Tuesday, January 26, 2010

Phlebotomy plebe

I owe this blog post to Laura the Nervous Intern.

I haven't been feeling much like writing lately. December and January were difficult months. I'm still healing from my breakup with Monte and reeling from the realities of living in a strange place. My friend Rebecca has kindly allowed me the use of her home for a couple of months until I get back on my feet, and that's been a blessing. But frankly, living alone in an unfamiliar place has not a been barrel of laughs. I've been feeling kind of lonely and removed from my life, and I haven't really wanted to write about it.

Stress set in a few weeks back and I was laid low with a bad illness. It felt like strep, or tonsillitis. With no health insurance, I turned to the Glide clinic for care. They put me on a slew of meds and fixed me right up. I was impressed that the nurse practitioner spent more time with me than any doctor ever has. And then for good measure she sent me to the hospital for a full lab work-up. "Just to be thorough," she said.

So today I went to the hospital to get my blood drawn. I'd been fasting since the night before, but then I overslept, so by the time I arrived at the lab it was late in the morning and I was getting hungry.

I checked in at the front desk. "Hi Errin," said a cheerful man in scrubs, locating my name with the merest glance at my forms. "Have you fasted for 12 hours today?"

"Yes," I said.

"Great. And do you mind having a student take your blood?"

"Nope."

"All right. Have a seat and someone will be with you in a few minutes." He gestured toward the chairs.

It was about twenty minutes before someone called my name, but I was occupied with my book and not perturbed. As a matter of fact, I didn't mind waiting, because I'd been doing the math and realized that it had really been more like ten and a half hours since I'd last eaten. I was hoping it didn't matter too much, but I figured it couldn't hurt to wait out the clock a bit.

People kept checking in at the front desk. "Do you mind having a student take your blood today?" I heard more than once. Nobody seemed to mind. I thought it was nice that we were all willing to help the students learn. It didn't make me nervous or anything. It was just a simple blood draw.

"Is there an Errin here?" came a low, timid voice. I raised my hand halfway and gathered up my things.

"Hi there," I said as I followed the woman down the hallway. She ushered me into a room.

"Hi," she said in a hushed monotone. "Um, have a seat." I took off my jacket and sat down. I noticed her name tag said Laura.

Another woman (another student phlebotomist I assumed) entered and greeted me as well. She and Laura conferred for a moment about what time they would each take their break.

"So, I think it's been more like eleven hours since I last ate," I told them. "Is that going to matter?"

For an instant they both froze. Laura looked at me with big round eyes and said in her odd voice, "That depends. Do you get queasy around blood?"

Hmm. "Probably," I said. "But I'm not going to watch."

She stared at me. "Do you have a problem with needles?" she asked.

"Well, sure," I said. "Doesn't everybody?"

"I sure do," said the other student, and laughed.

"I don't," said Laura emphatically.

I was starting to get a weird vibe from Laura.

"Anyway, it's more like eight to twelve hours," said the other student and she waved away my concerns. I watched as she took a juice box and a granola bar from a cabinet, dropped them into a labeled paper bag and then walked out of the room. There was a stack of paper bags on the counter beside me. I peeked at the label:

Phlebotomist who served you today is _______.

In our continuous efforts to provide you with Quality 5 Star Service, we acknowledge that you have been required to fast for these laboratory tests. If you have no other procedures that require you to be fasting, please enjoy this snack we have enclosed for your benefit.

I thought that was a nice touch.

Laura seemed unsure of what to do first. She picked up a few vials then put them down. "I'm an intern," she said abruptly. "I have to tell you that."

"O-okay," I said, in what I hoped was an assuring tone of voice. She seemed a little nervous. I adopted a pose of unconcern in hopes that she might draw from my well of calmness.

It didn't seem to work though. She pulled on a pair of rubber gloves and I knew right away that I was in trouble.

When doctors on TV pull on their rubber gloves they do so with one decisive snap. Putting on the gloves is second nature. It's not something you should have to think about.

But Laura was thinking way too hard about her gloves. She slipped her hand in halfway and then wiggled her fingers to try and shake the thing down to her wrist. When that didn't work she gave a series of half-hearted tugs, then pulled awkwardly around each finger until she finally shimmied her digits into place.

My heart sank. My physical discomfort was in direct proportion to her manual dexterity and the woman couldn't put on a pair of rubber gloves.

"Okay. Lay your arm on the table," she instructed, and I did. She tied a rubber strip above my elbow. It was WAY too tight. I lost the feeling in my hand almost immediately.

"Ow, that kinda hurts," I said.

"Oh, sorry," she said, pulling it off. "Was that too tight?"

"Yeah."

"Okay. Sorry. Sometimes we can pull your sleeve down like this," she said, pulling my sleeve down, "and tie it over the fabric so that the rubber doesn't pinch your skin." It sounded as though she were quoting directly from a recent lesson and my unease started to grow. Still, I wanted to give her the benefit of the doubt, so I smiled at her and said, "That's better."

"Okay. Um...okay." She was looking around the room, for clues, it seemed. I could almost see her reciting the order of operations in her head.

"Now I'm going to look for a vein. Make a fist." I balled up my hand. She inspected my arm closely.

"No, make a fist like this," she said, demonstrating. I released my hand, then made a fist exactly as I'd done it the first time. "Yeah, that's better," she said.

She leaned low over my arm and poked experimentally at the crook of my elbow. Poke. Poke. She looked at my hand. "Did you stop making a fist?"

"No," I said.

"Oh. Okay." Poke. Poke. She took my arm between her hands and turned it slightly. I felt a tremor in my arm and looked down at it.

Holy shit. Laura's hands were visibly shaking. We seemed to become aware of it at the same time, and she pressed harder on my arm to smother the trembling.

"Oh, there's one," she said, and her voice sounded weirdly high. She pointed at a vein that seemed to be out of the poking zone. It was closer to my forearm than the crook of my elbow.

"All the way over there?" I asked doubtfully.

"Sure," she said. "That should work." She let go of my arm, immediately lost the vein and started poking at me again.

At that point I started looking around for a supervisor.

"I'm just going to, um..." Laura said, losing her train of thought as she fumbled around in the drawers for supplies. "I'm going to...um..." She consulted my paperwork two, then three times.

I watched her with mounting alarm as she set up four vials on the counter. "You're filling four vials?" I asked her.

She squinted at my paperwork again. "Uh, yeah. You've got a lot of tests."

Oh my God. This woman was going to try to pull four vials of blood from what even I could tell was a non-participating vein. With shaking hands! Was I really going to let her do this?

She pulled out an alcohol swab and swished it tentatively over my skin. Her look of concentration was intense. I opened my mouth, feeling the words rush up from my gut. Wait, I was going to tell her. Wait just a minute.

But I didn't say anything. Because honestly, the blog post was already writing itself in my head, and I kinda wanted to see what would happen.

Laura discarded the alcohol swab and patted the spot uncertainly with a cotton ball. Then she prepped the needle. I watched her attach it to a vial and prepared to avert my eyes.

She swooped down on me. "Don't watch," she said fiercely.

Don't worry, I thought. I trained my eyes on the ceiling.

"You're going to feel a little pinch," she said. But I braced myself as though I was about to be stabbed.

To Laura's credit, it really was only a little pinch. I concentrated on the ceiling and breathed deeply in and out. It's not the needle prick that disturbs me so much as the perceived sensation of blood leaving my body. It's an odd thing, but sometimes I think prolonged discomfort bothers me a lot more than actual pain.

Out of the corner of my eye I saw Laura shake her head back and forth.

That couldn't be good.

But she made decisive movements with her hands and I thought I sensed her switching the vials, so I focused on my breathing and let her do her thing.

A moment later, another shake of the head. And under her breath I thought I heard her say, "Oh no."

My neck muscles tensed but I was afraid to look. I felt a sudden pressure in the crook of my elbow. "Hold this," Laura commanded with more authority in her voice than I'd heard so far, and I chanced a glance down to see her pressing a cotton ball to my skin. I put my finger on it, and thus relieved she took a big step back from me.

"I didn't get it," she said, looking me square in the eye. "I'm only allowed to try once. If I don't get the blood I can't try a second time." This seemed like an eminently sensible policy to me, and I nodded. "I'm going to have to get a phlebotomist."

There was a curious confidence in her manner now that the deed was done, and failed. Maybe it was a touch of defiance? Hell, I wasn't judging. I was just happy that this woman wasn't going to stick any more needles in me.

"I'm going to get a phlebotomist," she said again and swept out of the room to the right. A second later she bumbled back in and exited again from the door on the left.

While she was gone, I lifted the cotton ball on my arm to take a peek at her work. There was a neat little hole in my skin. It was nowhere near the vein.

A moment later the phlebotomist bustled in, all competence and swift movement. Laura slunk in behind her. "Hello," said the phlebotomist, snapping on her gloves with authority.

Instantly I relaxed. Now that's how you do it, I thought with relief.

"How about we try the other arm, yeah?" she asked as she wound bright green tape around my minuscule wound. I laid my left arm on the table.

The phlebotomist ignored the vials that Laura had so precariously perched in the little vial holder. She flicked a glance at my paperwork and pulled four new vials from the cabinet, then swabbed my skin and prepped the needle with admirable speed and certainty. I looked up at the ceiling again and felt the pinch in my arm. I breathed in and out.

Seconds later she was done. "Hold this," she instructed, and I pressed another cotton ball to my skin. I looked down at the counter and saw four full vials of blood. My God, the woman was good. Four vials of blood in what couldn't have been more than twenty seconds.

She wrapped my left arm in bright green tape. I thought a Band-Aid would have sufficed, but I wasn't going to complain. The needle part was over, and I wasn't spouting blood all over the walls, which was good enough for me.

"All set," said the phlebotomist. She swept up my samples and left, not even glancing at Laura, who had shrunk into the corner. I struggled back into my jacket, with arms that now wouldn't bend at the elbows, thanks to all the green tape.

Laura said, "I'm sorry about before."

"That's okay," I said. It wasn't, really, but at least I'd only been stuck twice and not treated like a human pincushion. It could have been much worse.

Laura was blocking the door, looking glum. I wanted to take her out for coffee and discuss her career options. I wondered if you can get fired from phlebotomy school.

Suddenly she brightened. "Would you like some apple juice and a granola bar?" she asked me hopefully.

"Um, okay. Sure."

Laura reached for a paper bag and snapped it open with authority. She dropped a juice box and a granola bar inside, then folded over the top of the bag with precision. She beamed as she passed it to me with hands that did not shake.

And I wondered if maybe there wasn't a career for Laura in Food Service.

I smiled and thanked her, and as I left the hospital all I could think was: I am going to write about that lady.

I came straight to this coffee shop to jot down the story. I'm still wearing the bright green tape. I haven't had an urge to write like this in months.

And so I'll say it again:

I owe this blog post to Laura the Nervous Intern.

Saturday, January 23, 2010

I'm not back yet...

...but this Craigslist ad I found today is just too good not to be shared:

tanned legs and feet


Date: 2010-01-20, 3:39AM PST
Reply to: gigs-xxxxxxxxxx@craigslist.org


I'm looking for a blond that has tanned legs and feet. I understand that there are spray and rub on tans but my client wants a natural tan. You must have nice legs and feet. This will focus and legs and feet. It will also involve rabbits and possibly a large lizard down at your feet so you must be comfortable with that. Please submit a picture of you legs and feet without polish to xxxxxxxx@hotmail.com. The pay is $50/hr there is a one hour min.

  • it's NOT ok to contact this poster with services or other commercial interests
  • Compensation: $50./hr

That really kind of made my day.

OK, I'm going back into hiding now. I will likely emerge soon.