There's something that happens when a woman turns 50 that makes it impossible for her to allow anyone she cares about to go to the hospital without her orchestrating the entire episode.
She pushes her way into the triage room, then answers all of the triage questions for the patient, including his or her pain level. I do draw the line at that, explaining that the patient is the only one who can answer subjective questions.
Along with the 3-way triage interview, her phone is constantly going off while she simultaneously attempts to control all the rest of her family and friends, while also summoning her clergy person.
Occasionally, she has to step out into the waiting area to exert her control in another direction and she always asks, "If I go out here for a minute, how do I get back in?"
"You don't." That's what I want to say and that's the truth, if I have any control over it, and I do, most of the time. But instead, I say, only so she'll leave, "Just hit the buzzer and we'll let you right back in." (fingers crossed behind my back)
Once in a while she is unable to accompany the patient to the hospital which makes for some creative control efforts via telephone or written instructions sent along with the patient on the ambulance, as in this next case, one of my favorites.
(Again, this is posted exactly as it appeared on the note book paper it was received upon. And, although I would have omitted it if it had, it did not contain any kind of identification or phone number, etc. with which to contact her, had we been so inclined which I can promise you, we were not.)
Since leaving emergcyroom last week or so, he has gotten very ill.
2nd trouble breathing
1st throwing up not stop for days on end
3rd dehundreaded (even thow he's drink liquids)
4th Weakness is getting worse
5th pain in stomack (not contenpaded)!!!!
Do something! even if you have to keep him which I Recomend until this is under control. I'm
disabled myself.
He HAS insurance, So there's no reason not to help him.
Please Call me to let me know what going on.
ThankYou,
GOD BLESS
no matter what, you keep him until you find out what's going on, or he's going to die. Do you
understand.
She got kinda nasty there at the end, didn't she?
Sunday, October 28, 2012
Friday, October 26, 2012
Brown Town
Lab tech goes into a treatment room to draw blood on an elderly gentleman.
Lab: Sir, can you tell me your full name?
Patient: John Brown.
Lab: Where are you from? (making small talk while setting out his venipunture
supplies).
Patient: I'm from over at Tarkinton.
Lab: Oh. There's a bunch of John Browns down there, isn't there?.
Patient: Yessir.
Lab: How many of them are there down there?
Patient: Well, my mother and father had 13 children.
Lab (smiling): How many of them were named John Brown?
Patient: Not too many of 'em.
Lab: Sir, can you tell me your full name?
Patient: John Brown.
Lab: Where are you from? (making small talk while setting out his venipunture
supplies).
Patient: I'm from over at Tarkinton.
Lab: Oh. There's a bunch of John Browns down there, isn't there?.
Patient: Yessir.
Lab: How many of them are there down there?
Patient: Well, my mother and father had 13 children.
Lab (smiling): How many of them were named John Brown?
Patient: Not too many of 'em.
Calculus
Male with displaced femur fracture.
Triage Nurse: "Sir, what number would you rate your pain on a scale of zero to ten?"
Patient: "One"
Patient's Wife: "One? Is that all?"
Patient: "That's the worst one, isn't it?"
Patient's Wife: "No! Ten's the worst one."
Triage Nurse: "A zero to ten scale."
Patient: "Oh! Ten!"
Triage Nurse: "Sir, what number would you rate your pain on a scale of zero to ten?"
Patient: "One"
Patient's Wife: "One? Is that all?"
Patient: "That's the worst one, isn't it?"
Patient's Wife: "No! Ten's the worst one."
Triage Nurse: "A zero to ten scale."
Patient: "Oh! Ten!"
Just the Facts
An actual nurse's note narrative:
Patient ambulated to room 4. Removed dressing to right upper extremity. Patient reports arm is "rotting off" because he found green drainage when he took the dressing off. Patient unsure but believes he had surgery 1 week ago to repair his humerus which was broken by his brother hitting him with a hoe while the patient was drunk. Surgical site intact, small amount of dark green drainage noted. MD to room. Site cleansed with Hibiclens and normal saline. Redressed with triple antibiotic ointment, telfa, cling, coban, splint and ace wraps. Patient requested dressing be tight at top and bottom of dressing because he has roaches at his home and he is concerned regarding prospect of roaches crawling under bandage. MD notified.
Patient ambulated to room 4. Removed dressing to right upper extremity. Patient reports arm is "rotting off" because he found green drainage when he took the dressing off. Patient unsure but believes he had surgery 1 week ago to repair his humerus which was broken by his brother hitting him with a hoe while the patient was drunk. Surgical site intact, small amount of dark green drainage noted. MD to room. Site cleansed with Hibiclens and normal saline. Redressed with triple antibiotic ointment, telfa, cling, coban, splint and ace wraps. Patient requested dressing be tight at top and bottom of dressing because he has roaches at his home and he is concerned regarding prospect of roaches crawling under bandage. MD notified.
Thursday, October 18, 2012
It Was the Best of Times, It Was the Worst of Times
So today, I felt like I was working in a big city ER. We were so busy, I got no breakfast or lunch. Saints be praised, I brought a protein shake to work with me so I got that life-saving 26 grams of soy isolates at least, and that's the only reason I didn't lose my shit several times.
Which brings me to one interesting patient. I connected with this gal. She was a GI bleed. About my age. The paramedic hadn't started an IV because she had no veins and before I could even get her vital signs, she'd crapped Blood Lake. I was in her room alone as the ER was blowing wide open and everybody was busy somewhere else. I was trying to clean her up a little bit but feeling that pressure to get an IV started and, for God's sake, some vital signs to get an idea of her life expectancy and she starts to hassle me about a drink of water. No, I said, no drink of water right now. Oh, but she'd be so much more comfortable if she had a drink of water as if she didn't know she was exsanguinating through her anus. I told her that we had several things to do before we worried about making her comfortable and that we weren't even close to being done making her more UN-comfortable. She was totally cool and went back at me a few times and neither of us held a grudge and I really appreciate that kind of human interaction. It feels real to me. And there's nothing more real than a big pool of shitty blood in a bed, right?
Toward the last, as the surgeon was stitching in her central line, she said something about something hurting and I was swabbing her spoiled rotten lips for her and said, "Bitch, bitch, bitch!" and she smiled. I hope she does okay.
We jumped through our asses all day long and once I was just acutely aware of how every single minute, there's somebody wanting something from us and it's almost made worse by the fact that it's usually a relatively small thing to ask and so appropriate. It's just that there are billions of bells and orders and people and phones and doctors and other nurses and hunger and having to go to the bathroom grabbing out for us at the same time until you think you're going to roll up in a little ball and roll under the desk. And they keep coming.
Yet, there was something oddly satisfying about today. Feeling like you fit somewhere, like you were used as a tool to turn a special nut on a bolt. Like you made one, small difference to at least one second of someone else's life.
Saturday, October 13, 2012
More Fun in Store
Elderly Male Patient: "I can vomick some more in a minute when I get sick enough."
Conversations With God
A construction worker comes in day before yesterday while I'm at lunch. They're all in Trauma II when I get back. Blood all over the floor, the stretcher, the clothes. Everybody's gowned up. Turns out the guy was cutting a board with a circular saw and somehow ended up severing his brachial artery. He was drifting off, every once in a while. The chopper was called to transport him to another facility and his wife was getting ready to head out on the 75 mile trip to the other hospital. I overheard another nurse giving her directions.
Me: "Don't hurry, now. Take your time. You don't want another accident today."
Spouse: "I won't. I'm fine."
Me: "You are taking someone with you, right?"
Spouse: "No, I'm okay to drive."
Me: "You need to at least take someone with you."
Spouse: "I'm really okay, I'll be okay."
Me: "I know you think you're okay and you probably feel okay but you need to take someone with you."
Spouse: (looking at the other nurse, now) "I'll be okay. The Lord will take care of me."
Pause
Me: "The Lord told me to tell you to take someone with you."
Me: "Don't hurry, now. Take your time. You don't want another accident today."
Spouse: "I won't. I'm fine."
Me: "You are taking someone with you, right?"
Spouse: "No, I'm okay to drive."
Me: "You need to at least take someone with you."
Spouse: "I'm really okay, I'll be okay."
Me: "I know you think you're okay and you probably feel okay but you need to take someone with you."
Spouse: (looking at the other nurse, now) "I'll be okay. The Lord will take care of me."
Pause
Me: "The Lord told me to tell you to take someone with you."
Friday, October 12, 2012
We Are The Champions
It seems no matter what the problem is in the hospital, the solution is to have the ER nurses take on one more responsibility.
Electronic charting, for instance. The patient's vital signs, height and weight doesn't transfer from the triage note to the flow sheet (where everything after triage is charted). Solution? Have IT or a representative from the software provider tweak the issue? No. Better to require the ER nurse before triaging the bleeding, moaning, puking, smothering, screaming and/or dying patient, to first click on the flow sheet option, open a flow sheet, apply it, save it, close it and then open the triage sheet by clicking on the electronic forms tab, triage sheet tab and then the go to sheet tab.
A patient in a hospital in Chicago killed himself by drinking a cleaning substance which was left in a treatment room. The solution? Make sure noxious solutions are clearly marked as such? Acknowledge the fact that, unless a patient exhibits suicidal tendencies, common sense dictates that we're simply not responsible for every single irrational thing anyone, anywhere might decide to do at any given time in any given place? Realize some people are just too stupid to live? No. Better to declare cleaning agents can no longer be kept in the treatment rooms, thereby creating a need for the ER nurses to go all the way to the clean utility area to get a spray bottle of solution to clean the rooms after patients leave, then go all the way back to the clean utility room to replace the bottle. Hibiclens, alcohol, betadine, hydrogen peroxide? Same thing. Can't be kept in the rooms. How did we ever keep from killing patients back in the day when we kept glass thermometers soaking in alcohol-based antiseptic in stainless steel trays with lift off lids in each treatment room? How do we keep them from hanging themselves with the sheets on the beds, for instance? Where does the responsibility of ER nurses stop?
ER doctors (whose salaries exceed ER nurses in our facility by in the neighborhood of nearly 10 times and rightly so considering the level of education and licensure required of them) can't seem to manage to a) sign the patient discharge instruction sheet or b) sign and document a diagnosis on their T-sheets. The solution? Discuss with the physicians the reimbursement issues involved with incomplete physician documentation? Create a system whereby physicians are motivated to complete proper documentation such as not allowing them to work until said documentation is complete, as would be the case if a nurse were to do the same thing? No. Better to devise a new form for the ER nurses to be responsible to fill out at the discharge of every patient requiring her to go down a list, checking boxes indicating each form is accounted for and that the MD has signed his documents and written down a diagnosis. If anything is missing, it will be the nurse's evaluation that suffers and she may miss out on her 2% annual raise, if the hospital happens to even give raises that year, which they often do not.
Somebody in the hospital is getting paid minimum wage to scan all the ER documents into the computer but can't quite manage to scan them in the correct order or even right side up in all cases. The solution? Counsel the persons responsible for scanning, impressing upon them the importance of legible scanned documents? Explain to the entire hospital staff in an in-service if necessary that the upside down, scanned electronic documents can easily be turned right side up by clicking the rotate button on the pdf file viewer? No. Better to add to the ER nurses' responsibility that of ensuring each discharged patient's chart is placed in the correct scanning order and paper clipped, once before giving it to the ER doctor to sign and add his diagnosis to, and then a second time when received back from the doctor in a messy pile, paper clip missing.
Patients come to the hospital without a clue what medications they take, nor the dosages or frequencies. The solution? Public teaching regarding the necessity of the above data in order to provide safe care of the patient? Requiring a family member to go home to retrieve the patient's medication bottles? Refusing to render care in non-critical situations until somebody magically remembers or retrieves said data? No. Better to require the ER nurses to find out what pharmacy the patient uses and call them and waste their time looking up the medication lists of patients who don't care enough about their own health to notice what chemicals they put in their bodies. Or call the patient's primary care provider's office and waste time they could be using to tend to the needs of responsible patients who actually make appointments and seek medical care in an appropriate setting. Or, in the event the pharmacy and PCP's office are both closed or the patient orders medications from an insurance mail-order system, require the nurses to pull the information out of their asses. Incomplete medication forms are unacceptable.
Some of the ER physicians are having difficulty mastering the task of ordering ER medications electronically. The solution? More and extensive teaching regarding the electronic ordering of meds to be done by IT with ER physicians? Reworking the current system for the physician ordered medications? No. Better to require the ER nurses to learn to enter medication orders electronically (despite an aggressive taboo in the past regarding taking verbal med orders from physicians) which is to only be done in an emergency. We all know how that's going to play out, now don't we? After all, we do work in the emergency room. They're all emergencies, aren't they? I mean, in somebody's eyes.
Besides, the ER physicians are busy. They have every patient in the ER to see and there are several nurses to share the (growing list of) responsibilities assigned to them. However, with the exception of a code situation, the doctor spends approximately 7 minutes with each patient and has an average of 2-3 orders per patient to put in electronically. Otherwise, the medications need only be clicked "Continue" or "Discontinue" in the electronic medication list which was entered by the nurse while the patient was bleeding, moaning, puking, smothering, screaming or dying, incidentally (see the paragraph on electronic charting). Otherwise, he has one T-sheet to fill out. With a pen. On real paper and not on a goddamned computer. Like in the good, old days. Is it really that difficult?
Meanwhile, the ER nurse has an extensive triage form full of medical history that hasn't carried over from the previous admissions due to yet another IT glitch, a medication form (including meds, dosages, frequencies, routes, last dose and time, doctor who prescribed and pharmacy filling the medication), a flow sheet including everything anybody in the ER or elsewhere has done for or to the patient during his/her stay in the ER, a list of vital signs, a treatment sheet where things like blood cultures, etc are documented, transfer forms (okay, the MDs do 33% of this form, too), discharge education, a charge form and the new form where all the other forms are accounted for.
In the interest of time I'll stop here but know that this is an incomplete list.
Electronic charting, for instance. The patient's vital signs, height and weight doesn't transfer from the triage note to the flow sheet (where everything after triage is charted). Solution? Have IT or a representative from the software provider tweak the issue? No. Better to require the ER nurse before triaging the bleeding, moaning, puking, smothering, screaming and/or dying patient, to first click on the flow sheet option, open a flow sheet, apply it, save it, close it and then open the triage sheet by clicking on the electronic forms tab, triage sheet tab and then the go to sheet tab.
A patient in a hospital in Chicago killed himself by drinking a cleaning substance which was left in a treatment room. The solution? Make sure noxious solutions are clearly marked as such? Acknowledge the fact that, unless a patient exhibits suicidal tendencies, common sense dictates that we're simply not responsible for every single irrational thing anyone, anywhere might decide to do at any given time in any given place? Realize some people are just too stupid to live? No. Better to declare cleaning agents can no longer be kept in the treatment rooms, thereby creating a need for the ER nurses to go all the way to the clean utility area to get a spray bottle of solution to clean the rooms after patients leave, then go all the way back to the clean utility room to replace the bottle. Hibiclens, alcohol, betadine, hydrogen peroxide? Same thing. Can't be kept in the rooms. How did we ever keep from killing patients back in the day when we kept glass thermometers soaking in alcohol-based antiseptic in stainless steel trays with lift off lids in each treatment room? How do we keep them from hanging themselves with the sheets on the beds, for instance? Where does the responsibility of ER nurses stop?
ER doctors (whose salaries exceed ER nurses in our facility by in the neighborhood of nearly 10 times and rightly so considering the level of education and licensure required of them) can't seem to manage to a) sign the patient discharge instruction sheet or b) sign and document a diagnosis on their T-sheets. The solution? Discuss with the physicians the reimbursement issues involved with incomplete physician documentation? Create a system whereby physicians are motivated to complete proper documentation such as not allowing them to work until said documentation is complete, as would be the case if a nurse were to do the same thing? No. Better to devise a new form for the ER nurses to be responsible to fill out at the discharge of every patient requiring her to go down a list, checking boxes indicating each form is accounted for and that the MD has signed his documents and written down a diagnosis. If anything is missing, it will be the nurse's evaluation that suffers and she may miss out on her 2% annual raise, if the hospital happens to even give raises that year, which they often do not.
Somebody in the hospital is getting paid minimum wage to scan all the ER documents into the computer but can't quite manage to scan them in the correct order or even right side up in all cases. The solution? Counsel the persons responsible for scanning, impressing upon them the importance of legible scanned documents? Explain to the entire hospital staff in an in-service if necessary that the upside down, scanned electronic documents can easily be turned right side up by clicking the rotate button on the pdf file viewer? No. Better to add to the ER nurses' responsibility that of ensuring each discharged patient's chart is placed in the correct scanning order and paper clipped, once before giving it to the ER doctor to sign and add his diagnosis to, and then a second time when received back from the doctor in a messy pile, paper clip missing.
Patients come to the hospital without a clue what medications they take, nor the dosages or frequencies. The solution? Public teaching regarding the necessity of the above data in order to provide safe care of the patient? Requiring a family member to go home to retrieve the patient's medication bottles? Refusing to render care in non-critical situations until somebody magically remembers or retrieves said data? No. Better to require the ER nurses to find out what pharmacy the patient uses and call them and waste their time looking up the medication lists of patients who don't care enough about their own health to notice what chemicals they put in their bodies. Or call the patient's primary care provider's office and waste time they could be using to tend to the needs of responsible patients who actually make appointments and seek medical care in an appropriate setting. Or, in the event the pharmacy and PCP's office are both closed or the patient orders medications from an insurance mail-order system, require the nurses to pull the information out of their asses. Incomplete medication forms are unacceptable.
Some of the ER physicians are having difficulty mastering the task of ordering ER medications electronically. The solution? More and extensive teaching regarding the electronic ordering of meds to be done by IT with ER physicians? Reworking the current system for the physician ordered medications? No. Better to require the ER nurses to learn to enter medication orders electronically (despite an aggressive taboo in the past regarding taking verbal med orders from physicians) which is to only be done in an emergency. We all know how that's going to play out, now don't we? After all, we do work in the emergency room. They're all emergencies, aren't they? I mean, in somebody's eyes.
Besides, the ER physicians are busy. They have every patient in the ER to see and there are several nurses to share the (growing list of) responsibilities assigned to them. However, with the exception of a code situation, the doctor spends approximately 7 minutes with each patient and has an average of 2-3 orders per patient to put in electronically. Otherwise, the medications need only be clicked "Continue" or "Discontinue" in the electronic medication list which was entered by the nurse while the patient was bleeding, moaning, puking, smothering, screaming or dying, incidentally (see the paragraph on electronic charting). Otherwise, he has one T-sheet to fill out. With a pen. On real paper and not on a goddamned computer. Like in the good, old days. Is it really that difficult?
Meanwhile, the ER nurse has an extensive triage form full of medical history that hasn't carried over from the previous admissions due to yet another IT glitch, a medication form (including meds, dosages, frequencies, routes, last dose and time, doctor who prescribed and pharmacy filling the medication), a flow sheet including everything anybody in the ER or elsewhere has done for or to the patient during his/her stay in the ER, a list of vital signs, a treatment sheet where things like blood cultures, etc are documented, transfer forms (okay, the MDs do 33% of this form, too), discharge education, a charge form and the new form where all the other forms are accounted for.
In the interest of time I'll stop here but know that this is an incomplete list.
Friday, October 5, 2012
Overheard in ER
Nurse to Elderly Male Patient: "Do you still have your gallbladder and appendix?"
Elderly Male Patient: "No, I never had them. I never had no appendix or nothin' that'a way."
Elderly Male Patient: "No, I never had them. I never had no appendix or nothin' that'a way."
Thursday, October 4, 2012
This Bud's For You, Bud
I used to get automatic emails of the local obituaries but somehow when I got this new laptop in June, I quit receiving them and haven't yet gotten around to re-subscribing. In September I was out of town roughly 3 weeks, altogether, and because I long ago stopped buying a local paper on a regular basis, I've been out of the loop. Tonight while writing another post which I've since saved in draft form for another day, I did an online search to check a fact and ended up on the obituary page of the local funeral home. There I tarried for 30 minutes, or so, catching up on people I hadn't realized had passed. There were a few surprises but I was aware of about half of them before tonight.
I'm sort of a connoisseur of obituaries. I love them. I love everything about them, even when I'm sorry to see some of the names, like tonight. And I don't think I'm alone. Back in the 90's, my daughter took a sociology class at the local community college along with the daughter of one of my co-workers in the ER. The instructor, a male in his 30's, shared with the class one day that he used to date a nurse who always listened intently to the obituary segment of the local morning news on the radio which he considered a bit strange. Upon hearing the story, my daughter and my co-worker's child turned, open-mouthed toward each other whispering, simultaneously, "My Mom does that!"
In a small town, there are certain people you see all the time, people you don't even know but who, because you're around them for sometimes your entire life, as in the case of the natives, or at least for 33 years, in the case of me, you feel a closeness to without even realizing it. Then one day, something reminds you of them and you say, "Hey, whatever happened to that great big, fat guy who used to sit on the bench in the city park and wave at the cars going by?" or, "Remember that gal who used to walk up and down the highway picking up cans? Whatever became of her, I don't see her anymore?". It's complicated because you don't even know their names.
Lately though, the obituaries have begun to include pictures and that helps a great deal. Although, oftentimes, for some reason the family picks a picture from 28 years ago that nobody would recognize and that certainly complicates matters. It's easy to miss one and never realize it. The internet helps but I managed to miss a bunch in September, I found out tonight.
So tonight I was browsing, reading in depth each obituary, one at a time. I read the obituary for the boss I had at my favorite nursing job in my entire life. She died while I was out of town and unable to attend the funeral. That one hurt. And it was unexpected. But I'd already seen it in the free paper somebody had lying around at work one day. On the second page of the funeral home website, after a few of our ER regulars who came as a shock when I heard about them last week, I saw a familiar face.
He was a jovial guy. Used to come in with his wife. And daughter. They were all three sort of regulars but only periodically. The daughter had her own set of psychoses and, okay, I suppose his wife was probably crazy, too. But he was just a pleasure to see coming and never had anything seriously wrong with him, just wanted to be checked out to make sure a twinge in the chest or a little swelling in his feet or a cough weren't anything serious. No big deal. I didn't even remember his name, until I saw it and his face on the same page together. But when I realized he'd died it made me feel really, really sad. It sort of surprised me, the way it made me feel, and I even cried real tears for a while. And I still feel sad.
We get our balls busted so much of the time by people who just make our lives at work a living hell, that when someone is polite and acts like an adult and even makes us smile once in a while, we appreciate it. And I know I'm greatly callused, maybe even pathologically but I still love people, even though I'd probably be better off if I didn't, and in a quirky, philosophical way, I loved that guy. And now he's gone and never coming back.
You don't realize how many people you touch. I think Bud would be surprised to have seen me cry when I saw his picture online tonight.
I'm sort of a connoisseur of obituaries. I love them. I love everything about them, even when I'm sorry to see some of the names, like tonight. And I don't think I'm alone. Back in the 90's, my daughter took a sociology class at the local community college along with the daughter of one of my co-workers in the ER. The instructor, a male in his 30's, shared with the class one day that he used to date a nurse who always listened intently to the obituary segment of the local morning news on the radio which he considered a bit strange. Upon hearing the story, my daughter and my co-worker's child turned, open-mouthed toward each other whispering, simultaneously, "My Mom does that!"
In a small town, there are certain people you see all the time, people you don't even know but who, because you're around them for sometimes your entire life, as in the case of the natives, or at least for 33 years, in the case of me, you feel a closeness to without even realizing it. Then one day, something reminds you of them and you say, "Hey, whatever happened to that great big, fat guy who used to sit on the bench in the city park and wave at the cars going by?" or, "Remember that gal who used to walk up and down the highway picking up cans? Whatever became of her, I don't see her anymore?". It's complicated because you don't even know their names.
Lately though, the obituaries have begun to include pictures and that helps a great deal. Although, oftentimes, for some reason the family picks a picture from 28 years ago that nobody would recognize and that certainly complicates matters. It's easy to miss one and never realize it. The internet helps but I managed to miss a bunch in September, I found out tonight.
So tonight I was browsing, reading in depth each obituary, one at a time. I read the obituary for the boss I had at my favorite nursing job in my entire life. She died while I was out of town and unable to attend the funeral. That one hurt. And it was unexpected. But I'd already seen it in the free paper somebody had lying around at work one day. On the second page of the funeral home website, after a few of our ER regulars who came as a shock when I heard about them last week, I saw a familiar face.
He was a jovial guy. Used to come in with his wife. And daughter. They were all three sort of regulars but only periodically. The daughter had her own set of psychoses and, okay, I suppose his wife was probably crazy, too. But he was just a pleasure to see coming and never had anything seriously wrong with him, just wanted to be checked out to make sure a twinge in the chest or a little swelling in his feet or a cough weren't anything serious. No big deal. I didn't even remember his name, until I saw it and his face on the same page together. But when I realized he'd died it made me feel really, really sad. It sort of surprised me, the way it made me feel, and I even cried real tears for a while. And I still feel sad.
We get our balls busted so much of the time by people who just make our lives at work a living hell, that when someone is polite and acts like an adult and even makes us smile once in a while, we appreciate it. And I know I'm greatly callused, maybe even pathologically but I still love people, even though I'd probably be better off if I didn't, and in a quirky, philosophical way, I loved that guy. And now he's gone and never coming back.
You don't realize how many people you touch. I think Bud would be surprised to have seen me cry when I saw his picture online tonight.
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