A further certified "arrival": at 1:05 am I sat down in the relative calm to read my email. "Why feign sanity?" I ask myself as I hear the cops arrive with several "frequent-flier" rowdies. A wonderful, helpful, supportive charge nurse quietly asked "Starfish," can you please deal with "bad boy #1" because you're more experienced, blah, blah,blah" Translation: the new residents will take forever. Gentles, mark my words: a nurse (s) WILL SAVE YOUR ASS at some point. Invariably & unquestionably. This particular nurse had more than earned her request, but never, and I repeat never piss off a nurse, especially when you are exhausted & and on call. Heed me not and you will receive a phone call every 40 minutes asking a "procedural question": "Can we PRN Tylenol for Mrs. contentedly-sleeping-soundly for back pain?" "Is she in pain?" "Not at the moment, but she might complain later." By morning, you've gotten the message. Trust me.

I approach Gentleman #1 appropriately gloved, and "half-masked" (very stupid, but it's so uncomfortable...), and try to check the obvious cut over his eye, and without even touching him, he head-butted me and spit in my face. I distinctly recall a switch go off and "better call the homies 'cause it's about to go down" ring in my ears. "GET THE CUFFS OFF THIS ASSHOLE! I'm trying to help you & you spit in my face? GET THE CUFFS OFF THIS ASSHOLE!" Bear in mind, if Gentleman #1 and his cohort are enjoying the moment (and you know they are), look for the hook in your lip... In my raging blindness, in steps the massive cop, cool as the proverbial cucumber, to walk me away, to save me from myself. "Do we need to sedate you or will you let me check you out?" "Go ahead, I'm cool." We both laugh as the cop (good naturedly) asks, "Do you want to press charges?" Yates wrote something about the ladder to heaven "always begins on the ground," and I suspect he had read Dante, concluding this phenomenon to describe the term, per diem.

Sitting back down to the computer, I became aware of how much the "head-butt" hurt; I was squinting and there was a dull sort of buzz in my head; described in the vernacular as "having one's bell rung." I told the charge nurse I was going to lie down in the dark. The lack of stimuli was immediately calming and I recalled reading in nearly a single sitting what I strongly recommend (blatant commercial) as a phenomenal read, My Stroke of Insight by Jill Taylor, a Harvard-trained neuroanatomist who, at age 37, experienced a rare (only 2% of all "bleeding") hemorrhagic stroke from a burst congenital arteriovenous malformation (in this case, an artery, rather than passing through the capillary bed - sorry, I know it was a cheap convention -- connected directly to a vein. Interesting in itself, it is unique that this is written by a gifted neuroanatomist who was able, first-person, to perceive exactly what was happening as she sequentially lost the ability to walk, talk, read, and define herself, yet managed to force herself to get help.

I was reminded that it was only several short years ago, I experienced a significant TBI with a bleeder inflicted by a psychotic, violent patient that left me on disability for nearly a year; a "lost" year. I continue to experience short-term memory deficits, cannot calculate numbers in "my head" (and I believe I've mentioned I've had to memorize portions of the MMSE because I can't remember!) I've twice contracted "Community Acquired pneumonia," and viral meningitis, and have had surgery 3 times for injuries "on the job."

You probably are aware of the story from Luke 10:25-37, otherwise referred to as the Parable of the Good Samaritan: A man is beaten by robbers and left for dead by the side of the road. The "good" people pass by, in too much of a hurry to bother with the poor injured fellow they see & choose to ignore. And along comes a lowly Samaritan - and if you didn't know, residents of Samaria were universally loathed and despised and were treated accordingly. One did not associate with a Samaritan. Obviously this adds to the poignancy of the story. He who is the most loathed stops and carries this injured fellow to the closest inn, offering a "down-payment" for his care, with a promise of full-payment upon his return. We are to imagine that the poor beaten man was treated with kindness & recovered, and the Good Samaritan served as a lesson in "integrity & mercy" where one would not ordinarily expect it be found. All's well that ends well, or does it?

I'm walking to the all-night pharmacy at about 10:30 pm, "camared," looking for the contrasts in light that intrigue me. It was an unusually cool evening for August in San Diego, and I had ducked back in my door for a light jacket before proceeding. A block away from the pharmacy, I come upon a man wearing (in my estimation an unfair qualifier) "wife-beater" t-shirt, and sandals with no socks:

"Hey, man, can you help me out? A few bucks for a blanket? I'm really cold" He is shivering, but what do I know...

"Come on to the pharmacy with me, I'll buy you a beach blanket or something."

"I can't man, I sprained my ankle."

"Then wait here. I'll be right back."

"It's so cold man, too cold to wait here."

"Look, I'll get you a blanket and you can have some bags of recyclables I have..."

"No, I broke my wrist. Just a few bucks?"

And the now disengruntled Samaritan mutters, "Get out of my face. Get the fuck out of my face," and moves on. I actually bought a beach blanket, came out, and he was long gone. Heading home, I venture upon a man seated at an outside table with grossly infected needle tracks, approximately 6-7 inches long, fiery and oozing, from injecting who knows what. He has a full bottle of isopropyl alcohol he is slowly pouring over the "wounds," and he has a roll of cotton dressing. He looks up at me, young but already missing teeth, and says, "I got an infection from a cut; can you believe it?" "Pal, you're slamming and you better get yourself to the ER 2 or 4 blocks away." "Nah, I'll be OK. The alcohol will clear it up." I start to say more, but set the blanket on the table and started home. Disengruntled, indeed.

It's a long time 'comin before the dawn.