Friday, April 30, 2010

Deadman, Chapter 6

Chapter 6

Mr. Posey’s doctor was at the nursing station, sitting comfortably in a rolling chair, with his feet on the counter and a handful of charts stacked on the floor next to him. To one side of the pile he had balanced Posey’s chart, and as I approached him, he picked it up and waved it around while asking me to come over and help him find some missing lab work. I pointed to the morning lab work that I had clipped to the front of the chart earlier. He laughed distractedly, and started leafing through the paper printouts as if he had always known they were there, as if the joke were on me and not him. I pretended to get the joke.
I talked to him about Mr. Posey. He looked at me as I talked. I looked at the breakfast he had left on his lab coat. He looked tired, disheveled and slightly oily, as if the person who had been making biscuits in his brain for breakfast had mistakenly buttered the outside and not the inside of his head.
 Standing next to him as I spoke, I told Dr Q about Mr. Posey’s breath sounds, breathing rate, and swollen feet. I had positioned myself carefully next to him, so I was sure he heard me, though I got no indication that he was listening to what I was saying from any of my senses. He just stared at me as I talked, but the eyes looked a bit iffy, and the body language he was expressing was facing a closet. I finished talking, then walked away to the IV room to check for any new medications that had been delivered from the pharmacy. I kept within earshot of Dr. Q in case he wanted to mumble something at me.
(He communications style consisted of mumbles and sharp barks, if he bothered to communicate at all.)
Unit doctors didn’t talk about the prognosis back then, it was something that rarely got brought up by, really, anyone. Most unit doctors focused on the treatment of symptoms, and avoided looking too hard at outcomes of patients. They seemed to feel their job was to do what was in front of them to do, and that what happened after they did it was social science or philosophy – something soft and squishy and to be avoided.
Doctors talked about things they could do, or tell us to do, -- interventions, treatments, testing – the stuff of action and moving, not the make a wish stuff of dreams and prediction.
It would have never occurred to Dr. Q to give Mr. Posey an option about his treatment – Dr. Q was dealing with a disease, something to be fought to the bitter end. Just as no one thought to ask the people of Atlanta if it was a good idea for Sherman to set it on fire – questions about prognosis didn’t get asked until after the war, and only the winning side asked them.
(At the time, I also thought prolonging the inevitable was the best approach, if for no other reason than to allow practice for new nurses.)
Dr. Q was a quiet, old time doctor who didn’t play well with others. He probably ran with scissors too, but then really, who didn’t back then? He rounded on his patients after dark—sometimes after midnight, sometimes in the hours before the crack of dawn. He made little noise when he walked, and although over six feet tall and kind of beefy, he had a habit, as many doctors do, of showing up out of nowhere.
Sleepy nurses sometimes fell out of their chairs when he barked a question at them in the dead time of the early morning.
What Dr. Q was known for on our unit was his impatience—he just could not wait for help, and hated trying to explain himself to others in order to get that help—it just took too damn long for him to tolerate. He was a legend in this way -- nurses told epic stories of the times he would take potent medicine from our stockroom and inject patients with them without mentioning that he was doing it to anyone. The first they would know of it was when drastic changes in heart rates and blood pressures suddenly started showing up on the monitors of previously stable people. As the nurses rushed breathlessly into the room, with calamitous thoughts in their heads, they would see the good doctor, in a shadowed corner of the room, hunched over the patient and looking curious. Never excited, he was just causing and effecting to beat the band— with the live person filling in for the band— which all kind of freaked everyone out a bit.
Most of the nurses on our unit were gun shy about Dr. Q. He had an enormous cruel streak in him that exploded on special occasions, and sometimes just randomly, as if it the anger were scheduled on a pre-set timer. At other times, the outbursts came after a slow build up, in a Mt. St. Helens kind of way. And like Mount St. Helens, sometimes he didn’t just blow his top off- he blew his sideways off. He got messy with his anger - lots of collateral damage to things invisible but felt—things like ego, self-esteem, and professional happiness.
Records weren’t kept on this, but unofficially, I think he made almost everyone he worked with cry at some point. He had the gift of assholeness, which he shared with others, though he wasn’t known for sharing much else.
Dr. Q believed that the process of drawing information out of people was the same as the process for getting a burrowing guinea worm out from under a victims skin. First he would slice them open – for access, then he’d wrap the slimy worm of knowledge around his pencil of inquiry and slowly twist and slurp the little bugger gently out of a now gaping wound. He would then plop it into the basin that was his head and leave.  The clean up he left to be done the less worthy. The satisfaction he took from this was not of the grim sort – it seemed to be the only thing that made him smile. I loved him for this – it was our greatest bond. It was the thing that separated him from an angry bear in a zoo. He acted like he did with other people on purpose, and for a reason. He wasn’t the bear – he was the one poking the bear.
Except with me, but then I was special—and big. I was also a little bit scary myself at that stage of my emotional development. I had a carefully cultivated reputation for being self destructive, and at times, I used this reputation to leave cautionary lessons for others that would do me harm. I don’t recommend it, it comes with a high price, but it’s worked for me at the time, at least in some limited, dysfunctional sense.
Dr. Q was also one of the smartest people that I had ever met. He thought faster than other people, and his impatience probably came from that. I think, for him, working with others was one long dream sequence in which all the participants made their every move from the inside of a large barrel of molasses—except for him. It must have been excruciating for him, like playing chess with animals that had only cloven hoofs to move around the pieces.
I also think he just didn’t like people—probably genetic, or due to some form of abuse as a child – high school could not have been easy for him. He was not warm and fuzzy—but, if seen in the right light, he could be amusingly absentminded, and this was the best you could hope for. If he wasn’t mean, he wasn’t really anything but alone with thoughts that begged to escape.
Because he was both unapproachable and unavailable—and because he needed an interpreter in order to communicate with those people slow of thought—I was his man, his go to guy. We got along in that sloppy way of the unconnected; we bonded though the attractive draw of symbiosis; we attracted in the way all one-track multi cellular beastie boys seek out when they are looking for a way to make a bigger pile. I liked playing with him; he never threatened to take his ball home when I poked him with a stick.
Dr. Q left the nurses station without speaking to me, and went to Mr. Posey’s room. I pulled up a chair at the station and started charting notes in the nursing part of the medical record. I wrote the notes in bullet form, and used incomplete sentences, just the way other nurses had taught me.  I charted  the facts as I objectively saw them, and made an effort to leave out opinion and feeling.
As I charted, I kept one eye on the heart monitor in front of me, evaluating the strip of the electrical activity that represented his heart function as it slide by (EKG.)
What I monitoring was a simplified form of the 12 lead EKG, – the standard kind that people get when they are old and see a doctor on an office visit.
The heart pumps by using chemicals to interact with muscles, which then make squeeze and relax. The contraction part is started by electrical activity that’s generated from specialized areas of the heart.  This action can be measured from outside the body – the skin. An EKG is a continuous picture of the electrical wave that a heart produces as it works. Weak areas show up as less electricity, delays in the conduction of the wave show up as absent, or blocked, areas. It’s a simple idea – much like radar, but with less energy and with much more fine and subtle indicators– it can be tough to interpret, even the newest machines need a cardiologist to review results for accuracy.
A standard 12 lead EKG measures electrical activity as it comes out from the heart from many different angles. Some of the angles are used to better to see certain parts of the heart. Since it’s standard, and been used for generations, it’s the best picture of heart function that you can get without poking around inside someone – everyone understands the wiggles, and everyone is on the same page when evaluating the them, (This has changed over the years – Echocardiograms are now used routinely at patient bedsides, as well as many other non-interventional techniques.)
But 12 lead EKG’s require stillness. Leads are placed on the arms and legs, and a suction cup thingie is moved across the chest, progressively, as the test proceeds – and movement messes it all up.
Because of this, a three lead EKG was used in the unit to monitor patients. The leads were all placed on the chest, and the nurse could vary the leads to get better looks at different parts if they needed to. It was not as good as a 12 lead, but was good enough to see any big changes.
As I watched the monitor out of the unused corner of an eye, I noticed depressed “t waves” on Posey’s EKG.  Depressed “t waves” indicated a dead area of heart muscle. I also noted the appearance of some thing new – a “Q” wave, also an indication of heart death, and something that predictably appeared on an EKG 24 hours after a big heart attack.
I was looking for things that would indicate to me that the thing I knew was going to happen, wasn’t going to happen.
I wasn’t having much luck.


Thursday, April 29, 2010

Deadman, Chapter 5

Chapter 5

When a patient arrives on the unit, the first thing that that gets done is an admission assessment. Much like the process people goes through when renting a car from Avis, and like all the documentation that’s required before they drive away -- an initial assessment is done to record the dents and dings and other things that need to be brought to management attention before treatments begin.
It’s not exactly like the examination that’s done on a trashed car after getting off a plane after long trip – it’s not a, you break it-you bought it paper trail of woes kind of examination -- It’s the finding of that exact place the bookmark got left, so we can read ahead and see the ending of the novel that is you. Or at least a place to start, and a starting point to work out from.
All context come from talking, information from tests and procedures can only give you information, the art comes in the things both said and unsaid by a patient, and this comes with careful give and take, and it comes in words.
In the navy, I was part of a team that gave medical exams to pilots for their required FAA certification. Each member of the team did isolated parts of the whole exam – lab tests, x-rays, EKG, etc. At the end of all these isolated events, the pilot went into a comfortable office and sat with an aging flight surgeon for five minutes. At the end of this, the old guy would yell out the door for one of us to follow-up something and it was always something important –or something that led to something else that was important. All he did in that office was review the tests and ask apparently casual questions. He would then come up with a picture the rest of us could never see in a thousand years. All he did was talk.
So I talked with Mr. Posey.
 He was retired from the army, where he had worked for 20 years as a cook. Most of his time in the service was spent in the area around his home state of Georgia. His retirement consisted of working as a civilian cook at the same base he was discharged, and doing the same job. He was in now in California with his wife on a vacation to, “get away and relax a bit,” and to visit his grandchildren. He remarked at one point in our conversation, "this relaxing thing is going to be the death of me.” He didn’t say it in a funny way, but rather, as a statement that he was putting out of effect, or maybe as a tryout phrase to see if might be true.
 As I fiddled with the intravenous lines, and worked them into places I could easily remember in a crisis, we talked little, and mostly around, about the possibility of his impending death that I had brought up earlier. We angled around things in our talking. We talked about his life and the lessons that it had taught him, but we talked about these things in a philosophical general kind of way.
Posey spoke to me in a quietly reflective voice, with slow speech and a noticeable soft drawl. At times, he paused as if he had lost something, and then stared at another something behind me for a few seconds, until he caught himself and continued.  He talked of mistakes he had made, and how they were giving him some perspective about the process he was going through now. He also told me that he wouldn’t change a thing about the past—that he had needed to do the things he had done in order to be who he was. “Everything I’ve done and all the things I’ve been through in my life seem pretty inevitable when I look back at them,” he said.
As we talked, I let him ramble for the most part, but occasionally reasserted my control by asking medical history questions from a prepared questionnaire that the hospital provided and required. I did the control thing because, that’s what we did -- we nurses –I had been trained to seize dominion over my immediate environment when working, and to keep a heavy thumb on all the pieces I could touch around me.
I understood that Posey was not talking about anything real when he talked to me. He was talking from his memories as he rambled. He had started the process of adding and subtracting, to this side or that, to a ledger he was keeping in his head. He was running the numbers as he talked to me – weighing and measuring his life in the safety of his past. He understood, that at some point soon, there was going to be a big thick line at the bottom of a page of numbers, and beneath that line, a sum. As he talked, he was getting the numbers straight. He was making sure that he would get credit for answering all the questions completely, for filling out the bubbles in number 2 lead.
I also understood that the way you talked was sometimes more important than the things you said.
 At some point I asked him how he managed to stay in Georgia his entire military career, when most service people were moved around every three years. He told me that he had been out of state a couple of times- one time for the war, and another time for “A bomb testing”. He told me that Georgia looked “pretty good” after those two trips, and that no one in charge of things ever wanted to lose a good cook once they had one.
 As we wrestled for control of the direction of our talking, Posey rambled into a story about his trip to Johnston Island in the early fifties.  He had been sent there to cook for people doing testing atomic bomb testing. I sat, sort of fascinated, on the edge of his bed and listened. (I wondered at the time if he knew I was a big A-bomb fan – not in their use, but in their bigness as a symbol.)
Posy had been attached to temporary duty as a general cook on the island in 1957, and spent 18 months feeding people, as others set up old surplus army equipment to be exploded, and then collected, after the bomb test, for evaluation. Posy said that it was a non-stop party the entire time he worked there – all 18 months, “fifths of booze for a dollar, and no women to interrupt us”, as he put it. He told me that the actual bomb blasts were the best part of the trip, “I couldn’t believe that I was living in a time when a thing like that was possible”, and, “The power of the blast made every thing and every thought smaller than their right size”. He described it as a “William James’s type of spiritual awakening,” and that, for the first time in his life, he was really aware that something bigger than himself was going on.
He told me about a high altitude test that they had shot up in a Thor rocket, that it had blown out all their radio communications, and had turned the night into day for over 5 minutes. He told me of the green blob that had replaced the whole of the sky, and that it was “shot through” with changing colored streaks.
 As we were talking, I rummaged around and broke open an admissions kit, a bundle of toiletries and other odds and ends that every patient got on admission. I took out a basin from the kit and filled it up with warm water, and then opened a soap packet and dropped it into the basin. With a wash clothe, I started to give Posey a bed bath as we continued our talking. The bath was to get the last 24 hours of dirt and sweat off him – the stuff not left on the ER gurney earlier. Posey was a dirty boy, and smelled bad as well.
I have always been in the minority about this, but I think the bath is more about getting close to my patients than getting them clean. I kind of mess the wash clothe around with slightly soapy water – it’s almost an affect the way I do it, with my the real purpose disguised – I’m really looking at my patient in detail, and listening to what they sound like really up close. This also fosters a kind of intimacy that allows them to share more with me than they would with their doctors. Naked – Intimacy – it works for in aspects of life. I like to do the bath early in my shift, or shortly after the more formal part of an initial assessment. It helps me to get both a baseline and a starting point to pivot the rest of my day around.
I noticed: Posey had small pale legs with cold feet, a large abdomen resting on narrow hips, and a medium-sized barreled type of chest. His hands were cold to the touch and he was having difficulty breathing with any exertion – even the exertion of moving around in bed. Getting him up and over to the side of the bed caused him to breath heavily. He needed to “take it in stages” in order to make it, and needed my help to keep steady once he was there.
 As I fake-washed Mr. Posey, I shared with him some of my life. I talked about growing up in a military family and moving to new places every few years. I talked of the 3-year relationships that I had tended to develop with others over my lifetime, and told him that I envied him for his sense of home. I talked about my family, and about the grandfather I had only met once, when small. I told him that my grandfather was only a picture to me, and that I spent a lot of time trying to attach a living breathing life to that picture.
 I guess the thing about intimacy is that it’s shared- you got to give to get. I shared with Mr. Posey as I washed him, and he listened quietly, if somewhat breathlessly.
As I helped him back into bed after the bath, I noticed that his feet were puffy and swollen after only 15 minutes of hanging off the side of the bed. I put the head of the bed elevated about 45 degrees to help with his breathing, and then left the room to call the doctor and give him an update.





Wednesday, April 28, 2010

Honest

Honest

I imagine you, alone in my house
For a day, without binding you to a promise
Not to search through angles and nooks, and
Other concrete memories filed away in haphazard places.

I imagine coming home to you
A pile of my past on the kitchen table
As you hold up each item and wordlessly
Ask me for a more explained honesty.

You ask of letters old and grey
Bound with a soft cord and a gentle knot.
You ask of pictures of me with her
And others implied by time and space.

You ask of official documents of a younger man,
Those things held for required years and more
In powered fear and presence--
Those years that ground the wild from me.

You stop me, you hold me
Comforted that all I am is now in you.
We read in quiet and look up at times
To bind with sight the closeness.

And as I fall asleep at night,
With your head on my chest and an arm around you,
I think of that kitchen table and recall the other
Unremembered thing from the dimness of my shadow.

In the darkness of a corner behind the basement stairs,
Crouches a pale and toothless unlit face
Seen only by an indirect gaze off the shine of a window
A bastard of a lonely thing sits, waiting for the dawn to come.

You have taken from me all my honesty,
And nothing of worth from the rest of me…

Mike Brady
December 2004/2008/2010

Deadman, Chapter 4

Chapter 4

It occurs to me as this tale is told; that “I” seemed to have been the one making all of the decisions, and that “I” was the only one doing any work. Since this is a first person account, it’s probably appropriate for me to leave other people out, unless they interacted in some way and add to the story--- but an explanation is in order. I worked in crowded rooms alone, and other people were not a net I felt I could drop into when things went bad.
 Becoming a Coronary Care Nurse, and then developing any sort of a mastery of it was a long process. I received extensive “book” learning, provided by the hospital, as well as six months of hand holding by a nurse preceptor (babysitter.) Then I went to the night shift for a year, for both seasoning and experience.
My night shift experience involved working with two old bats that had been nurses for longer than I had been alive. One of them would yell at me continually – usually as just a background roar of noise that they she used to establish the beat, while the other one lashed me verbally, and randomly, with specific, targeted sarcasm. They coordinated – this was not amateur hour, they worked together well, and their criticisms were not without merit.
This tag team approach worked, it came out of the long established eating-of-their-young tradition that nurses learned early in schoolyards from other girls and vicious men.
Motivated by the strangeness of inappropriate anger, and a fierce hatred of those with blue-haired, I eventually learned the physical “How” of nursing. I think the whole experience might have been something like the hazing football rookies get before their first practice camp, only as done by devil women.
I spent a year on nights and it was a long year.
What I was given while doing this time, besides bitterness and a general understanding of the shortcomings of men, was practice. I learned by doing, all of the routine parts of nursing. I learned this by doing the same things for all patients, every time. I practiced over and over, on every night. I learned how to assess a patient in a methodical way. This repetition brought a sense of order and routine to the fundamentals of my nursing. I learned to really see the things I was looking at, though it was only later that I began to know what those things meant.
My time on nights, and this practice of routines, made me a functional nurse. Once I had been “seasoned” (parboiled) enough on nights, they moved me to the swing shift.
 Swing Shift brought a different approach to polishing of me, less of the cleaving and more of a rougher grit for the grinding. It was the fun shift, the doctors had just gone home, and we were alone with the patients.
(Normally, the doctors would do rounds in both the mornings, before office hours, and at night, prior to driving home. Like the captain of an oil tanker- they would set the course out of the harbor, then go to their cabin and drink themselves to sleep. We were the 1st mates left on deck to look out for icebergs. As with icebergs, we looked for tips of trouble, shark fins of trouble, and any trouble heading generally in our direction.)
The thing about trouble in a Coronary care was, to paraphrase the patron saint of ICU nurses, Calvin Coolidge, “It’s like a truck coming down the road at you -- 9 out of 10 times it runs into a ditch before it gets to you.”
When you act and make an intervention on a patient, and in the acting do a thing that doesn’t need to be done, it’s almost always a bad thing – at least for the patient, although you might learn something useful in it for later. Using this as a rule, most of the actions I learned involved doing nothing. I learned to actively, passionately and aggressively do nothing. Not the sitting on my ass kind of nothing, more the life and death holding a trigger in my hand kind of nothing. I learned that more times than not, courage is found by standing still and allowing events to unfold in the way they are supposed to, no matter how much the Sturm und Drang bustles around you and begs for an action.
 New nurses in coronary care tend to do a thing called “roller coasting.” They over react to what they see, and then over correct what they over reacted to. It’s a learning process that develops over time, and with experience. It’s a learning that allows you to wait for things to come to you. It’s a form of active surrender, or lessons in patience under the stress of impending doom.
When I was new, the treatment for a heart attack was to support the heart muscle when it was failing, with intravenous medicine that increased the force of contraction (dopamine). At the same time, you would give medicine that would dilate the arteries that the heart was pumping blood into (Nipride). This was known as ‘afterload’ reduction; by increasing the size of the “pipe” coming out of the heart, you could decrease the amount of resistance that the pump had to work against.
The dopamine would increase the blood pressure, while the nipride would decrease the blood pressure. What you wanted was a little of both--- a little more contraction into a little bigger tube. What you got, if you were not careful, was a roller coaster of ups and downs as you played with the amounts you titrated into the patient. Because the concentration of the drugs you were giving were so potent, tiny changes caused big fluctuations. You could increase the concentration if you mixed the drug in a greater volume, but this would have just cause other problems, like fluid overloading and bigger bags of stuff taking up the space around you. Besides – we had both our pride to consider and long standing traditions, passed on by generations of scary nurses, to uphold.
Old nurses tended to “ride out” the ups and downs when they made changes to the IV dosage, but since the new nurses tended to chase the numbers, the ups and downs became a roller coaster—quick highs, and quick lows, with lots of wasted energy. You had to be there, you had to have put in the time before you understood, that by chasing the numbers you were doing more harm than good. What the nurse needed to learn by doing was to develop the ability to give firm short taps in a gentle way. All in sober reflection, with a steady hand and mind, and under the stress of fucking up big time.
This standing, watching, and waiting had to be learned by doing, and not just the active doing of movement – it had to be learned by the active doing of nothing. This wasn’t a thing that they taught you from a book, this wasn’t a thing they taught you at all – it was a thing that got rubbed into you, until you smelled it in your sleep, and knew it by the movement of your bones.  

Tuesday, April 27, 2010

Low Sparked Tone

Tone

Shaken words that paint as sound on fire
A willful brush, shaped by lips and tongue.

You pause to listen to an echoed something
Still seeking in the rushing of the noise
To see the scree of tones shorn rough and ugly
To count the colored parts and name each one.

As the rush of anger starts to fold around you
Its plastic rubber blowback burns your ears
Those ears that pin against the rail in waiting
Are still waiting there to lose the pain in time.

And time is only there to be remembered
And remembering is the pain you want the least.

Fear and faith can hold a shape forever
Till twisted by the arms of no one cares
And you sit alone and blind in pounded rubble
Seeking only more of dimness from the gloom.

Mike Brady 2010

A New York Poem


A New York Poem


I see the fad is putting something
Here
To move the eyes and function as a
Pause
Though I wonder if the concepts kind of
Queer,
And I fear I’ll start to do it just
Because.

It’s not enough to pause with just a
Stop
You have to break the line a bit in
Show
So no loose crap is gumming up the
Thought,
It's all to wrap the view of words in
Gauze.


Mike
         Brady
2010







Deadman, Chapter 3

Chapter 3

Day one


I met Mr. Posey for the first time shortly after getting a report about him from the ER nurse. It was the start of a new day for me, for the ER nurse it was the one last thing he had to do before he went home to bed. I got a bunch of facts from him, and then he shuffled out the sliding door and headed home.
I was in the ER to pick up my new patient, and to safely deliver him back up to the unit.
Posey had walked into to the ER about midnight with a complaint of, “An elephant sitting on my chest.” The ER nurse told me that this particular elephant had been parked on him for the better part of the day.
 Posey was sitting up on a gurney, and was a large guy, about 325 pounds.  As I introduced myself, he started talking to me with a real thick Georgia accent- something I remembered from childhood when visiting my dad’s family. I liked him on speech; it was “like at first sight.” He reminded me of my grandfather – the dead one I didn’t have. (My grandfather had died years ago when I was four, from a massive heart attack, at the age of 47.)
 Mr. Posey seemed happy to see me. It might have been that we had one of those mythical bonds on contact, some weird connection that was instant, but solid -- a long-lost, long-term family thing. It might also have been that he had been sitting on a hard gurney for eight hours waiting for something to happen. It might have been that the elephant was no longer sitting on him.
I had seen his admission lab work in the ER and I knew the numbers – they were bad – the CPKMB was well above 20,000. I could see there was a death drill coming in our futures, but it was hard to get my game face on for it.  Things were not going to happen in the usual way, I had lost my distance by connecting to him too soon, connecting because he had channeled my grandfather back from the grave.
 In my years as a nurse, I had never lost a person who wasn’t supposed to be lost. I had always been able to see the big picture of how it worked, was always able to stand back to help. Distance made it easier for me; I took in the information, and converted it to honest words -- much like a United Nations interpreter.
From the ER, we took a short ride to the elevators and went up to the forth floor, and into the unit. After scooting Posey from the gurney to the bed on a slide board, I plugged the leads for his monitor into the console, and made sure the IV’s were working. As I set the IV’s up on controllers and made sure the oxygen was turned on and the suction machines working, I started my unit orientation talk to him.
Mr. Posey stopped me before I got started. He asked me to tell him what was going to happen to him.
For some reason, I told him the truth. I told him that he would probably die. He seemed to measure both the thing that I told him, and me, at the same time. I told him the exact truth, in straight language, without any mixed message.
My style has always been to give options, to present both sides of things. I was surprised by how direct my answer was to him. I have always felt that it’s not my place to decide life and death issues, that’s for God and the patient to work out. I am more a facilitator, a helper, and a front line grunt sort of guy. What I told him was outside my chain-of-command. I had stepped over the line with Mr. Posey, and I was now committed -- I had become involved.
I was thinking of my grandfather, sitting alone in a backcountry doctor’s office after a long day on the lake fishing, just waiting for an ambulance to take him to the hospital. His pain had started mid-day, but he had been alone in the middle of nowhere. By the time he got to help, there was no help.
And he did it alone. No one should do it alone.
The blood supply to the heart comes from the outside to the inside. With a blockage in an artery, every part of the heart supplied by that artery dies; again, it dies from the inside to the outside.
On the first day after a heart attack - the heart is still deciding how much of it will die- From an initial area of absolute death where the cells breakup and release the poisons of their intra-cellular machinery, the injury creeps out to the nearby and merely damaged tissue and starts to kill this as well. These days we have medicines we can give to keep some of this stuff from happening, but on Mr. Posey’s first day in that long ago time all that could be done involved forms of watching.
During the first 24 hours after a heart attack, the heart- both the good part and the dead part, hold together, mostly because they don’t know any better. The dead part doesn’t contract, or pump, anything so the heart doesn’t push the blood out as well as it did before, but on that first day, the heart itself holds together fairly well. I think it’s like a dead tooth in your mouth- it sort of stays in place out of habit, until a push comes to a shove. Push always comes to shove -- that's life.
The secret thing you fear the most always works its way free and the movements of life have a way of bringing stuck things to the surface. You can’t stay still because if you stop moving, you’re dead – that’s life too.
What you see on the first day is the pump, also known as the heart, not working quite up to snuff. As the pump begins to fail, blood starts backing up into the lungs. You can hear this happening with a stethoscope by listening to the movements of air as they go in and out of the chest. When Mr. Posey would take a deep breath, you could hear a sound like a clump of hair being rolled back and forth in your hands.
This was the first objective sign that his pump was failing -- that a backed up pool of fluid was starting to bathe his lungs and interfere with his breathing. He was becoming juicy, and not in a good way. The lungs are not a good place to store extra fluids – it gets too bubbly. Think drowning.
At this point I could only hear fine crackles of noise from the lower part of the chest, and this was mostly in the lower bases, only heard well when listening from the back.
  Using the standardized unit admission orders, I increased his oxygen and gave him a diuretic (Lasix) to help him pee off some of that backed up fluid. I also started a drug through continuous IV drip to help make the heart beat more forcefully (dopamine). I added Nitroglycerin (NTG,) at a constant infusion rate to make the muscles on the venous side of the blood system relax.  By relaxing the veins, which drain and pool in an area before the pump, the blood gets more room to back up into – a sort of forebay, or waiting room. Nitroglycerine helps increase the size of the intake part of the pumping system (Preload).
 None of the things I was doing would make him better; they just slowed things down for a while and made him more comfortable. They treated the symptoms, not the causes. What I was giving him was comfortable time, quality time – not a small thing, but not really anything I valued at the time.

Monday, April 26, 2010

The Edge

The Edge

(2017 ed. -- to H.S.T.)


At night on longish sweeps of coastal road,
As fog and dampness coat the graveled path
And ocean winds caress the broken shore
In summer mists that wash the evening clean.

The engine roar ablates an icy steam
As man and bike now drift to catch an edge
The drop-off deep, its concrete railings worn
The centerline now vague and mostly gone
The engine redlines, clutching up a gear,
As silence screams the loss of grip beneath.

On meaty beast of iron polished bright
Soft helmet flapping loose against the wind
Hunched in flex to seat him for the slide
His fears a focused symmetry of time
As hours tick the seconds yet to ride.

With speed, the secret gift that god allows --
It bites in chattered twisting as it pulls,
And hops, and jerks, and burns the ground in touch --
As wheels begin to catch the angered thrust.

It snaps upright and scatters broken rock
And leaves the point of an edged razor cut.

As he rolls his chair through stagnant kitchen heat
The wordy bastard stops and lifts his gun
To turn the engine's key to off he shoots
And picks the spot he slides from road to death.

The edge a place we seek to measure self,
To seize the flame in dance before it’s out
The way to fight the coming of our end
The way we carve our names among the dead.

Mike Brady 2005/2010

Deadman, Chapter 2


Chapter 2

After graduation from nursing school, I returned to the hospital I had been working at as an orderly. I was now a new nurse in their coronary care unit. I had arrived; I was now one of the elite, a regular cock-robin.
Like most mid-sized hospitals of the era, the intensive care part of the hospital was divided into two sections – a coronary care unit and a surgical ICU. I was hired for the coronary care part. This was where they put the best and brightest – the cowboy nurses who could make a decision quickly, or not make one just as fast. The job required a combination of speed, restraint and judgment – the unusual mix of a beta mind in an alpha body – nervous, twitchy chain smokers who sat a lot and argued about the arrangement of bones.
 I spent most of my time with other nurses, all small ‘g' gods like myself. We sat in front of banks of heart monitors most of the day, just smoking our cigarettes and arguing with each other about the rhythms of our patients as they scrolled methodically in front of us. Our job was to watch... to patiently sit and anxiously watch until the time came when we leaped into action (mostly in the form of a reaction) as sudden, panicked alarms went off around us.
We learned to become passionate with inactivity. Like Calvin Coolidge’s theory of practical governmental inaction, we believed that the wheat would separate from the chaff if we allowed the movement of time to shake it loose. We pounced on grave concerns only, and set the bar as high as it could be set before we acted. We were the best; we were the people other people in the hospital came to with life and death problems. Most of all, we knew, in the core of our souls, that we were Gods chosen people (At least the people God chose to take care of really sick people.)
We were true believers in the religion of western medicine -- we believed that our individual actions made a difference, and that we were the ones on the front line with the job of making it happen.
We also believed that if you couldn’t beat death, you could at least explain it in scientific terms that were easy to understand.
We had a thing we called, “dead man talking”. Back in the old days, before TPA (Tissue Plasminogen activator- a “clot busting” drug) and other fancy treatments, we had nothing to stop a heart attack. We could treat the pain with morphine and nitroglycerin; we could rest the patient in bed, and give oxygen by a tube in the nose. None of those things would actually STOP a heart from dying, so we spent most of our time watching for signs of a damaged heart getting progressively worse -- irritability, irregularity’s, and other signs of a pump that no longer could pump.
We also tested for damage by running a lab test for the enzyme released when heart muscle was damaged (CPKmb) --- the higher the number, the more the damage. Back then, when you saw a number over 10,000, you knew trouble was coming. When you saw numbers over 20,000, you knew that they were dead.
          I remember seeing a borderline famous guy in a picture from a newspaper. He was sitting in a dirty swimming pool and looking stunned during one of those late summer Malibu fires. He looked alert and relatively untouched, but died later that day of massive burn injuries.
That’s the way dead men looked on arrival to our coronary care unit- kind of dazed, but otherwise normal. There was a real strangeness when you looked at a normal person and knew that he would be dead in three days- it took more than getting used to it, it took practice.
          It was like a drill that had become a process. These soon-to-be dead people would come up from the ER, with their pain mostly relieved. They looked thankful and almost happy that the worst was over. Once they arrived to the unit, we would make them safe with the structures of industrial caring – forms filled out, procedures explained from pre-prepared sheets of paper, and orientations made to new equipment. We established our bonifides through these displays of confident competence – even if we had to fake it. (Nursing is really one of those jobs where it’s much more important to look good than to be good. Fair warning.)
To the person involved in the death of their heart, it comes out of nowhere. It happens at a routine part of a routine day, usually a day like every other day--- nothing special. A big attack usually slams a man down with sudden acute chest pain, usually radiating down an arm or up the chest to the throat. They have an acute feeling of impending doom and their anxiety escalates big time -- worse than when they were a child and left waiting alone in a room for hours, waiting  “for their father to come home.” Sometimes they can’t breath, sometimes they can’t lay flat- but they ALL know that they are involved in a major life event, a thing that will change them forever.
 What they are is dead, with three days of grace. The real working part of the drill was to be with them as they figured it out.

Sunday, April 25, 2010

Deadman, Chapter 1

When you shake hands with a nurse, follow the eyes – they’ll be checking out your veins for plumpness.

Chapter 1

 I left the Navy in 1977, after four years as a hospital corpsman. I became part of a larger world. The world got bigger, I didn’t. I found it useful to hide out in a lot of part time activities to keep the bastards from finding out that I was on the loose. I thought they might rub me out. I worried a lot about being rubbed out.
Though I had no idea who the bastards were, I did know that they were renting space in my head for meetings on a regular basis. (As a schizophrenic once told me, in a clear moment, “You know those voices in your head all the time? To whom are they talking to?)
I started school at a community college in Pacific Grove, California – general studies –, which consisted of a lot of dope smoking with other students that I had instinctively meet the first hour after arriving on campus. I also went to some night classes. I grew my hair out, moved to a hippie part of town and kept a low profile. Living off the grid soon became a distant ambition – a thing to work back towards.
 I found myself stuck in a long-term skittish mood. Since I was getting $400 bucks a month from the government to attend classes, I thought of the time as a therapeutic easing, as a gentle preparation for my eventual reentry into society. It was like living in my own halfway house, without the benefits of structure or therapy.
With time, I got better -- a yak butter on an open sore mixed with time kind of better. Or maybe I just got the butter and the time.
By the end of 1978, I was working as a teaching assistant in an English-as-a-second-language program for special needs students at a local high school. I didn’t speak Spanish, but did reasonably well given the circumstances. I started dating a hippie chick with large breasts and three peasant dresses. She wore the dresses in consecutive order, never with bras or panties. I learned to think of underarm hair as good, and that the smell of patchouli and skunkweed was pleasant. Months passed, I began to see faces in clouds. I sunk in deep and prospered. I was not unhappy.
I would sit on the railroad tracks by my cabin and get stoned. I’d watch the fog creep in, until confused by the banks of it. I’d stumble my way to the Fat Cat cafe, two blocks away, and get something to eat. It always seemed to take forever to get there, but I always had just that amount of time to spare.
By 1980, I was better. I broke up with my girlfriend and left her alone -- with a limited wardrobe, an aging cat and a bad feeling. The hippie thing had finally worn me down; I was tired of talking reason to plaster garden gnomes. I headed off to the big city -- San Jose.  
   For work, I found that my Navy experience was helpful. I started at a big downtown hospital as a nursing assistant, part time. The way it worked: they would call me when they needed someone, and I would answer the phone if I ran out of money. 
I returned to dating – big city dating. I’d spend nights at the St. James Infirmary in Mountain View drinking like a fish, and then, when lucky, have casual, drunken sex with women I hardly knew, in hot tubs of apartments I didn’t live in.  It was new to me that such things were possible. I cut my hair and prospered, with women who now wanted me for what I could give them and not who I was. Relationships became more practical, if also more mechanical.
Women, at least women and me, have always been a problem in my life. I tend to go for two types – the emotionally unavailable, and the unattainable by me: The sultry basket case with drug problems, or the blond goddesses that falls into my emotional lap while stumbling across a room to talk with someone else – those types. It’s distracting and consuming, and, as the famous Ralph Wiggins once said, but probably not about me, “It smells like burning,” and it did. I burned both bad and often.
My life arced whatever and whomever it touched in a strangely twisted electrical hum of unmet need, as well as a scarifying disregard for anything that was good for me. But, life was good. I felt I was cooking with gas in an electrical wonderland. Obliviousness became my true advantage. I practiced slash and burn social engineering and left smokey crisps on human radar ranges though out the city. I blamed the drugs and the poor influence of friends for my indiscretions, when I bothered to blame anyone at all.
Then I met a girl. When I say girl, I mean it – she was a senior in high school working in the lab at the hospital me as a technician.
Gina was very mature for 17, but I was 26. I stopped talking to her until the summer she graduated. She was decent, cute, Catholic and crazy about me in a magnificently co-dependent way. Her life revolved around me, and I was flattered.
I made a decision to settle down with her, a sort of ‘time to put down childish things’ decision. I went to school and became a nurse; we stumbled into plans for the future together.


Saturday, April 24, 2010

Introduction to the Plan


The plan

I’ve been working, off and on, the last ten years on a piece of writing. I think that it’s a book, but it may turn out to be something else. I call it a memoir, unless Oprah starts grilling me and then I’ll crack and call it something else. It will still be a memoir, but I crack easily around strong women. I’m the ultimate unreliable first person narrator in all areas of non-fiction – it’s my gift -- and time to put it to work.

One of the problems I’m running into -- at 50 thousand words, I’m losing my place – I keep coming back to the story without a feel for the story. I’ve been trying to find a way to read it, and then write more of it – all in one big chunk of time.

I’m trying to do too much, so I’m not doing anything.

The only way I can think to make it manageable (other than getting software that follows my plot and lists my characters, which, let’s face it, is not going to happen.) is to go back and break it down into chapters and build up from there.

It’s not that I don’t know the story – (I’ll outline it at the end of this) – it’s organizational.

So, since I‘ve been averaging about 700 words a day for the last month, I’m going to turn my daily blog of random things into a daily update of chapters. I think that getting a bunch of chapters together will tell me what to do next.

This will be a process – I will try to get the spellings right and the approximate shapes in between the rough lines. I might leave gaps to be filled in later. This is going to be a warts and all thing – but since I don’t have too many readers, it should be fun -- a in-on-the-ground-floor experience of funness.

It’s also what I’m calling the, “plan.”

Here’s the story:

In 1984, a man comes into the hospital with a massive heart attack. Lab tests show that the heart attack was large enough to destroy his heart muscle, and, based on the experience of the RN taking care of him, he will most likely die in three days. Because the heart will die progressively, not suddenly, the man will be intellectually alert and responsive for most of those three days.

The nurse knows that the patient will die, but the patient does not.

That’s the story – 3 days in a coronary care unit with a nurse and a dying man. Each day a major section, each day with a theme.

Also – expect lots of ambergris, and the mucking around in fluids.

The nurse changes – the man dies, (or does he?) The real story is in the nurse – the question and the tension in the story will come from the development of the nurse over the three days– is he Ishmael, Ahab, or the big fucking whale?

Starts Monday!

Friday, April 23, 2010

There is No Plural for Pajama

There is No Plural for Pajama

Your pajamas want you back,
They miss you, (not in words,
They are not capable of speech.)
As they fold under your pillow,
Poking out; an inanimate lament.

I think...
Your shampoo is starting to leak
Thickly teared bubbles…
And your soap!
Don’t get me started on your soap!
I don't think your soap will make it.

Your coffee is getting cold
And I don't think that cream was a good idea
I already see a milky film
And it may go the way of the soap,
Maybe even sooner.

When you get back, it might just be me
Waiting with arms open
Holding a cold pajama
For you to warm.


Mike Brady 2005/10

                                
                                    

Thursday, April 22, 2010

Why I'm Me

I think that most of what I write is stuff that should have been brought up years ago when I was a teenager. It's really a bunch of self –self in all the basic ways -- absorbed, conscious, flagellated and fish. I’m still struggling through the Nietzsche and Sartre phases of personality development, and doing it much too late in life – I should be at the Niebhur stage and coasting comfortably into my old age; all compromise and apology to the forces that demand my surrender, be it gravity or guilt.

Granny used to say that I was just a “willful” child, but I’m thinking it’s much deeper. Granny had the gift of understatement.

All true, though I’m trying to be pleasant about it. I am just trying to figure out what the point is.

I not interested in the big bang, I want to find the big vagina that it shot out of. I’m not interested in time, I want to find out who’s keeping the score. I don’t want to know where I’m going after I’m dead, I want to know where I was before I was born.

It seems too human to focus on explosions and not consider the source. At times, on nights alone, I look at the stars and consider god. I consider everything. At sometimes, I get it – the bigness in the small of my head. Then I ask – is there more? What’s beyond everything?

There’s at least a couple of ways to go with this:

Without end, always, infinity and forever seem platitudes for, “You are too dumb to get it.” Absolutes are the lazy way of getting out of doing the work – it’s a way substituting. “I know” for, “I’m working on it.” Yes, it’s simple, but it’s not that simple.

Life seems, at minimum, to involve cycles -- It may be spirals, if you think progressively, but it does seem to basically have a circularly way about it. Things come around, seasons change, and meteorologists predictably get the weather wrong.

The law of fractals implies that what we see in the small is just  a scaled model of the large. If true, and it seems right, then the things we see around us, the principles we use to guide us, -- all should be universal in their applicability. What is everything? – Well, just about what you’d expect after looking around a bit.

So, understand, the point of it all is -- to see the patterns in the chaos. (This isn’t much help, but it’s better than infinity.)

Or, we can accept things the way they are – surrender to the thing that’s bigger than us – life, god, whatever. Give up and get on with it.

This might work – all of us have enough to do without worrying about crap like, “what was before anything was?” Kids need to be loved and clothed, jobs all  have there own focused stress, and the comparing of what’s in us to what others have outside them, seems to fill us up enough. Looking for the big stuff is almost a criminally negligent act, when you think of it.

But I believe that everything is a part of everything else – that we are all one big thing – and this includes the things that are not there – the big disappearing vagina in the sky, the place we were before we were – all of it. I also believe, like the old timey Jews, that you can’t say what “it” is, that any attempts to say it, limit it – the answer you get when you ask is, “Yes, it’s that, but it’s much more too, you blasphemer of a reductionist.”

But if we are everything, we are also nothing.

Which brings us back to me. From a list of all the forms of self, I choose to seek self-awareness. To whatever form of god there is, or what form she takes, she’s only going to accept my awed surrender if I’m actually the one who shows up to give it.

I don't want to get absorbed, I want to show up at the front door with flowers. I want to ring the bell.

















Wednesday, April 21, 2010

Webmaster update

I've been busy today going through all of my old blog entries, getting rid of bad links, pictures, and some bad writing. I have finished the first year -- 200 entries, and will try to get to this years entries later today (think, tomorrow.) I'm also posting a picture of my daughter, Allison, with her new car.

It's cold and rainy this afternoon -- perfect for both writing and napping. We shall see which way I go, but you probably already know.

(My apologies for the movie review of Kick-Ass I did yesterday -- it was more tone than informational. I can make almost anything about me, and you'd be surprised how easy it is. You may not know too much about the movie, but you know a little more about me.)

Mike

Tuesday, April 20, 2010

Kick Ass, a movie review


“They are ruining the ending,” she said.
“What do I care, I don’t even know you,” I replied.

It was the Tuesday special, in a small theater with old seats. Half crazy and more than moderately disabled people were chanting from the back row:

“Hot chocolate, Hot OJ, Hot coffee, Hot hot dogs,” went the chant. Pause, repeat.

I expected to see them after the movie shouting, “Bring out your dead” in front of the pancake house next door. I saw them in my head, like a movie, with Styrofoam cups in their hands. I also expected to see actual dead people as well.

My seat dipped to left, slightly and I bought no refreshments. The movie last two hours and it seemed like two hours.

I wanted to like it, and I guess I did, in a way. Nick Cage was Nick Cage, but his daughter was a real delight – funny, cute, expressive and articulate. When she asked, “What do you cuxt’s want?” when facing down some bad guys, I really bought it. (She wasn’t really asking a question.)

The violence was not up to the caliber of the movie “Shoot ‘em Up’,” but then, what movie is? They made up for the lack of it with quantity -- Head explosions, bazooka rides, etc. – gore galore. I’ve both seen and expected better – but the film was sharp and crisp, and though I expected the graphic violence, many others might be in for a surprise.

Based just on the trailers, this movie looked more like “Spy Kids” than a John Woo’s greatest hits remake. It’s not Spy Kids, trust me, it’s much  more a graphic novel than a comic book. Think Watchman, not Jughead.

The people that have been marketing this movie must have never seen this movie – or, maybe they did, and the campaign they put out is actually another, different, film -- a short satire on something uniquely American that features cartoons and guns in a world where no one can die, even if they should, (“I’ll get that wascally wabbit,” but he won’t.)

It’s probably about money. This is clearly a cult movie, but, at times, it must have seemed to the money boys that it might be much much more if you just nudged it the right way -- by lying. I can see the temptation, but can also imagine a lot of disappointed parents that the studios might never get back after the cute little girl says, “mother fucker” the second time in anger. She really is adorable, by the way.

I grew up in Oklahoma and I was considered strange. After I moved to California I realized I wasn’t – well, I am, but compared to??? Because of the stress that I received in early childhood, I like my entertainment to be over the top of what I see as over the top. If I could imagine it, why would I want to see it? If it’s not stranger, or at least better, than me, why bother? – It would be like having an argument with someone I agreed with over something I agreed on.

But, I’ll see it again, just not right away. I’ll see it at one of the midnight movies in a funky art house, on a night that the “Big Lebowski’s” is not playing. I’ll be the one in the back chanting lines from Donny Darko to all that are interested.














Rolling Away the Stone

Issue #1 of Mike’s solutions to everyday problems. 
(If you have to ask what the problem is, you are not ready for the solution.)

The advantage of the paper against wall method is -- the natural braking action of the wall prevents paper runaways. This is useful if you are a forceful person, have mad pets, or are a practicing Sufi with whirling dervish tendencies.

It’s also a bit unhygienic – the need to touch the wall when pulling the paper can come at a “bad” time – especially if you need additional paper after the first pull and wipe. It’s the ultimate of a double dipping no-no. Since yankers tend to more emotional and impulsive, they may want to plan accordingly. It’s better to take too much and not need it than to have poop on your walls. Inderal can help – ask your physician. Enough said, really, enough.

The advantage of placing the roll so that the paper free falls into the center of the room is convenience, it’s easy – and it’s more ethereal and cottony – like pulling an air bidet, with padding, to effortlessly, and obviously, cleanse yourself. It doesn’t take thought or care – perfect for the conditions. Sometimes, thinking is not your friend.

The downside is, again, the runaway problem – piles of paper loosely unleashed onto tile floors. This is a bad approach for those with dogs, kids, tardive dyskinesia, or attention problems in general. As well, people with septic tanks may find themselves walking through puddles of poo in their backyards after rainy days, if not careful when flushing the extra paper.

The solution is -- give a gentle fold to the roll before you put it on the bar. Your front facing “free roll” will now have a brake! The oval lumpiness will “chunk” itself with each revolution, and thereby limit runaways, saving paper for what it’s really for –wiping shit off your butt.

Monday, April 19, 2010

Goldman Sachs, Simply


What they did:

A client (Abacus) came to them with an idea. They wanted to take a pile of bad mortgages and bundle them into a bigger pile. Packaged, and with the reputation of a major investment banker (Goldman) behind them, They wanted to sell them to investors and bet their own money that they would fail.

Playing with loaded dice makes it Wall Street, not Vegas.

The mortgages were selected to fail with Goldman's help. Goldman was brought in to both help in the selecting of the bad stuff, and to make the sales to the unwitting -- people who felt that Goldman was acting as a fair broker -- as a  "Banking Investment Firm."

After Goldman et. al. found the worst of the worst, they bundled them into a package, then sold the package to investors. And, this is key, when the package was sold, there was no mention to the investors of the certainty they would lose all of their money.

And when the mortgages failed, the client would collect the insurance money (CDO's and shorts.)
That's the money shot of the thing – the collecting of the insurance money for the client, all else just the  incidental mechanics of a scam.

So -- Three months after the sales, the package failed and the investments became worthless – just as planned. The people who bought them lost all their money. The client who set the scam up with Goldman collected the insurance money.

Goldman made its money from the fee it charged to set this up. It was a big fee.

So, fraud? scam? business as usual?

It's also interesting to note that the big ratings agency, Moody's, gave a triple A rating to the package. No one would have bought the package if the rating wasn't high. Rating agency's evaluate risk -- that's their job. And remember -- this package's value went to zero shortly after it was sold and rated. (What a scum bag job they did -- I mean, how awful can you be and still be in business kind of scum bag job?)




Put another way:

I want a house built for the purpose of it burning up as soon as possible. I arrange for a contractor to build it -- using full gas cans for the framing, and then painting it with a colored napalm. The contractor charges me for the building costs -- he's a good contractor, with a great reputation, so he charges a lot. I then take out an insurance policy that will pay me when the house burns down. 

I sell it to a person after I build it -- but keep the insurance in my name. The house burns down a week after I sell it. I get my money when the insurance pays out. 

The difference is:

What I did is a pretty straightforward crime. I would go to jail, and the contractor would go there as well. No one would argue that the person who bought my house should have known better and it would not be a case where I could say  that they did not do due diligence. I framed the fucking house with gas cans.

"We didn't set the fire," they say.

What Goldman did is now being argued on Business TV. Hours of excuses are being forwarded – “Yes, what they did might have been TECHNICALLY wrong, but not LEGALLY,” and, “It’s business, and the people who bought the big pile should have known better,” and, “Goldman was just doing what was best for their client and there is no crime in that,” and, "They (democrats -- but you knew that, didn't you?) are trying to demonize and destroy America's financial industry."

If the  crime is not clear – what they did is. Goldman  is considered to be the best of the investment banks. They have a written code of ethics that is a model of the industry – everyone says so. They roared  out of the last recession like no other. They did it for their investors and for their bonuses -- not for the good of anyone or anything else. (For how -- see the link below)

Used car salesmen have more ethics, and they certainly have more regulation. Maybe car dealers just  need to get a better lobby, or they need to give more money to their regulators.

Most of the TV talking heads, and all of the experts they bring on, say that what Goldman did is the common practice.

Wow, who would have thought -- wealthy people using their money to manipulate the system by buying smart people without internal ethics, and politicians that are seeking to keep themselves in office at any cost. Huh --Wealthy people gutting the system that tries to regulate them by buying the people who set the regulations, or, using their own in house help to write the damn things if they have to (lobbyist's are very helpful to overworked congressional staff.)

As if we didn't know. 

For more, and more complete, information about how they have done this, read Matt Taibbi’s Rolling Stone article, (below.) It's about Goldman Sachs’ and their business practices. When this article first came out, it was poo-pooed by the mainstream media, but now, just a few months later, it's almost scary real in how accurate it shows things.

And, never forget, eat the rich.