Sunday, June 11, 2017

Appalachia vs.Appalachia at the ER

Appalachia vs. Appalachia at the ER 
(c) 2017 Trinny Sigler

I found myself in search of a quick emergency room in eastern Tennessee which was mission impossible  because all they do down there is moonshine and zipline, and that's a bad combination. I wish I could say I had been engaging in both, but at mid-forties, I don't need either to mess up my back. I was tucked in bed by 10 and woke up in the eighth ring of hell for no reason.
My buddy told me choices for a hospital that, to my pain-warped brain sounded like "Wellmart" or "Hell's Path." I don't need no discount chain ER, and I thought I was already halfway down hell's path at least, so I picked the later. While I'm waiting for the phlebotomist to come in, I can  hear her talking in the hallway.
"I had to punch in late. I locked my keys in the car."
"Well how'd you get here?" another one called.
"I had to call  my mommy."
Hear that? A girl who couldn't find her way to work without Mommy's help is about to play with needles in my tiny, rolling, spider, muppet veins. Then she walked in, and she's new. I know when they are new in the same way a horse knows the rider is spooked, in the same way a baby knows when someone has never held a baby before. She's nervous. I'm scared.
Veins and blood are the reason I'm a writer and not a nurse. I could have a thriving career making fifty an hour over time if it weren't for blood. Instead I hide in the attic and make shit up and hope you like it. I look away as she takes my arm and ties it up. She pokes with her finger. She takes a deep breath.
"Little pinch."
She stirs and stirs and stirs.
"Hmmm," she says.
I say "What?"
Another nurse comes over, "What'sa matter? Cain't you find it?"
"I cain't get it to thread."
"Oh well, try again."
"Oh no! That's a mess!"
"We can clean that up. Try again. That'un will probably bleed again."
"Ok...well...I cain't get it again."
And I'm thinking: Now half my state shoots up heroin, and any one of those shaking addicts up any holler can find a vein daily and multiple times. What's the issue here?
"Well!" The second nurse says, "You done blew that'un out. Try the other one."
I grasp her hand, "You got one more try in that other arm, and then I'm gonna puke, punch, or pass out. I don't know which. Your move."
"I'll try the hand, hon. Honey, your lil ole hands are I's co."
My mind flips through every file I've got working, and I know I've heard this somewhere before. Where? Where? Where? I's? Co? I know what this means. I got it! I heard this when I was a breakfast waitress at Cracker Barrel in Fayetteville North Carolina  in 1997.
"Ice cold!" I yell out loud with all the pride Helen Keller must have felt when she figured out water. "Yes! My hands are ice cold."
And now that the code has been cracked, I finally understand what the waitress at the barbeque shack meant last night when she asked me if I wanted "co-saw". And then the thought occurred to me that this is all Paula Deen's fault. I'm a little afraid of Pennywise from It, the nurse from Misery, and Paula Deen. If you think about it, they all have the same smile. That smile that says: Extremely friendly or psycho, I could go either way. And her damn cookin' is so good that I think she has to be in dutch with the devil. Anyway I think I ate so much for lunch that my stomach blew out my backbone.
They finally get the blood drawn, and the IV in. Another one comes in, "What brings you here today?"
"My side hurts, and my back is having spasms."
"Hmm..." she looks at the others with that look that says: These West Virginia pillbillies are coming down here now trying to get opiods. I've read about them. Saw them even on the CNN." You know that look. We've all gotten it in the ER.
Finally after about two days, the doctor comes in. He says my muscles are pulled and I have an ovarian cyst and to follow up with my doctor, and then he leaves. The nurse comes back.
"Okay, hon! You are free to leave. Here's your script."
I stammer, "But it's Easter Sunday, and I'm just like I was when I got here. I have to drive 300 miles in a Jeep Wrangler today with a busted back. Can I get a dose of pain meds?"
She gives me that look again. "Lemme ask! Doc may be at lunch now so you'll prolly have to wait."
She comes back and shoots something in my IV. "Well now  you'll have to wait on a med check."
"How long is that?"
"Fifteen minutes."
"Jesus, girl. I've been here, sitting at a 90 degree angle on this gurney for about two days. Fifteen more minutes won't hurt."

I finally get out of there and leave Hell's Path behind me. I get back to good old West-by-God and go the next day to follow up with my doctor. She takes one look at my blowed-out vein and gives the nurse a look that says: Umm hmm...all these hillbillies are on heroin. You know that look. We always get it at the ER. 

Tuesday, April 18, 2017

In response to Giuseppe Sabella's April 15th article, "Teen's Death Comes Amid Complaints at Rescare's WV Facilities."

I write in response to Giuseppe Sabella's April 15, 2017 article, Teen's Death Comes Amid Complaints at Rescare's WV Facilities. I am a children's therapist, a social worker, and the mother of "Resident 2" that is mentioned in the article. My son, Russell,  has severe autism and has resided at the Woodward home since 2014. The other boys at the home are like family to me, and I am heartbroken over Jeremy Bush's death.
However, I visit the Woodward home regularly, anytime I want to, announced or unannounced and have never found staff to be anything other than professional and caring. When problems have arisen, they have been handled quickly and efficiently. As someone who is deeply involved with this facility, I have multiple issues with Mr. Sabella's article.
First, while in an ideal world, there would be no substantiated allegations of neglect, abuse, or staffing issues at any care facility, we know this isn't the reality. According to the article, Rescare facilities statewide had 32 complaints in a four-year period among 10 facilities, so on average, that's less than one complaint per facility per year. It would have been helpful if Mr. Sabella would have pointed out how this number compares to other agencies who serve similar clientele over the same period of time.
Later in the article, Metro 911 records were reported, and Sabella highlighted that emergency services responded to the facility 35 times in two years. Most of them were for triggered fire alarms. Ten "were from people concerned about patients outside the facility." An average of five times a year, someone in the neighborhood called to complain. How many of these were true issues?
Sadly, abuse and neglect could occur anywhere: in families of origin,  foster care,  group homes,  daycare centers, hospitals, nursing homes. In any agency, sometimes employees look good on paper and in interview and turn out to be bad people, but companies have no way of knowing this until an incident occurs. Additionally, the reality is that these clients are mentally impaired and can be "aggressive, assaultive, and security risks". Often, this population cannot be reasoned with, and they can randomly act out aggressively. It takes special people to work with these clients, and sometimes new employees feel that they "have what it takes" until they are faced with the reality of it.
Sometimes families have to make a decision for placement when it becomes evident that they can no longer care for their loved one in their home. What troubles me most about his article is that you've highlighted the worst without any balance. You've likely discouraged families from reaching out for group home care when they desperately need it. You made no mention of the thousands of other clients that dedicated Rescare staff work with daily to improve their quality of life.
"Resident 2" had listed in his record that he "was known to flee from his home and out of staff's eyesight." That was likely put in there because I told them. He is severely autistic and nonverbal. I tell all new staff that my son will do what you expect him to do nine out of ten times, but the tenth time, he will do something so unexpectedly that you won't see it coming. When he lived at home with me, he used to try to grab my arms when I was driving, has slapped me so hard that it left marks, has the ability to stay up for multiple days with no sleep, and yes, with autism, elopement is always a concern. He is 6' 2" at age 15, and some days he would throw himself  in the floor and refuse to dress. Some days I would  have to grab him around the waist and pray I could keep him from running outside in the snow naked. One day he got off the bus and threw himself in a ditch on the side of the road. He was unable to toilet train and would smear feces on the wall, and sometimes if he got mad, he would purposely urinate on his mattress.  You take these behaviors and multiply them by 2500, which is what Rescare is dealing with daily. You're going to have "incidents". You don't slam one of the few agencies that is truly there to help. You don't understand this unless you have lived it, but Russell and I are available if anybody wants to talk.  
Rescare and their staff saved my life and Russell's too. They took him in when no other local facility could manage his behaviors. If it wasn't for the Woodward home, my son would be at best six hours away from me and could be sent as far as Florida. Since he has lived at Woodward, he has become fully potty trained,  his speech has improved, and he dresses himself. He is more social and goes on outings with staff. Elopement is no longer an issue. He is no longer aggressive. For the first time in his life, he has friends who are like brothers to him. I tell the boys that we are all family.
My final issue is that the article  highlighted all the problems without offering solutions. The solution is better pay for staff. This would attract, reward, and keep caring people in place. Day programs are also needed for those with mental impairment so that they have productive things to do to fill their time. The Charleston area needs a respite center similar to the Potomac Center in Hampshire County. We need more schools such as the Applied Behavioral Learning Center in South Charleston, and Kanawha County Schools needs to find an effective way to educate and work with students having the severe behavioral issues that come with autism instead of putting the students on homebound.
In summary, Rescare is one of the few agencies in this state that tries to give these clients a meaningful quality of life. I know from experience that many therapy centers, doctors offices, churches, and the school system do not want to deal with my son and other clients like him. But these children are here, and they have the right to be. Jeremy Bush's death should be a wake up call that more services are needed in our area, but it shouldn't be used as a license for the media to sabotage the few helpful services families like mine do have.

Monday, March 6, 2017

These Daffodils and I

These Daffodils and I

These daffodils to the funeral came 100 years ago
and still surround the grave.
Why this one in the whole field of stones?
Only the daffodils remember,
only the daffodils know.

These daffodils were planted by the front door
and once tended with care,
like yellow ribbons beckoning her solider back there.
Did he make it back? No one knows anymore,
but these daffodils stand, still sentinels as before.

These daffodils surround a cinder-block frame.
No family, no home, no memories remain.  
What made them  decide to leave one day?
Ask the cheerleaders of decay,
because only these daffodils can say.

I buried these bulbs before the baby came.
I wanted them to honor him this time every spring.
He's gone now, along with every other thing,
but the daffodils  and I stand just the same.

These daffodils, I know,  are tired and tossed
despite  their cheerful yellow outward gloss.
These daffodils, I know they know the cost,
of a lifetime spent hovering over all that is lost. 

 (c) Trinny Sigler 2017

Sunday, February 19, 2017

One Seventy Two

One Seventy Two

One seventy two
was my aunt's weight
before cancer started
eating her.
We took her to appointments,
and each time presented her license,
her weight there in print,
and she was okay at 172.
At  16, I knew that 172
made a woman
hefty, sturdy,
strong enough to
hold up the world.
When I learned she'd be leaving,
I decided to go too.
I was 132.
She'd take her medicine
in a spoonful of applesauce.
I wouldn't eat a spoonful of anything
more than once a day.
We got weak together.
Our hair fell out.
We became delusional:
Me in a weight competition with her,
thinking that if I was her size or smaller,
and if I was still surviving,
then so could she.
She, telling me pretty lies like:
The doctor says if I drink my Ensure,
I'll be all right.
We got down to 118
the month before she left.
I  celebrated my 17th birthday
in bed with her.
Then she said she hated the sticky summer
and died on the 20th of June.
I dropped down to 104
before I decided I'd stick around.
Since then I've gained and lost 50 pounds three times,
but I always come back to 172.
I don't know how else
to be where she was

back when we were okay. 

Monday, January 2, 2017

Kindergarten Round-up

Kindergarten Round-Up

I was happily unshod in my pasture,
my mane blowing in the wind,
before kindergarten round-up.
I bucked. I tried to run away,
but they returned me to school every day.
They had no creek.
They had no woods.
They had no blue skies.
They had windows,
that you weren't allowed to look out.
Stop daydreaming!
I focused on the ping, ping, ping
of the old wall heater.
I tossed crayon pieces on it
and made me a kaleidoscope.  

Afternoon recess brought with it
the smell of freshly cut grass,
the promise  of a cool drink
when it was your turn in line,
a snack followed by the smell of diesel fuel.
I liked the diesel fuel fumes.
Diesel fuel meant they were about to let us go. 

Middle school:
You could get better grades,
if you'd focus!
You could be a good basketball player,
if you'd focus!
Stop talking to your neighbor,
and focus!
I'll move you away from your best friend,
if you can't focus!

High school:
Football games,
the frozen burn
when bleachers meet ass,
chafed by stiff denim
as we walked around with friends,
thawed only by the sex
nobody was supposed to be having,
in basements, in attics, in the back of cars.
Graduation day they take you to a field,
tell you you'll never all be together again,
and turn you loose finally,
but it's not the same.

Thirty years later:
Even in the yearbook,
they forced us into boxes.
I study the little faces,
the messy haircuts,
the jack-o-lantern teeth,
the shiny eyes,
before any of them considered
drugs or suicide,
before any of them went through
divorce, disease, death.
But some little hearts still held secrets.
The only thing similar,
the only thing equal,
is the size of the box.
We didn't know these things
before the kindergarten round-up,
so, yes, we've be educated.
We get educated into submission
or sent off to steeper restriction,
but  we never again get to be
the wild carefree ponies we were
before the kindergarten round up.

(c) Trinny Sigler 2017

Thursday, November 24, 2016

Eulogy for Ken: "Here's the magic. Take it, and don't spill it."

One of the last things Kenneth said to Nanny and me was, " Here's the magic. Take it, and don't spill it." Yes, he had some confusion at that time, but this made sense to me, and he couldn't have said a more perfect thing because the way he touched my life and the lives of countless others can only be described as magical.
Kenneth was such a spiritual and calm person, a man who found peace within himself. There has never been a more devoted caregiver, son, father, and grandfather, and there is no doubt that he has impacted his loved ones, the patients he cared for, and their families in major ways. But he would also leave behind thoughtful and simple surprises that would deeply touch others.
Once I hosted a cookout at my house and after everyone had left, I found a glass with a single white hydrangea he left for me in his space. He was always slipping me books he wanted me to read. On one of our family camping trips to a state park, I commented on how much I liked the Native America flute music they were playing in the gift shop. Six months later for Christmas, he presented me with the CD.  He continues to surprise and comfort us, and after he passed away, we found a simple note he left for Nanny telling her what a blessing she was to him and how much he loved her.
Kenneth was a writer himself, and I enjoyed the unique way he phrased things. When I was excitedly telling him that I wanted to go to graduate school, he said to me, "You always drip with enthusiasm". At one of the recent visits to the nursing home, he looked at me and very clearly said, "The Lord's done all he can with you. Don't ya figure?"
I want to share with you some of the magic he's left behind. We can find him in the first spring violets, a summer fern, a fall pumpkin,  in an autumn walk through the woods, in the smell of wood smoke. For the grandkids, he will come back to them each time they reach for a single stick of gum. We can see him in Nanny's eyes, in Emily's eyes, in Cliff's facial structure, in Larry's calm voice and quiet strength. We can see him in Tracy's devotion to Nanny and in Toby's excitement when Nanny comes home from the store. We can see him in baby Bralen, whom he continued to call for even when he couldn't remember anyone else.
Kenneth was my birthday twin, and I'll always find him on that day and  in the books I think he'd enjoy, in windchimes I know he'd like, every time I walk through a greenhouse, and in the enjoyment I get from a cup of coffee. He will come to me when I'm out shopping and see a short sleeve plaid shirt in just the right shade of blue that would make his eyes sparkle. In so many ways, he's still with us and though we will spill tears, we all carry a little of the magic that will never go away.
I want to share what I feel is a message he left for us all. As we were going through some of his papers, we found a story he had been working on. It is called "Hill Teacher." There were many pages clipped together, but when I flipped them over, I found a passage from the story. It's part of the dialogue, but it's very fitting today, and out of all those pages, this is  part I just happened to stop and read:

"It is wonderfully comforting, though, to have blessed assurance that there is a family circle in heaven which can never be broken. In this time and world we live in, religion comes back to doing the best we can  for as long as we can. Part of the best we can do is to help others as you folks have helped me. We appreciate you. We love you. We will never forget you." 

Monday, August 8, 2016

Dear lil homies, make friends with firsts...

Dear lil homies,
Make friends with firsts. I know you're nervous and don't want the summer to end. You don't wanna go to that bus stop, don't wanna pack that backpack, don't wanna force your summer feet back into sneakers, but today is your first step toward next weekend. It's your first step toward next summer. The only way out is through. It's also your first step toward new friends and new experiences and toward figuring out what you want to do and who you are and who you want to be.

There will always be firsts. First days of school, first dances, first dates, first time one your own, first cars, apartments, jobs. Every week Monday gives us a new first, and every morning of every day gives us a new first to start over. A fresh start.

Firsts are not something to be dreaded or feared, but a place where once again we are all equal, a place to catch your breath and to know that you have just as much right and power as anyone else to make the most of your firsts. You come to your firsts with something no one else has: your own unique talents and abilities. Your tiny first steps may add up to something major that the whole world needs. So wipe the sleep out of your eyes, wash the summer off your face, and go rock your first day knowing that you're one step closer to next summer than you were yesterday.