Truth really IS stranger than fiction

Some of you may know, or not, that I’m obsessed with true crime/murder shows and podcasts. Obsessed! To the point at least one friend has told me “you scare me!” (I think she was joking.) Anyway, what is so fun and fascinating about true crime is you could NOT make some of these stories up. You couldn’t make up the motives or the ridiculous alibis and lies criminals can come up with. We’ve all heard the Mark Twain quote that truth is stranger than fiction, and it really IS! This story I’m going to tell you about is a perfect example of that. It is the quintessential “truth really IS stranger than fiction” story.

In November 1999 a Huntington Beach, California couple were murdered. Dr. Kenneth Stahl was an anesthesiologist and Dr. Carolyn Oppy-Stahl was an optometrist. You would think they’d have a pretty wonderful life, right? You’d be wrong. Apparently Kenneth was having an affair with medical secretary Adriana Vasco. As police investigated the murder, they came across phone logs showing multiple phone calls between Dr. Stahl and Ms. Vasco specifically on the day of the murder. Her explanation was they were just calls about computer issues. Eh, ok, maybe plausible. Further investigation uncovered the two were indeed having an affair. Apparently not Dr. Stahl’s first affair. What differed from previous affairs he’s had was this time he decided he wanted to be with Adriana and no longer with his wife Carolyn. Ok, fair enough. That does happen. But what doesn’t generally happen is instead of simply divorcing his wife, Kenneth decides he’ll ask his mistress to hire a hitman to kill his wife. Because that makes complete sense, right?

What Kenneth isn’t aware of is that Ms. Vasco is also seeing a man by the name of Dennis Godley AKA Tony Satton. Mr. Godley happens to be a man with a criminal past. And for whatever reason, Adriana decides to ask her boyfriend to be the hitman who kills her other lover’s wife. My mind doesn’t work in any way that makes that make any sense, but apparently it did to her.

So Dr. Stahl and Dennis the hitman make plans for Dr. Stahl to be driving on a highway with his wife and pull over off the highway. Dennis Godley will be following then and be prepared to murder Carolyn. As far as anyone can tell, at this point Kenneth had no idea of Adriana’s very personal involvement with Dennis. The plan goes as arranged and Dennis performs the “hit” he was hired for. But… here’s the part you couldn’t possibly make up… Dennis wants his competition for Adriana’s affections out of the way and murders Kenneth as well! So to sum it up, Dr. Kenneth Stahl was murdered by the hitman he hired to murder his wife. Really?! When I first heard this story I was shaking my head at that final twist.

Ms. Vasco and Mr. Godley were arrested and charged with two counts of murder approximately a year after the murder. Ms. Vasco went on to be convicted of both counts and is in prison for life without the possibility of parole. Mr. Godley pleaded guilty and later died in prison. So no one at all in this story got their happily ever after ending.

San Diego Excitement

With 4 days scheduled off work and some airline credit to use, a quick trip to San Diego to visit my cousin and his wife seemed like a wonderful idea.  “Sure, it will be a fun time,” I thought.  Never could I have imagined the way the trip would end up.  A few days before, I’d had some mild aching pain in my right thumb joint.  I thought it was just from spending a lot of time crocheting and took ibuprofen and aleve for it and didn’t think about it much.  So I left for San Diego and began a wonderful weekend Friday night.  Saturday was a lot of fun as well but by Saturday afternoon my thumb joint was really throbbing and ibuprofen and aleve were no longer helping the pain.  That got a little concerning but I was determined to enjoy my time out of town.  Sunday I noticed some slight swelling to the right hand mostly at the joint and the pain remained a pretty constant throbbing.  I was thinking some sort of arthritis given the fact the pain was very localized to just the joint but I was a bit concerned that nothing over the counter was helping the pain.  And it was getting concerning that I had no grip in my right hand and my finger pinch was really weak.  Woke up Monday morning planning to fly home that evening and go to Urgent Care the next morning.  But my cousin pointed out to me and I agreed that now my entire right hand was very swollen and red.  I knew that just wasn’t normal or good and there was definitely something going on.  So on my mom and cousin’s advice, I agreed to go to an Emergency Department at a hospital there in San Diego.  I really thought they would do something temporarily to relieve the pain and swelling so I could get home that night and follow up with my doctor at home soon after.  Never in a million years was I expecting to be admitted to the hospital there!  But the doctor in the ED was thinking it was cellulitis or some other infection and I needed a few doses of IV antibiotics to keep it from spreading to my bone so wasn’t willing to let me go home.  I was incredibly disappointed and exhausted and cried a bit at that news.  But I recognized it was indeed the safest thing to do.  And she told me I would just have to stay overnight and could leave the next day.  Ok, I can live with that.  And I was relieved to have an end in sight to the pain as the infection cleared up.  But then things took another turn…

I got to my bed on the medical floor of the hospital and the hospitalist who would be following me while I was there said “I really don’t think it’s an infection.  I think it’s some arthritis.  You’re going  to get an arthritis anti-inflammation medication tonight and if the swelling isn’t down quite a bit tomorrow, I want to have a rheumatologist see you.”  At that point I knew if a rheumatologist was going to be consulted, I wouldn’t be going home Tuesday.  And I was right.  Monday night was miserable and I was in no shape to go home Tuesday.  Monday night the pain continued at a throbbing 7 on a scale of 1 to 10.  Constant.  NOTHING was helping.  Not norco, not percocet, and then not even a dose of IV dilaudid!  And I was getting truly scared when the dilaudid didn’t even work.  I’m not used to narcotic pain medicine.  I’ve been lucky enough to only need them maybe 3 times in my life and only for brief periods of time.  So when I broke down and agreed to take the dilaudid I was telling the nurse “This is the 1st time in my life I’ve ever needed IV narcotic pain meds!”  And I was very confident it would be effective.  But no.  2 hours later I was still in must as much pain as before.  I put my call light on to let my nurse know that and I told her “I’m not angry.  I’m just in a lot of pain and I’m scared that the dilaudid didn’t help.”  I’m not exactly sure why I wanted to tell her I wasn’t angry.  I suppose  I was trying hard not to be a “difficult” patient.  My nurse came back a few minutes later and had made a phone call to the hospitalist on that shift and he had given her an order for a one time slightly larger dose of dilaudid.  Thankfully, that dose did bring the pain down to a dull 3 out of 10.  At that point, that was very tolerable to me.  While I was laying in my bed in the hospital crying from the pain and fear, I was thinking “I know people do live with chronic pain every day, but I really don’t know how I’m going to do this if I have to do it every day.”  After the pain medicine helped, the next step was to get the swelling down.  The rheumatologist ordered a dose of IV steroids to get on top of that, and it was very helpful.  By Wednesday morning the pain and swelling were under control enough that I was discharged with prescriptions for an arthritis anti-inflammation medication and oral steroids.  And I can follow up with a rheumatologist here at home.  The final diagnosis on my discharge paperwork was osteoarthritis.  They had ruled out gout and rheumatoid arthritis based on lab results.  This wasn’t a big surprise to me; especially considering there is a family history of osteoarthritis.  I was surprised at the amount of pain and swelling that arthritis could cause, but both the hospitalist and rheumatologist who saw me there did not think it was terribly unusual and both told me it wasn’t unheard of.  I guess I just have to be unique and do things my own way!

My cousin and his wife were wonderfully caring and attentive and visited me every day and I couldn’t thank them enough for their help and support.  And my wonderful sister and mom both gave me lots of encouragement and support long distance.  And I have only good things to say about Alaska Airlines and how they were so helpful in changing my flight reservations with only minimal extra fees.  All of those things helped to make being admitted to a hospital in a strange time less scary and more bearable.

And here is a photo of what my hand looked like while I was in the ED waiting for my bed…

Words CAN Hurt

Last night while driving home from work I was thinking of an event that happened to me as a child that comes to mind every once in a while.  It was an example of just wrong that old children’s saying “Sticks and stones may break my bones but words will never hurt me” is.  Words can hurt.  Especially when they’re being said to a child.

I was in 4th grade, 10 years old, and was taken to the hallway to be reprimanded by my social studies teacher for something.  I don’t remember specifically what I was being reprimanded for, but I’m guessing I got done with my work quickly and was being disruptive bothering other students who were still finishing their work.  That’s what I was usually being reprimanded for.  Anyway, while out in the hallway this teacher ended the scolding with the statement “I don’t like you and I’m only nice to you because my wife told me I should be.”  (His wife happened to be my Camp Fire Girls troop leader.)  Admittedly, 36 years later I may not be remembering the words he said verbatim but that’s very, very close to exactly what he said.

Memories are tricky things and I would very much like to hope I’m just misremembering this incident and that’s not really how it happened.  But I’m really pretty confident that it is exactly how it happened.  I find it interesting that this many years later I don’t remember what I was being disciplined for, but I do remember the end of what was said to me.

I was raised to be respectful to people in authority and to my elders.  So when this teacher was saying this to me, I was incredibly hurt but I honestly don’t think it ever entered my mind there was anything I could do about it.  So I never told anyone at the time.  I did eventually tell my mom about it a few years ago.  As an adult now when I do think about it, certainly it still hurts but mostly I just think this man is a coward for bullying a child like that.  I feel his words crossed a line into a personal attack.  He was no longer discussing my behavior in class or my performance as a student.  He was attacking me.  And that is just not ok for a teacher to do to a student.

Yes, words really can hurt… even many years later.

 

 

Changes in Healthcare

Recently there was article being linked to on Facebook by a few of my coworkers titled “Patient Satisfaction is Overrated” written by Dr. William Sonnenberg.  Here’s a link to the article.  A few years ago we were called to staff meeting and some changes being made to how Medicare reimburses hospitals and doctors were explained to us.  Basically, Medicare is now holding back a portion of what they would normally pay to a hospital or physician for a certain hospital stay or procedure.  The hospital or doctor can then earn back that percentage of payment by having high/good patient satisfaction scores.  The reasoning is that Medicare wants hospitals and physicians to provide not just mediocre, decent care but quality care.  They want health care providers to not just do their job, but to do it well.  I can understand that reasoning and in theory completely agree.  Hospitals and doctors who skate by and provide just the minimum level of quality of care considered adequate should be told they need to improve.  But as with many theories, putting it into practice has a few problems.  The biggest ones were hit on perfectly by the author of this article.  By being essentially forced to bend over backwards to give the patient exactly what they want and keep them happy, we’re not always giving them the best care we can.  Sometimes not even the appropriate care they need, in the case of overprescribing antibiotics when they’re not necessary.  It ends up putting the emphasis in the wrong place.  It takes the emphasis away from patient teaching and preventative medicine and places it on what amounts to customer satisfaction.  While listening to our patients and their needs is definitely a positive thing, making what they think they want and are asking for such a priority is not.  It ends up creating frustration in doctors, nurses, and others directly involved in patient care.  I’ve seen changes come and go over my years as a nurse.  I hope this change goes… the sooner the better.

Truth is Stranger…

I have a guilty pleasure when it comes to television… True crime shows!  I find them fascinating for one simple reason.  As Mark Twain said, “truth is stranger than fiction.”  Watching these shows, I realize just how very true that is.  I could not possibly make up some of the stories I’ve seen profiled on these shows.  (Maybe all that proves is I should stick to being a nurse and not a novelist.)  At work I also get to see this statement proved correct.  A few coworkers and I were recently discussing the fact that if the general public was told some of the stories about what we see and do and hear in a shift, they would think we were making it up.  Things patients do and say are sometimes almost unbelievable, and probably wouldn’t be believed by the general public.  There happen to be some pretty significant laws in place to protect patient privacy that prevent us from sharing these stories, but trust me when I say these stories are sometimes sad, sometimes funny, sometimes shocking, and always interesting.  Just one more thing I love about being a nurse!  There is truly never a dull moment.

Cat Behavior

Oliver meows like he’s going to visit an executioner when I have to take him to the vet… or to the groomer.  But every single vet or groomer visit, they tell me what a well behaved cat he is for them. Once his vet called him her best behaved patient all day.  The office vet tech tells me “We love him here.”  What’s puzzling about that is he is NOT as well behaved at home.  Nope.  Recently I had to give him a pill a day for a month.  I lived with scratches on my hands and forearms for a month straight.  Try to trim his claws?  He cries and fights and acts like I’m trying to torture him.  So why, exactly, is he so well behaved for others?  At his last vet visit, his vet and I discussed that.  My theory is that it’s similar to the concept that toddlers will act up for mom and dad more so than for other people caring for them because mom and dad are “safe.”  (I know that’s a huge generalization, but let’s just go with it…)  They can act up and know that mom and dad will still love them.  Could he know I offer him safety and he can act up with me and I’ll still love him?  Or am I giving a cat far too much credit?  Hard to know for sure, of course, but his vet thought I might be onto something.

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Camera Critters Meme

A shot of mom’s fish pond I took a few weeks ago… Can’t believe how big the koi are getting!  She’s had them for several years now and takes great care of them.

To join in the fun of Camera Critters just click here!

Thoughts on Healthcare Spending in the U.S.

So, I’m sitting at home today not feeling well and bored out of my mind so I was just perusing some websites to kill some time.  I came across a link on aol.com that caught my attention… a link to an article titled Why Does the U.S. Overspend on Health Care?  One Simple Reason.  (Here’s the link to the article should you want to read it yourself:  http://www.dailyfinance.com/2013/10/19/health-care-why-america-overspends/)  As a nurse, I am interested in different observations and opinions about our health care system.  So, of course, I wanted to read the article.  And it was definitely interesting.  In a nutshell, the author theorizes that the amount of money we spend on end of life care, trying to buy a patient more time when they are going to die in a matter of a short time anyway, is how and why we’re overspending on health care.  He writes “The U.K.’s National Health Service, for instance, is known to practice “denials of costly treatments for life-threatening diseases” toward the end of patient lifespans — a decision necessitated by “resource constraints.” But that’s not necessarily a bad thing.”  I’ve worked with dying cancer patients, dying patients who’ve had terribly debilitating strokes.  And yes, sometimes the aggressive treatment the medical community uses to prolong their lives is futile.  They are going to die with or without the treatment; it’s just a matter of how soon.  And sometimes that probably isn’t the best use of our resources and health care dollars.  Sure, it’s easy for me to sit here saying that as it’s not my family member or loved one we’re talking about.  I guess I’m saying, in theory, I understand and even agree with what the author of the article is saying.  But I’m admitting I may very well feel differently if it were my family member or loved one we were discussing treating aggressively.  I think the ethical problem that comes into play is already touched on when it comes to organ transplants.  We only have so many resources to go around and who exactly gets to make the decisions about how those resources are allocated?  Who gets to make the final decision about when a patient should be denied costly/aggressive treatments towards the end of their life?  (That’s provided we know the patient’s wishes and they would want the treatment, of course.  Otherwise it’s a moot point.)  Those are the kinds of decisions that are incredibly delicate ethically speaking and letting the wrong people make them could be a very slippery slope.  But who, exactly, are the “right” people?  Not an easy question to answer at all.

In speaking to a friend (a U.K. citizen) about this article I was informed that the U.K. National Health Care System is very focused on preventative medicine and treatment of diseases rather than maintenance.  That focus makes sense on many levels.  First of all, it makes fiscal sense.  It’s much cheaper in the long run to prevent a disease than to treat, cure, or manage it.  And it just makes for a healthier society to prevent diseases so they’re not spread through the society.  I don’t necessarily know if I think a national health care system is the right answer for the U.S.; but I do think there are some positive things about having one in place.

What I Learned at Deborah’s House

Recently I had the opportunity to spend a week visiting and working at Deborah’s House.  That is a shelter for women and children coming from domestic violence situations located in Tijuana.  I want to share with you the biggest lesson I brought home with me from that trip.  I have a new definition of the word strong now, of what it means to be strong.  The women staying there have suffered violent, horrific, awful circumstances.  I don’t know many specific details of their stories, but I do know enough that the circumstances they’ve come from are unimaginable to a caucasian woman from the U.S. with a middle class upbringing like mine.  The fact they’ve lived through these circumstances is testament enough to their strength, but they’ve gone on to survive those circumstances by coming to Deborah’s House and learning to make a better life for themselves and their children.  Some inner strength gave them the power to keep the hope alive that they could have a better life.  I can only begin to guess at the amount of strength that takes.  And they don’t even realize just how strong they are.  They probably also don’t know that they will forever now define that word for me.  But they will.  

Turner Syndrome Insights

For a variety of reasons, I’ve been a bit introspective yesterday and today. That lead me to do some searching online for Turner Syndrome forums and message boards. The literally dozens of comments I came across from women with T.S. talking about never quite feeling like they fit in at school or with groups of coworkers amazed me. I never really felt like I fit in at school… always felt like I was just on the fringe of each clique or group of students. As an adult I’ve felt the same way at work with groups of coworkers. And I just chalked it up to a fairly normal dose of insecurity. But wait a minute… I have every reason to feel a bit different. I DO have something about me that makes me very different than most of the women in the world. I was diagnosed with Turner Syndrome at the age of 13. It only occurs in 1 in 2,000 to 2,500 females. In a nutshell, it’s a chromosomal abnormality that leaves a female with one of their two X chromosome either partially or completely missing. The hallmarks of it are short stature and infertility due to the lack of ovary development. There are also a whole host of other possible symptoms but I’ve been fairly lucky that the only one I have is some hearing loss. Well, that’s what I thought until today. Is it just possible that the feelings of not quite fitting in are part of the T.S.? Very possible, especially if the few dozen women I read comments from online today are any indication. And there have been many times when I’ve had a vague feeling someone just doesn’t really like me, but couldn’t quite put my finger on why I thought that. I couldn’t give any specific example of anything the person had done or said to make me feel that way. And do you know what I read today? On the MayoClinic.com website I read the following listed as a symptom of T.S.: “Difficulty in social situations, such as problems understanding other people’s emotions or reactions.” Wow. There could be an explanation for my feelings other than insecurity? Today is the first time in my life I’ve ever considered T.S. as being a cause of those feelings. It’s definitely an interesting … and refreshing… thing to consider. From the time of diagnosis at age 13 until my mid 20’s my life seemed to be all about the T.S. for the most part. Learning to accept what it meant to me, doctor’s appointments to try to get the hormone replacement therapy doses just right, doctor’s appointments to make sure my heart and kidneys were fine, and so on. But after that, for about the past 20 years, I’ve more or less ignored it. I’ve just accepted it is something I have and will have the rest of my life and there’s no changing it. Now I have 20 years more life experience and wisdom to use to go back and reassess what having this syndrome means to me.