It has been too long. I've been doing a lot of writing lately, but most -- really all -- is legal documentation. My best piece is:

"Pt slept through the night, denies fevers, chills, nausea, vomiting, diarrhea, chest pain or shortness of breath. Hoping to go home tomorrow. Mentioned that he has not been eating well over the past several months due to losing teeth when he eats solids. States "wife usually mixes up 2-3 quarts of koolaide" this is his main form of nutrition.

-Plan to consult nutrition&dietary"

I've been spending long days and longer nights at the VA hospital. Vets of all ages attend, but our biggest patient population is men who fought in Vietnam and Korea and are in severe decline. Hard living mixed with minimal education, less money and more mental illness make for a hard life, and these vets have it all. They avoid the doctors until a critical breaking point and then they seem to become professional patients. In and out of the hospital, multiple visits per season.

Not by choice.

I love working with these guys. They got drafted and then shunned, and it's nice to be a part of their safety net. They are also tough and nails and have huge balls -- not just from anasarca. They'll limp in gangrenous. Drive in from the country in a deadly heart rhythm, passing out on the freeway.

There are so many small victories and losses that it's hard to keep track of the score. But one take away I've had is that if I see someone stopped in the middle of the highway ever, I'll go and check if that person has a pulse.