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kesmarn On November - 13 - 2010

Nobody, including the patient, was entirely sure when the last time was that she had been able to walk unassisted. Was it when she hit the 350 pound mark? Probably not after she reached 400. Now that she was just below the 500 mark, she knew and we knew, that it was no longer possible.

She came into the hospital with a list of medications that was 12 pages long. Much of the list was tranquilizers, anti-depressants and pain medications. The size of the dosages was enormous. But then dosages are often calculated on body weight. She was also on four different types of anti-diabetes meds — three of them various forms of insulin.

It took 4 staff members to move her from the gurney to the bed. After a few attempts, it became clear that starting a peripheral IV on her would be impossible. No needle was long enough to penetrate the fat and reach the vein below.  A PICC line (longer catheter placeed in a deeper vein) insertion, done by an interventional radiologist was scheduled.

The attending doctor ordered an 1800 calorie diabetic diet. The patient  ate it all and then ate another meal brought in to her by a “friend.” After all, there was always more insulin to “cover” the blood sugar elevation that would result, wasn’t there?

The doctor did deny her request for a Foley catheter, though. He felt that the small movement from the bed to the picnic-bench sized commode we placed in the room (since the toilet ten feet from the bed was too far  to walk) would be about the only exercise she would get, and she badly needed it.

The pain in her knees, hips and shoulders? Well, getting rid of the weight would have relieved a great deal of that. But instead she said: “Can’t you just give me enough pain meds so that I don’t feel it any more?”

About now, dear reader, you’re probably saying: “My, my, aren’t you the judgmental little witch!” And I answer: “I’m not a witch. I’m not any of the things you’ve heard. Because she is us.”

My patient is a human being with intrinsic value. And she is America — or at least a segment of America — at the moment.

She says: “Please — don’t ask me how I got this way. Please, don’t tell me I’m going to have to do anything hard to fix things. You don’t expect me to be patient for the years it will take to get back on track, do you? Surely there’s some brilliant person out there who will — any minute now — invent a pill that will fix all this.”

In the mean time — someone else has to do the heavy lifting. Someone else has to plan, to think ahead, to try to ward off the consequences of years of bad management.

The problem is, there are getting to be fewer and fewer of those “someone elses.” People who step in and rescue when things go haywire. People like Barack Obama.

And there are getting to be more and more “you-do-it” people…who think that paying taxes is for suckers, and siphoning money from the pockets of the working class into those of the idle rich is what capitalism is all about.

A nation can only support so many 500 pound Wall Street boys, Fox News commentators and Rush Limbaugh fans. People who want the goodies without the price tag attached. Beyond a certain point, when these guys push the call button — there won’t be anyone left to answer.

Written by kesmarn

History major "back when," who recently retired from having been an RN for a bazillion years. Political junkie. Warren, Sanders and Reich fan. Happy to have been a Planeteer for more than five years now!

25 Responses so far.

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  1. PatsyT says:

    Kes, This is excellent!
    First of all… Bravo! You have put together a powerful piece of work.
    Your post got me thinking about the chain of addiction and how both of your subjects are victims of it.
    Food -Drugs- Money- Greed- Power
    They will always need more and more to support the habit.
    We really need Richard Simmons!

  2. SueInCa says:

    What a great analogy. Do you mind if I use it in other blogs? It is really a great way to get people’s attention. You really should write more. I loved it!

    • kesmarn says:

      Sue, you are too kind! Please feel free to C & P the whole darn thing, if it helps to get the word out!

      This was one of those things that really more or less wrote itself, based on some real life experiences at work. I usually do outlines, research, drafts and stuff, but --for better or worse — this one was WYSIWYG.

      • SueInCa says:

        Ok Ok, I will ask, what is wysiwyg? And believe me you do have a knack for writing and should do it more often, as the spirit moves you that is.

        I am always about getting the word out.

        • kesmarn says:

          Ooops, Sue! That’s what I get for hanging out with my grad school son!

          wysiwyg (often pronounced as “wizzy-wig”) is short for “what you see is what you get.” 😆

          I do so much appreciate your encouragement, Sue. I do love writing. (Have always felt like a bit of an impostor as a nurse, to tell you the truth…)
          Like painting and drawing, writing feels like the “real” me in many ways. But enough self-analysis!

          Thank you again, your words are just like getting a bouquet of flowers!

  3. Questinia says:

    I have so often used this same comparison, kes, when describing our country. You hit the nail on the head. I thoroughly agree with wts and the phenomenon of learned helplessness. The only people who aren’t in the thralls of LH are those who abuse and control. We know who they are.

    • kesmarn says:

      Thanks, Q! I think we all know people (or have been there ourselves) who have gotten to such a desperate place in life that summoning up the energy even to formulate an exit plan becomes almost impossible. That’s when it really helps to have someone around who says: “Yes, we can!”

  4. whatsthatsound says:

    Great, Kesmarn! So true. What a powerful metaphor for the state our country is in. “Learned Helplessness”.

    • kesmarn says:

      “Learned helplessness” is the word for it, wts!

      Maybe the trick to coping is that age old suggestion about making a determination about what things we actually do have some control over, (getting up out of our chairs? voting?) and what we don’t. (tornadoes? Martian invasions?) Then we do what we can and chill out about what we can’t!

      Sometimes easier said than done.

      But this way lies sanity, no?

      • whatsthatsound says:

        Exactly. And I think it’s important to experience greater sadness than anger over what’s happened. At least that’s how I see it. Anger leads to the polarization that doesn’t do anybody any good. We may see people who appear to us as “losers”, either physically or mentally, or in so many cases in the U.S., both.
        But we need to recognize them as in essence victims, of a society that made too many wrong turns and went off a cliff. We used to produce such quality minds, from Twain to Thoreau to Fuller. So much of what we produce now is just shlock, junk food for the mind and the body. Our society actually engineers people like the lady in your story. That’s the real shock of it, and the real tragedy of it.
        There’s too much anger already. What I think we need is a great big “Cry-A-Thon”; a national grieving over what we’ve become, and what all we lost on our way to getting here.
        Not Glenn Beck fake tears, either. Maybe no tears at all, certainly nothing showy. Just getting in touch with the deep sadness we feel that our country isn’t what it could have been, and then going from there.

        • kesmarn says:

          The national Cry-a-thon might be an idea worth looking into, WTS! Cathartic at least — and a starting point for re-building hope.

          Yes--our society does engineer people like the lady I described. She’s in a difficult spot because all her “sins” and mis-judgments are so very public — so external and “in your face.” Hence, she becomes a target for peoples’ contempt.

          But what about the people who have 500 pound souls, like Dubya or Ann Coulter? Acceptable-looking on the outside, but greedy predators within. They do much more damage than my poor patient ever could.

          And the wealthiest 1% who fight any small additional tax with such fury? They may be liposuctioned and “personally trained” into shape, but their spirits are gigantically flabby.

          I guess the question of the hour is: when is enough enough?

      • boomer1949 says:

        I posted this last year, but it still fits. Never mind OH-IO just beat PSU, but as a Psychology major, this fits the bill:

  5. Kalima says:

    Oh kes, this is just what the doctor ordered. A postively delightful take on the “double genre” filled with facts about the mind set of far too many of your countrymen and women today. The apathy is truly frustrating and confusing to me, and I believe that anyone who was too lazy to vote, has no right to complain, and those who voted GOP or TP out of “anger” deserve exactly what they get.

    Wonderful post!

    • kesmarn says:

      And I’m afraid those angry/apathetic folks are just about to get it, Kalima!

      Thank you for your kind words.

      • Kalima says:

        Unfortunately, the rest of the country is too.

        Of course the baggers have no hope in he’ll to change or successfully repeal anything they promised their voters, but they can waste a lot of precious time with their crazy nonsense.

  6. bitohistory says:

    Calories In and In and In, and ignoring the facts make for an unhealthy body, eh!

    Good post k’es!

    I just read a piece on the plan That President Obama has dealing with the tax cuts and how they affect the deficits and the debt. His ideas, plan is quite good and sound, yet he is seen as the doctor attempting to control the diet, and made out to be an evil and nasty man, while some ignore the facts and smuggle in the pizza, ice cream and chocolates to the already obese.

    Keep lower rates for rich on dividends, capital gains: A rewrite.

    ( and never mention atrial picc’s again please. OW! :-) )

    • kesmarn says:

      Kinda the way Sarah Palin makes sure she brings cookies to the school party, b’ito…

      Just to show that big bad Nanny Obama where his “place” is?

  7. AlphaBitch says:

    Great post, kesmarn!

  8. AdLib says:

    What a wonderfully brilliant piece, Kes!

    You have artfully “embodied” the American psyche so simply and concisely!

    And the “body” of our democracy as well, a victim of its own excesses, bloated, helpless, immobilized by how huge its grown.

    Well done! This post needs to and deserves to be circulated around the web!

    • kesmarn says:

      Gosh…I’m blushing.

      That is high praise indeed, coming from one of my favorite writers!

      Thank you so much.

      • AdLib says:

        As Boomer says, the props were well earned and well deserved. You really hit it out of the park!

      • boomer1949 says:

        Oh for heaven’s sake — don’t blush. It is excellent! When the big guy speaks, it is the real deal. Congrats kes, great post. :smile:

        • kesmarn says:

          Thanks so much, boomer.

          Living in Ohio — well you “get” what I’m referring to here! 😀

          • boomer1949 says:

            And a thumbs up from the Big Guy does make ones heart skip a beat or two (don’t tell him I made even the slightest connection) — blush or whatever — still feels good, eh? xoxo

            Wallow in it girlfriend, wallow in it. Way cool & others have never made it this far with the Big Guy!! Of course we’re drop dead gorgeous and some leave much to be desired. 😉

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