking to my mother on the phone and rejoicing because Gore was evidently going to win.

Then everything fell apart. They took Florida away from Gore and returned it to "too close to call" status. By the end of the evening, it was apparent that Bush had won, even though Gore was evidently going to end up with more total votes.

I was surprised the following morning to discover that the election was not yet over. Like everyone else, I watched and wondered and debated during the next few weeks, anxious to see how it was all going to turn out, and hoping beyond hope that somehow Gore would get the votes he needed in the recounts in Florida. I hoped, at the very least, that perhaps a revote would be called in Florida, since there were so many questions about "hanging chads" and confusing voter cards.

Then the Supreme Court, in a vote split along ideological lines, put an end to the recounts and declared Bush the winner. This crushing blow was bad enough, but it was made even worse by the fact that the Supreme Court did not appear to even have the constitutional or legal authority to do such a thing. But who are you going to appeal to when it involves the Supreme Court itself? God?

I can't honestly remember if I was "supportive" of Bush in the early days of his presidency or not. I can't remember if I was saying that I would give him a chance and support him until he screwed up (like some Republicans are saying now about Obama), or if I was pretty much feeling derisive and resentful right from the start.

I remember watching the inauguration and realizing that for good or bad, it was an important day in American history - as is any inaguration of a new president. I remember specifically feeling sad to see Clinton go, and I think I might even have shed a tear during his final speech, which he gave at an airport or someplace later that afternoon/evening. I remember the anchorman on TV remarking about how America's peaceful "transfer of power" should not be taken lightly, because many other countries don't have such peaceful transfers. I also remember the anchorman saying that it was customary for the outgoing president to leave a note for the incoming president on the oval office desk.

Whether I was initially supportive of Bush in the name of unity or not, I know that I very quickly came to regard his presidency as a shambles, a sham, and a travesty. When he cut taxes right away and gave everyone a nice little "rebate," I felt that he was simply trying to buy support. I also recognized that the measly 300 bucks I had in my hand didn't compare on any level to the kinds of tax cuts wealthy people and big corporations were getting.

After 9/11, I experienced the only time during Bush's presidency where I had "nice" feelings towards him. If I had been polled in the first month after 9/11, I probably would have said I approved of how he was running the country. But it did not take long for me to recognize that he was going to exploit people's fear and outrage for his own political ends. By the end of October at the very latest, I was recognizing that bad things were on the horizon.

I opposed Bush's war from the start. I recognized that his stories about Weapons of Mass Destruction were a lie and a sham. The name itself was such an obvious propoganda creation that it was difficult for me to believe that otherwise educated Americans couldn't see through it. The U.N. weapons inspectors inside Iraq insisted there was no evidence that the Iraqis were making these WMD's. The entire world was satisified with this - but Bush and his cronies pushed forward anyway.

I watched with growing disillusion as Bush drummed up support for what I already believed was an immoral war. This was made all the more worse because so much of the world was patently opposed to our actions, and I recognized that we were making enemies and that Bush was doing incredible harm to America's reputation. As far as the world stage was concerned, I felt embarassed.

The war, of course, wasn't the only thing that I found distressing about Bush. I watched as he loosened environmental policies, promising instead - you guessed it - tax cuts (yay!) - for companies that voluntarily cleaned up their pollution. I watched as Bush antagonized Iran and North Korea with his Texas cowboy slang. I watched as Bush backed out of the Kyoto Treaty, a longstanding environmental treaty that every developed country on earth was a part of. I watched as Bush kowtowed to the religious right and banned stem cell research, effectively putting the U.S. years behind the rest of the world in one of the most important sciences in the modern world. I watched as Bush maneveuered the country closer and closer to removing the rights of a woman to choose what to do with her own body.

By 2004, I was desperate to see Bush replaced with a Democrat - some balance in Washington after 4 years of unilateral Republican/Conservative rule. I strongly supported John Kerry, feeling that he was several steps above Al Gore, and that he was a great choice for president. I still didn't feel like Kerry was the absolute "best candidate ever," but I felt that he was above Gore, and head and shoulders above Bush - who had already proved that he wasn't competent to do the job. Up to that time, I routinely heard Bush supporters talk about how "awful" things would have been if Gore had won. It was a way, I felt, that they made themselves feel better about Bush's less than stellar record. But regardless of speculation about Gore, I felt that Kerry was clearly the better choice, and Bush had demonstrated for everyone to see that he was a failure as a president.

But it was not to be. Kerry did not run a particularly stellar campaign, and Bush ended up winning more votes than he had in 2000 - which at the time totally shocked me. I couldn't believe that ANY Democrat who voted for Gore in 2000 would have voted for Bush in 2004, and I felt that at least some Republicans would switch to Kerry. But that's not how it turned out.

By that 2004 election, I was divorced from M and living by myself in a grungy little apartment. I don't actually remember watching the election results in 2004, the way I remember watching in 2000, although I'm sure I did. I suppose it was probably obvious fairly early on that Bush was going to win, so I turned it off. I do remember getting up the following morning and checking the TV to make sure, and feeling that sense of hopeless dread when it was confirmed for me that Bush had won a second term.

That evening, after getting home from work, I wrote the following poem:

the aftermath

november 4th, 2004

i woke up in the middle
of the night
and it was raining.
i let my dog out,
standing before the
sliding glass door
in my boxer shorts.
it was cold
and the rain dripped from
the doorframe.

by dawn, the rain had ended,
but it was chilly
and a fierce wind blew out of the east.

a heavy shelf of dark clouds
hung overhead,
and in the distance, white-peaked
cumulonimbus piled on the horizon
like snow-covered mountains.

everything was wet
and the trees were spindly and bare.
dead leaves, clumped and muddy,
clung together in gutters,
as though hiding from the cold…

or something else.

morning traffic went on as normal,
and businesses opened and
fast food restaurants served their morning coffees.

but you could see the difference
in the weather.
nature knew,
even if the two-legged creatures who ruled her
remained oblivious.

they didn’t seem to understand,
couldn’t see what they’d done,
how they’d poisoned their own futures.

but nature knew.
she understood the display of
hubris reinforced by ignorance,
knew what a dangerous combination it was.

and she was in mourning.

I definitely remember feeling a legitimate feeling of hopelessness that day. I had hoped for so long that things would change, and instead the American people simply handed Bush their seal of approval. I felt far more upset by the resuls of the 2004 election than I did by the results of the 2000 election. The 2000 election, for me, was a choice between the lesser of two evils. I felt that Gore was clearly the lesser of those two evils, but I was able to see that neither candidate was particularly excellent. However, in 2004, we had 4 years of substantial proof that Bush was a failure. The fact that Kerry lost, for me, was a sad and depressing commentary not on the inadequacy of Kerry or the Democrats, but on the American public for re-electing a president who had proven that he was a profound disaster.

Well, four more years passed. The rich got richer and the poor seemed to get poorer. The economy worsened, America's reputation on the national stage was in shambles, and the war - which Bush said was over a month after the initial invasion - dragged on and more and more soldiers kept dying.

I got interested very early on in the possibilities for the 2008 election (for obvious reasons), and I felt more passionately for Obama than I had for any presidential candidate in my life. I literally felt pent-up with anxiety throughout the election season, wondering if we would take four more years of the same failed policies, or if America would finally wake up. The day Obama was elected was one of the most exciting days of my life.

It's now 1:27 - exactly 1 hour since I started writing. Bush has less than 11 hours left in office.

It has been nice, in the last few weeks, to see Bush actually act like a real person in several interviews. He has been a puppet on a string for the last 8 years, and I think we've seen more of the real George W. Bush in the last few weeks than we've ever seen before. I was surprised to hear him admit that he is not a bible literalist a few weeks back. He sure did do a lot to make those bible literalists happy during his presidency though. One might say he spent 8 years sucking their proverbial dicks.

It was also nice to hear him admit a few mistakes. I recall specifically during the 2004 election when he was asked a similar question. "What mistakes do you think you've made in your first term?" He dodged the question and responded with something like: "Well, I don't know, I'd have to think about that. I'm sure you news people could think of some. I'm sure I've probably made a few mistakes, but I can't really think of anything right now." I just remember thinking to myself that if he had actually had the balls to admit a mistake or two, I might have gained an ounce of respect for him. Instead, he just went deeper into the realms of uselessness. Honesty, integrity, openness, and unity were never part of the Bush administration's agenda. So it was nice to hear him finally admit to a few mistakes, but the honesty came 8 years too late.

Bush has said that he believes history will vindicate him. He believes the historians will remember his presidency favorably. Well, of course he's going to say that - what else would he say? "Yeah, historians will pretty much rank me down there with Andrew Johnson and Warren Harding." The fact that he even has to make remarks about how historians will view his presidency is pretty powerful evidence of just how much his legacy is in jeopardy.

I believe historians will not look favorably upon Bush's presidency. I believe he will get credit for toppling a sadistic dictator in Sadam Hussein, but I think that his invasion of Iraq will be seen as an abuse of power that was carried out with lies and unfounded propoganda, exploiting people's fear, outrage, and suffering after 9/11.

I believe his tacticts in the "war on terror" will cause historians to remember him as a president who felt that he was above the constitution and that the "means justified the ends."

I believe his poor response to Katrina will be seen as evidence of poor leadership. I believe he will be remembered as a president who held America back from technological advancement in the field of genetic research - a feild that promises to change the world in the next century.

I believe he will be remembered for flouting science's warnings about pollution, global warming, and the environment, and I believe he will be blamed for not doing enough to stress the need for alternative fuel sources, focusing instead on drilling in national parks.

Finally, and perhaps most significantly, I believe Bush will be compared to Herbert Hoover in regards to leading our country into a severe economic recession, bording on outright depression. I believe that blame will be put on his shoulders for failure of oversight, for continuing his predecessors policies of deregulation despite the strong economic indicators saying things needed to be changed. His obsession with war and the "war on terror" will be seen has having blinded him to what was going on in his own backyard. I believe Bush's connection to this economic recession will be remembered even more strongly if Obama succeeds in bringing the country back into prosperity.

Perhaps more than anything else, I believe Bush will be remembered as a president without vision, a president who was always reactive instead of proactive, a president without the leadership ability or charisma to unify America during difficult years, a president who made difficult years remarkably more difficult with misguided policies that served the elite at the expense of the average.

Bush says history will remember him well. He apparently cannot even understand why his presidency is such an abysmal failure. If he can't even understand that - or be honest enough to admit it - then is it any wonder that he failed in the first place?

Saturday, January 10, 2009

Musings from the Operating Room

This week at my clinical site, I got to run the C-Arm in the operating room for the first time. Other than seeing occasional surgeries on TV, I had never actually witnessed one myself.

I suppose my first impression was that surgeons really are just butchers. There is a lot of blood everywhere - all over their aprons and gloves, dripping all over the floor, soaked up by surgical towels.

Furthermore, when they are installing hardware to repair broken bones, they are literally using carpenter's tools. Drills, hammers, rods, nails, and screws. I don't mean specially-designed surgery screws, for instance. I mean actual screws that differ from the screws you use to hang a picture only in that they have been sterlized in an autoclave. These are screwed into place with screwdrivers with specially-modified handles.

Additionally, I always had the impression that surgery was very gentle and careful. You see shows on TV with neurosurgeons using computer-guided robots to carefully and precisely go into veins and arteries - very sensitive procedures where a slip of even 1 centimeter might mean catastrophic results.

In regular old surgery, however, it's not like that. They are standing with legs apart for good support, and hammering away with big strokes at rods that are being placed inside a bone. They are opening the flesh and then straining to hold it back with clamps and other wedge devices, exposing all the blood and gore and tissue beneath. It's not unlike watching a butcher cut up a rump roast.

Another thing about surgery is that most people think of what surgery looks like, but they rarely think about what it smells like. The smells were sometimes very bothersome. It literally smelled sometimes like a slaughterhouse. When they cauterize bleeding vessels, you get the pungent whiff of burned flesh.

Finally, if anyone has any delusions about dignity during their own surgery, they can forget them. During the procedure itself, only the area being worked on is exposed. But before and after the procedure, the person - still asleep - is literally just laying there buck naked, everything showing, being turned over and moved and oriented like a corpse. Tubes are in their mouth and nose, and their eyes are taped shut and they are drooling and their lips are all swollen and hanging open, and they essentially look like a vegetable in a loony ward, or a dead person. I saw them insert a catheter into a 15-year old boy's penis, and the catheter was about as thick as the shaft of a pen - maybe thicker. WAY thicker than what you'd expect could fit into that opening. Another person was having a hip fracture repaired, and he was laying on his stomach, buck naked, with a sanitary cloth under his butt to catch any fecal matter that might come out, and someone was literally perched over top of him on the table shaving the hair on his butt and back.

All told, I saw five procedures this week. The first day was the aforementioned 15-year old boy, who was having a pretty serious elbow fracture repaired. I walked into the room and saw nothing but an arm protruding from under the sterilized sheets, completely laid open from mid-triceps to mid-forearm. I could see one of the broken bones - a sharp peice from the bottom of the humerus - jutting out like a spear head. I could also see the base of the humerus, which is essentially like a spool of thread, that the elbow rotates against. It was cracked as well. There was very little blood because they had a tourniquet on his arm to keep all the blood above his shoulder. So the arm was white and limp and wrinkled and orange from antiseptic, and the doctors were busy putting in screws and plates. When they finished, I watched them sew up the opening.

Later that day, I was in the room for a broken hip - this was the aforementioned butt hair patient. After they started the surgery, only his left butt cheek and upper thigh were visible, and they basically opened him up all along that portion of his body, then held the tissue back with tools that looked like door wreath hangers. There was one person there - perhaps a med school student - whose only job was to hold these in place and keep the opening nice and wide and gaping.

The following day I saw two cases where patients were getting rods and screws placed to fix broken legs, and a third case where they were inserting a "portocath" into a woman's heart. She was awake for the procedure.

I was able to do a lot with the C-Arm, positioning it where the doctor wanted and then taking spot films. They use the C-Arm - which is fluoroscopic (meaning, sort of like a "video" X-ray...or real time X-ray) - to see where the screws and rods are that they are putting in. So we took a lot of spot films as they determined exactly where they wanted to drill, hammer, and screw. The blood was so thick on the floor of one of the femur patients in the spot where it was dripping that it had the consistency of jello.

When I wasn't in the O.R. this week, I did a bunch of portable X-rays on inpatients there at the hospital. These are difficult because you are X-raying people in their beds inside their rooms, using a portable X-ray machine. Depending on how sick they are, you usually have to lift them and turn them and orient them to get the picture, and they usually have tons of IV's and other tubes and wires all over them, which are easy to pull out if you aren't careful. We did a number of people in the various ICU wards, including one man in the burn unit who was so badly burned across his torso that he looked like he was rotting. We did another guy who had just been moved from his room down to the ICU because he had coded (meaning he started dying and they revived him), and so we had to go down to the ICU to do his picture there. He had severe emphysema and other lung problems, and was gasping for breath so hard that I could see the entire outline of his sternum and ribs beneath his chest each time he gasped for breath. I could even clearly see his xiphoid process, which is the very lowest tip of the sternum and which is even hard to feel on a patient, much less see. I thought he was literally going to die right there on the table.

So it's been an interesting week, and while its disturbing and depressing, it's also something new and exciting for me. I really think I would enjoy working for a big city hospital like this, a level 1 trauma center. And I haven't even been to the E.R. yet.

I was glad that the surgeries didn't bother me. I never got queasy or woozy or anything, and I was able to watch and even get pretty close to see what was going on, without having any problem. Because the patients is completely covered during the procedure, and because the skin is white and wrinkled and orangish with antiseptic, its almost hard to imagine that it's a real human being. It looks more like a rump roast in the Kroger meat market. It doesn't look human. The only thing that really bothered me was the aforementioned smell. You have a mask on, but it doesn't keep the smell away, and in fact it sort of traps it in front of your nose and its hard to get away from it.

Despite not being physically bothered by the surgeries, I think I was psychologically bothered, even though I didn't realize it at first. The reason for this is that last night, after my third day, I had really bizarre, violent, gory, bloody dreams. I woke up feeling very disturbed and with the recognition that the dreams had occurred as a result of being in those O.R. rooms. At the time, when I was still groggy with sleep, I actually thought to myself that I didn't want to go back there again. I don't feel that way now though.

I'm scheduled to be on another week of O.R. rotations, and then 2 weeks of E.R. rotations. My final week there will just be on the floor, doing fluoro exams and portables.

Sunday, January 04, 2009

Back to the Grind

My month-long vacation (which wasn't really a vacation since I worked the whole time) is just about over. School starts up again on Monday, and this is going to be a difficult quarter because I have class from 10-2 on Monday and Friday, and then clinicals all day Tuesday, Wednesday, and Thursday. For the past few quarters, I've had the 3-day a week clinicals, but only had class for 2 hours on Mondays only. So I'm picking up an additional 6 hours per week of class time, which also results in a proportional increase in studying time. Also, from what I understand, the classes I have this quarter are going to be difficult and require a lot of reading (Pathophysiology and Quality Assurance).

We spent Christmas at the in-laws, and then we just got back Saturday morning from the Lake, where we spent New Year's with M's sister and her family. We had a good time, and it was nice being down there all week with no one else around. The Lake isn't a popular place in the winter, and the resort where M's parents have their lake house was empty and quiet. We took a trip on Thursday out to Cumberland Falls, a place I had never been before. It was beautiful.

Cumberland Falls

That's not a picture I took; I found it on the Internet. But it gives a good view of the falls. The water flow was actually considerably heavier when we were there than what it is in this picture.

Cumberland Falls is apparently the only spot in the Western Hemisphere that produces a Lunar Rainbow - or what is more commonly called a "moonbow." On clear nights, particularly in the fall, when there is a full moon, it causes a rainbow to form. The rainbow colors are there, but you usually can't see them, so it look instead like a white or silvery rainbow.

Anyway...we had a nice time down there. Got back Saturday morning and I had to work Saturday evening. I also work on Sunday, and then - as I said - back to the grind of school on Monday. So my "time off" is essentially done - I don't know when I'll have an honest-to-God day off again.

I've been giving some thought to possibly eventually entering a Physician Assistant master's program. If I did it, it wouldn't be for a couple of years - obviously I want to finish my X-ray program, and work for a while in the field, before I make any final decisions. But I've been looking at P.A. programs, and I think I would enjoy it and be able to do well. P.A.'s, of course, are a step below doctors, and they work with doctors, usually doing the more routine things, thereby allowing the doctors to focus on the more difficult patients/procedures. I've worked with several P.A. Radiologists, and I think I would enjoy doing that - they do a lot of fluoro examinations, and they read X-rays etc. The pay is also really good - according to the Department of Labor, the average 1st year P.A. makes 70K per year, and the top 10% of P.A.'s make over 100K.

I've looked into a program in Kettering, OH, which is near Dayton. It's a Master's Degree program, and takes two years - you basically do a year of classes, then a year of rotations - not unlike what medical school students do, with required rotations and then "elective" rotations so you can get experience in whatever field of medicine you are interested in. I would have to take about 3 semesters' worth of prerequisite classes first, however, because my degree is in History, not one of the sciences. So it would probably take me about 3 years, all together.

So anyway...maybe 4 or 5 years down the road. I suppose it will depend on how much I like the medical field once I am out there working, how much I'm making as a radiographer, how much opportunity I have for advancement wherever I'm working, how my writing is panning out, etc., etc.

I haven't forgotten that I'm a fiction writer, by the way. I do still dream of writing novels and publishing books and writing for a living. I just haven't written any fiction in about two years. I knew that's what would happen when I went back to school - which is why I didn't do it until after I was 30. That's also why I say that my writing aspirations will play a role in deciding whether or not to go back to school AGAIN in 4 or 5 years.

I have a file on my computer with a list of about 10 book ideas, some of which predate starting school, and some that I've developed in the last few years. I even have rough outlines on a couple of them. So I have plenty of material to work with once I get back to having a normal lifestyle again. Of course, with all my loan debt, I'm going to have to work a lot of overtime when I get out of school, and possibly even have to get a second job somewhere - so it's not like I'm going to graduate and suddenly go back to working 40 hours a week again, and having the rest of the time to myself (for writing) and my family.

The important thing is that it is now 2009, that seemingly long-awaited year that I finally graduate. Granted, it won't happen until December, but it at least feels nice that it's finally 2009. 2009 seemed like a very long time in the future when I was starting this program in 2006.

I just finished the book The Last Week, written by scholars Marcus Borg and John Dominic Crossan, discussing the story of the final week of Jesus' life as depicted in the Gospel of Mark. It's a fascinating exegesis (interpretation) of that text, and I highly recommend it. It's written for the average reader, and interprets the text within its own context, meaning it's not about any attempts at a historical reconstruction or proving that this story or that story is true or not true. It's simply a look - almost a sermon, if you will - about what Mark is saying about Jesus' last week on earth. Very, very enlightening. I would even say inspiring.

We're having a middle-of-the-night thunderstorm in January. Very odd. There's probably a poem in there somewhere, but I'm not sure I'm up to it.

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