25-Hospital Sketches

I have been a huge reader ALL of my life. The first book I ever read to myself was Ferdinand the Bull about the bull who would rather smell flowers under his favorite cock tree than fight in the arena. The first book I ever stayed up all night to read was Magic’s Pawn by Mercedes Lackey when I was a sophomore in high school (shhh, don’t tell my parents). The first chapter book that I ever read by myself was Little Women by Louisa May Alcott.

We’ve all seen the various movie adaptations where various actresses spanning generations played Jo, the headstrong March daughter. These actresses vary from Katharine Hepburn to Saoirse Ronan, seven in all from 1918-2019. Her story remains the same. So does the story of the doomed March sister, Beth March, the gentle soul that contracted scarlet fever while providing care for a poor family in their town.

But as a child and teenager I read all the Louisa May Alcott books I could get my hands on. Little Women, Good Wives, Little Men, Jo’s Boys. I own a very old copy of Aunt Jo’s Scrap Bag that I got in an antique store in Wyoming. These are the books that dealt with the March sisters. There are also more like the Eight Cousins or the Aunt-Hill, Rose in Bloom, Under the Lilacs and Jack & Jill. This last book was written in 1880 and the Jill of the title was a poor girl who had a friendship with Jack of the title while they were young. Through childhood misadventures she tumbled down and broke her back, like the nursery rhyme while Jack got a bump on the noggin.

Louisa May Alcott desperately wanted to go to war and wanted to enlist but she was denied because she was a woman. She volunteered as a nurse during the Civil War in 1962 and was confronted by the dirty, nasty, medical mess that accompanies war. She served only 6 weeks of her 3 month assignment, becoming seriously ill herself. She sent home stories that were compiled into Hospital Sketches in 1863.

I had no idea this novella existed until I heard about it on an NPR program about Louisa May Alcott. The library didn’t have it but Amazon did and I purchased it immediately. It is a little book, only 99 pages. I am glad that I didn’t read this book until I was an adult and a working nurse. Because my 24 years in the hospital trenches allowed me to understand Tribulation and to empathize with her.

It is about a woman in the 1862 who is bored. This is Tribulation Periwinkle. She doesn’t want to teach, or write, or get married, or act. Her little brother suggests that she go to war. And she does.

Although not without difficulties or barriers in her way. The battlefields were a long way from New York.

While nursing the desperately wounded, Tribulation has conversations with the dying soldiers. One dismisses his injury as just being shot in the stomach and wishes for a drink of water. But there was no water to be had as the water pails were being filled. Tribulation took the first mug and hurried back to her patient patient, who was dead. There is something about the description of the patient patient who is patiently waiting for water that never comes.

Louisa May Alcott touches on the senselessness of war and the unceasing dying of the soldiers. She writes of families that are holding vigil at bedside for those who were dying. She writes of sitting vigil herself and the conversations that she had with the wounded.

Tribulation Periwinkle goes home and writes about the surgeons and the patients and the other nurses. The last paragraph in the book is about her wish to volunteer at a hospital for “colored regiments” because she knows that society owes them a great debt.

A little book, yes, and a bit disjointed, but it really gives a snapshot of what it was like serving in the Civil War battlefield hospitals. Some good, a lot of bad.

Rather like today. Even with all of our pharmacological advancements and surgical advancements and technological advancements we sometimes don’t in. And Louisa May Alcott knew that.

Medical fiction and non fiction book report 7/20/25- Re-reading in a different political climate is surreal

An ode to re-reading everything.

And I mean everything.

Do you mean every book you’ve ever read, Kate?

Yes, every book you’ve ever read.

It is amazing how a re-read shows that the story has changed. I have heard this from a lot of different readers. The books they loved as children, the books they loved as adolescents, the books they’ve loved as young-adults, the books of their early adulthood? All different because you’ve changed.

Well, you’re not the person who originally read the book anymore.

Things have changed. You may have gone back to school. You may have gotten married, or had a child. The country might’ve been taken over by a despot whose only concern is himself and how much money he can bilk out of his followers. You might have changed jobs.

I didn’t start this series out in a bid to change my mind about the classics that I’ve read, or about books that I enjoyed in the past.

But it has happened.

You’ve heard the Star Trek joke about not liking Shakespeare until you’ve heard it in the original Klingon?

I am not the person I was when I originally read these books. Fiction AND non-fiction. That means the lens through which I see them is different now. And my interpretation will be different now.

Case in point- I am re-reading the book Lock In by John Scalvi. Yes, that same John Scalvi. I started three books when I was on vacation. Lock In by John Scalvi, All Systems Red by Martha Wells (this is the books the Netflix show Murderbot was based on), and The Soul’s Guide to the AfterDeath by Gwenna Laithland. Lock In was the only book that was a re-read.

Back to the analogy-

I originally read this book when it first came out in 2015. And I remember liking it. It is a near future story about people who have had a disease (Haden) and are locked in. There has been a flurry of these books over the years, think The Butterfly and the Diving Bell, but this was the first one that I read that was was fictionalized. This book has robots that can be piloted by those who are locked in.

The United States has just passed a law that will seriously impact those who are locked in. By taking away their subsidies. These are everyday Americans who have been struck down by an illness that they didn’t want and didn’t ask for because it is expensive, baby. To care for all of those 5 million Americans who are locked in. And the government would rather you take the cure that no one has yet, than be on the dole.

Not that most of the Haden sufferers don’t have a job. From coding, to the FBI agent main character. But caring for a body is expensive and having a second life piloting the robots is expensive. The robots are also expensive. You have to care and feed for the body that you are not using and you have to maintain the robot and make sure it is charged. That is why most of them have jobs. And still the funding for their survival and medical care has been cut.

Sound familiar?

This was definitely not how I interpreted it when I first read it.

It is funny how times and circumstances and bullshit that those in power and those in power desperate to stay in power are pulling on us changes our perception. Isn’t it?

Re-reading this book about a pandemic that locked in 5 million Americans and 20 million people around the world? Well, those the Haden virus didn’t outright kill. That has been a mindfuck to this operating room nurse who worked in a hospital nearly every day through the real 2020 pandemic.

Of course the government tires of taking care of these disabled Americans. Have we learned nothing?

Eye roll.

No Tuesday Top of Mind 7/8/25- Review of When the Moon Hits Your Eye by John Scalzi

No Tuesday Top of Mind for this Tuesday because I cannot get this book out of my head.

And also because there has been so much crap that has entered our consciousness in just the last 5 days as to require a little processing time.

Okay, it’s me. I require processing time.

AKA my mind is too full to discuss any of a number of things. From the supreme court giving the conman in the white house unchecked power to the minimal amount of reaction that I am getting from different source to the unfortunate but somehow warned of flooding in Texas to the idiotic yes-men in the federal legislature that are rubber stamping these inhumane practices to the attacks on healthcare to Medicaid being virtually unfunded through attrition because they put the bar so damned high to the continued attacks on higher education to to the file with names that didn’t want the names released disappearing tricks to the attacks by those who should know better but they are grasping at power anyway they can in any number of sectors to the thought of what will undoubtedly additional deaths to the concentration camp on American soil to apology we have to make to those who cried out never again and then they did it anyway to the women who are dying because of policies that purportedly put the child first, no matter that there is no child to the families who have been upended or straight up ended because of inhuman immigration policies to the man who has never heard the word no and paid attention to the boundary to any number of things.

This just in (July 8, 2025, 3:15pm)- to the conman who is “looking into” the take over of 2 American cities (DC and NY, if he doesn’t like their elections) because of the “red scare” that he is trying to engender. Well, the Muslim scare.

Ugh.

Cruelty is the point indeed. And so is irrationality.

To cleanse my mind, I will review When the Moon Hits Your Eye by John Scalzi.

Published March 25, 2025 through Tor Books.

This book has been on my radar for quite some time. I massively enjoyed Starter Villain, which was released on September 19, 2023. But the first book I read by John Scalzi was Lock In, which was released on August 26, 2014. This was another of my library finds. I kept seeing it on the New Releases shelf and it mocked me until I picked it up.

Fabulous read but not the book I want to write about today.

I picked up this book from the library last week. It’s been on my library holds list for months.

I read it in two days.

I have thoughts. Many thoughts.

There will be spoilers for this book. But this is my take on this book.

Last chance for spoilers.

**************************************************************************************************

What struck me was the structured/unstructured path of the chapters. It wasn’t until I was nearly at the end that I realized that each chapter was numbered with a day since the moon had turned to cheese. And that the entire book takes place over 28 days, the length of a lunar cycle. This is genius and sneaks up on you.

Each chapter has a different voice and a different narrator. From a group of old men in a diner in the Midwest, one of whom is a retired philosopher, to the billionaire adrenaline junky, to the astronomy student whose entire academic life and potential career that has been upended, to the board of a bank who are worried at people pulling all their money out of the bank to live their bucket list, to the President of the United States and the First Lady getting ready for bed, to the writer who grew up a gifted and talented writer who got stuck on the first three chapters of her book to realize that there is no time, and more.

The first point is that the moon has suddenly, absurdly turned to cheese in an instant. Specifically around 1700 EST. Alarms were raised immediately when it was noticed.

Also the quarter moon is brighter than it should be in the sky. This brings to mind the moon shifting of the movie Bruce Almighty.

Of course, the moon mission that is a must do for the billionaire whose company developed the lander. Of course, the United States outsourced outer space to the billionaire class. Of course, the astronaut who was destined to be on that mission hears of the moon turning to cheese while on the phone with her mother.

Of course.

The following are notes straight from the notes app that I wrote to myself, annotated with page numbers. And also my stream of consciousness thoughts on the events of the book. I tried to match these up as best as I could. Your thoughts and notes will be different.

Philosophy. Astronomy student feeling unmoored because the moon has turned to cheese p. 145

Billionaire subplot. My thoughts are that it is basically a pull em out boys space race. Including the race between 2 billionaires to be the first to taste the moon cheese scene.

NASA outsourcing the space program to billionaires p. 169. My thoughts are of course they are.

Dry heaving in zero G was an interesting application of physics p. 175. My thoughts on this is what I learned p. 173 is something I already knew. That billionaires are spoiled brats and have never been told the word no. And they also get bored, to our detriment. The billionaire’s death (Jody) because of hubris was definitely an homage to the billionaire deaths from hubris on the way to the Titanic. See also billionaires being bored.

President and First Lady having a conversation, starting around p. 210. He drops his shirt on the floor, she tells him to pick it up, he argues that they have staff for that. She says, “If you dropped a shirt with the expectation that someone would pick up after you, I would divorce you immediately.” She continues “Dropping your shirt for someone else to pick up shows contempt. I didn’t like it when I was the person who had to pick it up. I don’t see why I would like it less now that someone else would have to do it.”

My thoughts are that I loved this exchange. And is also an answer to my own husband on leaving things on the floor for me to pick up. This will be my new answer to that. I feel that most women are frustrated or have been frustrated by this exact issue.

Back to the philosophical discussion p. 210. My thought is that there is a lot of philosophy in this book and it is a common thread. I have recommended this book to my cohort and will be recommending it to my dissertation chair.

The reaction of everyday Americans turns into fuck the moon sentiment and flipping off the moon to relieve stress. My thought on this is that might be the energy we need for I.C.E.

Unfortunately fuck the moon unraveled quickly to an attack on a cheese shop p. 217. My thought is that at least the estranged brothers who are running rival cheese shops across the town square from each other have reconciled. Also this is very evocative of Romeo and Juliet, which is actually mentioned in a previous chapter from the astronomy student.

Immigrant cook who says they want to go back to their home country because he isn’t as hated there as he is in America p. 228. My thought is that I realize this was written before the current administration crack down on illegal immigrants and naturalized immigrants. But oof.

There is a development in that the Lunar One which is the projection that is not unlike a meteor has been detached from the moon and is hurtling toward earth. My thought is cue the asteroid that killed the dinosaurs. This has been earned because wipe it all out is something I’ve heard from various quarters.

Oh and Lunar One will impact the earth in 2 years and three months with a 95% confidence. My immediate thought was that I understood that reference. Which is a meta reference in and of itself to Captain America in The Winter Soldier.

The Lunar One impact will be devastating and lead to the cessation of life on the planet.

There is a chapter on the filming of an Saturday Night Live show shortly after the announcement that the earth has an expiration time. The studio audience laughs at none of the skits and are very unsettled. Finally, the host stands up and starts to sing “Imagine” to placate the audience after a pretty speech of coming together. He is immediately clocked by a chair and a riot ensues. My thought is that this is a delayed reaction to the celebrities singing Imagine on Zoom during the lockdown in 2020.

There is a chapter on a drunk, Caleb, interrupting a church service. Remember, the world knows that time is ticking. The pastor throws out his dial a sermon that he got from a sermon service and speaks from the heart. He calms fears and basically toes the religious line p. 253.

The private conversation he has with God later that night is perfection.

A bank meeting about people panicking and taking all their money out is next. It is revealed that the bank has modeled the end of the world. But, hey, the bank still has to make money. The plan is that they will introduce a zero interest rate $40,000 limit credit card with no repayment due for 2 years. The bank model also says that the consumer confidence will end after the planned last Christmas. After all, people hold it together for Christmas. Thought for this is that yes, yes, they do.

The last major character is a gifted and talented girl child who only wants to be a writer. Her entire life is pointed in this direction. Until she gets caught in the writing group trap after the third chapter and gives up. Until there isn’t enough time because, hey, the end of the world is upon us. Her husband says who cares if there isn’t enough time to get published, she should write for herself and because he wants to read it. My thought for this part is that she has the uncomfortable realizing that gifted kids can’t give up when it gets hard. You have to work that much harder to succeed.

Really the entirety of Chapter 23 spoke to me, the former gifted and talented kid. And has inspired me to write my dissertation chair and get this train back on its tracks. The world will still be a dumpster fire.

The most hopeful tidbit of this entire book is that “American Democracy has survived worse than the end of the world.” p. 302. Well, I needed to hear that.

The hardest tidbit of this entire books is that when you know that it is going to be the last of a thing (because, you know, part of the moon will be crashing into the earth and killing everyone), that knowledge weighs on you.

There will always be the last Christmas, the last birthday, the last day at a job you love. The thing is to keep going anyway.

After all, it might not be the last thing.

I will not address how the book ends.

Just know that my take aways are flip off might be the energy we need.

And do the hard things.

Medical fiction review 6/8/25- The Surgeon By Tess Gerritsen

The medical fiction book The Surgeon by Tess Gerritsen.

This is another reread. I read it for the first time shortly after its publication in 2001.

I was deep in a murder mystery kick.

Here was an amazing, kick ass, take no shit heroine, Jane Rizzoli. She is on the hunt of a copy-cat serial killer in Boston.

This book series, 13 in all, that introduced Jane Rizzoli police detective to Maura Isles coroner.

They solve crimes together. And were the headliners in a cop and medicine show, a la CSI, NCIS, Crossing Jordan, and a slew of others. This aired from 2010-2016 and had seven seasons in total. I severely curtailed my television viewing in 2010 and I missed this one entirely.

But this is the book that spawned all of that.

I remember at the time that I enjoyed it. Nothing like a good mystery with high stakes and bodies all around. The serial killer this copycat was well copy-catting is a trauma surgeon (Dr. Catherine Cordell) in a Boston hospital who killed the original serial killer. Who happened to be a fellow surgical resident in Georgia.

It sounds more convoluted than it is.

Dr. Cordell is the pre-Isles, I guess. She is traumatized by surviving the original serial killer and had to have the mental fortitude to help find the copy-cat.

Jane is a good all around detective with a chip on her shoulder. She is the only girl in a rough and tumble Boston family. Her fellow detectives treated her poorly, beside her fellow detective Frost. One of them left a tampon in a bottle of water on her desk, hoping for a rise out of her. There is another detective who will be instrumental to the case. And to healing Dr. Cordell.

Misogyny aside this was a solid book.

I thought it would be a stand alone book. I was wrong. Maura Isles is introduced in the next book, The Apprentice. And she and Rizzoli unite against the haters.

Dr. Cordell is off having her happily ever after with Detective Moore.

I give this book a solid B. My first reading was an A. But points off for misogyny that the detectives display and the in poor taste practical jokes they pull on one of their own. It isn’t her fault that she is more observant than them and has a set of breasts. This was before the backlash to the “boys will be boys” pervasive attitude that we’ve been trying to kill for YEARS.

I still have The Surgeon and the second book The Apprentice on my bookshelves.

Post-it Sunday medical non-fiction series 5/25/25- When Breath Becomes Air

This was another book I read pre-BSN. I was a working nurse and had been for 13 and a half years When Breath Becomes Air by Paul Karanthi was published January 12, 2016.

Admittedly this was mid-BSN course work but I just had to read it. I love neurosurgeon medical non-fiction, I always have. From the first one I read in 1997- When the Air Hits Your Brain: Tales from Neurosurgery by Frank Vertosick Jr., MD. This goes along with the ditty that I learned in nursing school- when the air hits your brain you are never the same.

This is the story of a neurosurgeon resident before and after he is diagnosed with lung cancer in the final years of his training.

Neurosurgeon training is a loooonnnnggggg haul. The google results vary. Some call it 15 years after high school (includes a bachelors of some sort and medical school, internship and residency) and other programs clock it at 7 years (which is minus the bachelors years). In a simpler format, it is seven years after the undergraduate degree and the medical degree. Of course, type-A personalities that 100% of them are, there may be additional fellowship after the end of residency.

In short, you have to REALLY like cutting into people’s heads.

Or the aforementioned type-A personality.

Or just want to care for people who are sick and have no where else to turn.

Sit down.

I’m going to hold your hands and gently explain that I didn’t enjoy this book.

Like, at all.

Take your fingers off your pearls. It isn’t personal.

I get that Dr. Paul Kalanithi wrote this while he was actively fighting lung cancer and actively dying. And that his wife, Dr. Lucy Kalanithi wrote the final chapter explaining his death.

I understand.

I just don’t think it is that great a book.

Seriously.

I re-read it this past week to make sure that I still felt that way. Also I re-read it with the knowledge that I had finished two whole nursing degrees and am most of the way through the third in the intervening years.

There are entire passages of brilliance. I marked 11 pages of them.

This book is this man’s journey to coming to grips with a fatal disease. I can understand that.

I can also appreciate how they let his voice drive most of the way through the book. It starts off strong when he was a boy and stronger when he is in medical school, before petering out over the course of his illness. If this was intentional this is masterful editing. If this is not, it is still masterful storytelling.

My biggest pet peeve with this book is that it is over-confident in its own brilliance and the author is a huge name dropper. Granted most of the names dropped were author’s names but nurses were not named. Not once. His surgical nurses were only mentioned a handful of times, including the conversation about his long hours at the hospital that apparently the nurse didn’t understand? I bet she did. Oh, and they were always women, nameless women who didn’t understand the pressures on a rising neurosurgeon resident. My feminist heart didn’t like this one bit.

I appreciated how he let his patient’s be fully realized people in his mind. I find that is the best way to approach a patient. As if they are people too, not just a problem for him to do surgery on. This I liked.

But I kept thinking how one note the nurses were. In fact the only named women are his co-resident, his wife, and his oncologist. Otherwise they were referred to as the relation to him and his wife and his family. No, thank you.

I stand by my first impression of the book as a memoir of residency. That there were better instances out there. Even as a memoir of his death I give it an 8/10.

Would I read it again? Yes, and I have.

Would I shelve it on my bookshelves? Yes, and I have.

Would I recommend it? Yes, as a book on dying.

Post-it Sunday medical non-fiction series 5/11/2025- Happy Mother’s Day to the mother of most of modern science, The Immortal Life of Henrietta Lacks

Yes, yes, Happy Mother’s Day to all mothers, be your children human or not.

The non-fiction medical book for today is The Immortal Life of Henrietta Lacks by Rebecca Skloot. Henrietta Lacks (and the cells that were taken from her cervical cancer) is the mother of most of modern medicine. Until her, the cells that were to be used to medical research died. But hers did not.

And have not. Still.

Her cells have been to outer space, ridden on airplanes, or in cars, and even in the breast pockets of pilots as the cells were flown to additional hospitals/laboratories.

I first read this book shortly after it had been published in February of 2010. The cover is striking, a beaming black woman, hands on hips takes up the left side of the cover. The right side is the title “The Immortal Life of Henrietta Lacks” and the subtitle of ‘Doctors took her cells without asking. Those cells never died. They launched a medical revolution and a multimillion-dollar industry. More than twenty years later, her children found out. And their lives would never be the same.’ It is a striking cover with the background being, well, cells. Yellows and pinks against a red background with Henrietta Lacks in black and white with the colors bleeding over half of her.

Frankly, one of the reasons I probably picked up the book was the cover.

This is a tale of medical misadventure in the beginning of the medical marvels of the 1950s and on. Cancer treatments were developed using her cells, medication treatments were developed using her cells, the ability to keep other so called immortal cells alive was developed using her cells.

This book is the story of Henrietta Lacks. Her life was a quiet one, albeit a hard one. She was married at twenty to the father of her 2 children. He was her cousin. They went on to have three more children, moved away from their hometown to have a better life for them and the children.

Henrietta knew that something was wrong with her insides shortly after the birth of their fifth child, Joe.

This book is also the story of the explosive growth of medical innovation after the survival of Henrietta Lack’s immortal cells. It is the story of the man who first cultured the cells, of the callous way medicine used her cells but didn’t tell her family. It is the story of her family and how they survived after she died.

I don’t want to give away too much of the story but for me this is an absolute must read.

Every time I read it I notice different things. I re-read this recently and from what I know and understand now about HIPAA and medical consent as a PhD student I was struck anew of how important the story of Henrietta Lacks’ immortal cells are.

I will continue to recommend this book to all who want to learn more and those who want to know the wrong way to go about medical research. Because this book is a warning about getting it right. Not only for the family of the woman who died but for us all.

Post-it Sunday Medical fiction series 4/20/25- Call the Midwife- in the Shadows of the Workhouse by Jennifer Worth

I am not sure if you are aware of a wonderful BBC show about midwives in the late 1950s. It is called Call the Midwife and is about women and Anglican nuns and the midwives who attended them. Through the post WWII population boom in East London and the attendant struggles of women and midwives with overcrowding and money struggles that they had. It is in its 14th season and has been renewed for a 15th season.

The episodes also aired on PBS, on delay.

I loved this show when I was still watching television.

Melodramatic? Yes.

Melancholic? Yes, mothers and children die from what is now preventable diseases.

There isn’t a so called woman’s issue they won’t touch. Often with great delicacy, sometimes with a mallet to the head.

I am not alone in adoring this series.

But first it was a series of books. I have them in various forms.

The one I want to write about today is the third in the series about the workhouses that the indigent were sent to. Each were ruled by a man who didn’t take any pushback and certainly didn’t spare the child. If you know that I mean.

I chose this book out of my stack of medical fiction or non-fiction books at random and re-read it.

I had forgotten that the first part of the book is about three people who were brought up by the workhouses and their different troubles.

What struck me most at this re-reading was the chapter where one of the three is dying. He doesn’t want his sister to be told of how sick he is.

But the home nurse knows and goes on to expand on how in hospitals, where she trained, no one died alone. No one died in the dark.

I had to stop reading for a moment. Because that is how I feel.

When I was a med surg nurse, I would have patients who were expected to die. Of course I did. I would get such push back on keeping a dim light on, even the one over the sink. Those who pushed back on me about having the light on when the person dying in the bed wasn’t even conscious enough to be aware of it never understood my feeling that people should not die in the dark.

Jennifer Worth, the author gets it. She write that unconsciousness might not be a state of unknowing. How are we to know what they are experiencing? The light might be comforting to the dying. A reminder that they are not unnoticed and unwatched and unloved.

I recommend the series wholeheartedly.

I can recommend reading the books at least once. There are nuances that come across on the page that are sensationalized and or missed on the screen.

However, re-reading the books after 24 years in the trenches, I would rather watch the show.