CON honors, remembers those lost

You just wanted to hug those kids.

Tommy, 10. A good boy, glowing, talking about his dad’s job, and jets. “Tommy can tell you about any plane around,” said his grandfather, Tom Blake.

Lily, 8. An angel (literally; she’d just danced in the Nutcracker) in a purple snow hat with hearts on it, and sparkly boots. When her brother blabbed about how she sometimes forgets names, she leaned in, stepped on his foot and gave him a look. That little-sister-to-big-brother look.

“She was born 19 days after our boy was killed,” her grandfather said.

The Blake kids, Tommy and Lily, pictured earlier in front of a display honoring their father, Navy Pilot Lt. Com. Thomas Blake, bottom left. In a coincidence, the other serviceman honored by the College of Nursing, Staff Sgt. Tricia Jameson, is in another of the photos, top left.

The Blake kids, Tommy and Lily, pictured at an earlier memorial display honoring their father, Navy Pilot Lt. Com. Thomas Blake, bottom left. In a coincidence, the other serviceman recently honored by the College of Nursing, Staff Sgt. Tricia Jameson, is also among these photos, top left.

“Your daddy helped make you before you were born,” her grandmother, Carole Blake, told her as she gave Lily a squeeze. “He and your mama picked out your name.”

Navy Pilot Lt. Com. Thomas Blake

Navy Pilot Lt. Com. Thomas Blake

Their mama is Jessica Blake, today a UNMC nursing student. On this morning, her Policy and Leadership class was different. The class – her class – was presenting her with an Honor and Remember flag.

Navy Pilot Lt. Com. Thomas Blake died in an S-3B Viking jet crash in Jacksonville, Fla., in 2005. He was 33. He left behind a wife, a son and a daughter he never got to meet.

The flags are a relatively new movement, started by a father who lost a son. The flags go to the families of U.S. servicemen who died “in the line of duty.” The flags have been officially adopted by 16 states, the charity’s website says, and have been “endorsed” by eight more (Nebraska is among those still being lobbied). They don’t come cheap. The UNMC College of Nursing Policy and Leadership class raised $700 for two.

The other went to Pat Jameson, a nurse, and the mother of Tricia Jameson, who had always wanted to be one.

While she applied to nursing school, Tricia, a staff sergeant, was serving as a full-time health care specialist for the Nebraska National Guard. She carried a medical bag in her car, in case she came across any accidents. She taught combat lifesaver training to Nebraska Guard troops. When an opportunity came up to deploy to Iraq herself, she jumped to the front of the line.

Today, Nick Hornig is a UNMC nursing student. In 2005, he was in the 313th Medical Company (Grounded Ambulance) in the Nebraska Guard, in Iraq, when Tricia showed up, a replacement. He helped her unload her bags.

Nebraska Guard medic Staff Sgt. Tricia Jameson

Nebraska Guard medic Staff Sgt. Tricia Jameson

She was the new kid; he barely knew her. She’d been with them for about three weeks when, out on the Humvee ambulance, she and her driver came across a convoy of Marines that had been hit by an improvised explosive device (IED) attack. There were casualties.

She was racing to the rescue when she was killed by another IED.

“It could have been any of us,” Nick said.

At that time it seemed like something like that was happening every day.

She was engaged to be married. She was 34.

When called to come up to accept her flag, Tricia’s mother took a breath and closed her eyes: steeling herself.

As she stood up there, Nick held his face, rubbed his hands and fought off the tears that welled in his eyes.

He’d barely known Tricia, but he knew this: he’d made it home to nursing school and she had not.

Tricia's mom, Pat, displays the flag presented her by UNMC nursing students with volunteer Cliff Leach.

Tricia’s mom, Pat, displays the flag presented her by UNMC nursing students with volunteer Cliff Leach.

When he heard about the flags, he’d asked his classmates if they could make this happen, for Tricia, and together, they had. Keyon Royster said that Jessica should get one, too. Kate Weidemann organized a bake sale.

With Tricia’s mom, Nick was tender. It could have been him.

It could have been any of them.

Those kids. Tommy, 10, and Lily, 8. Their faces said this was a good day. They got to hear about how great their dad had been. They beamed as they held up that flag.

But those other faces – those of Jessica, and Carole, and Tom, of Tricia’s mom, Pat – those were the ones that all but knocked you to your knees.

The audible sniffles in the auditorium said they were not alone in their tears.

These people had been wounded beyond endurance, and yet, somehow, they endured. There they were. Standing.

UNMC nursing student Jessica Blake, third from left, holds a flag that honors her husband, Thomas, a Navy pilot who died in the line of duty. With her are her husband's parents, Carole and Tom, and her children, Tommy and Lily.

UNMC nursing student Jessica Blake, third from left, holds a flag that honors her husband, Thomas, a Navy pilot who died in the line of duty. With her are her husband’s parents, Carole and Tom, and her children, Tommy and Lily.

And when it came time to click a picture, Jessica brushed the tears, lifted her head, looked right into the camera. And smiled.

Later, in the hallway, Jessica ran into Nick, her nursing school classmate, the guy who had the idea to do this to honor the fallen teammate he’d barely known.

She grabbed his arm. “Thank you,” she said. “That was really cool.”

She laughed at having made something for the bake sale, not yet knowing, at that point, one of the flags was to be for her.

And then, they were late. She was heading back into the classroom and Nick not far behind. They had a test to take. The flag ceremony was over. Quick as that, class was starting again.

Nursing school, much like life, keeps moving forward. And you remember, and smile bravely, and carry on the best you can.

Putting off vision care leads to (surprise!) impaired vision

When you’re having problems with your eyesight, there are probably worse places to work than on a university campus that has just opened a state-of-the-art eye care facility.

And I’ve always had problems with my eyes.

Staring down the business end of the laser. (Photos by Kalani Simpson)

Staring down the business end of the laser. (Photos by Kalani Simpson)

I remember when I first realized my eyes were bad. I was an entertainment reporter for a small newspaper in upstate New York, and I’d been sent to review an opera.

To help the uncultured, the opera was translated via subtitles. As the mezzosoprano belted out the Italian aria, an English translation ran across a thin screen hanging high above the stage.

The problem? I couldn’t read a word. And no one around me was having any trouble at all.

To that point, I’d never realized I had a vision problem. Sure, things got blurry in the distance, but at some point, doesn’t everything? I never knew that my definition of “too far to see” was much closer than a normal person’s.

Still, no long-term effects. I got a pair of glasses, spent a week or so marveling at how crisp the lettering on stop signs was, and life went on.

Many years later, I was put on prednisone for a medical condition. The drug did what it was supposed to do, and I was pleased – but apparently, one of the possible side effects of prednisone is that it can cause cataracts.

The laser wasn't as frightening as I thought it would be. (Photos by Kalani Simpson)

The laser wasn’t as frightening as I thought it would be. (Photos by Kalani Simpson)

I began to realize something was wrong the following summer, when it became increasingly hard to see people’s expressions clearly — especially if they were facing me with bright sunshine behind them. (It was a problem most common in the late afternoon.) A trip to an ophthalmologist showed that I had what the doctor described as “classic” cataracts.

So two cataract removals later (I’m counting one per eye), I was fitted with a pair of trifocals and sent on my merry way, once more able to ascertain whether people were smiling at me after 4 p.m.

Oh, it wasn’t a perfect situation. To remove the cataracts, they also had to replace the lenses in my eyes.

I wouldn’t have cared, because quite frankly I was beginning to feel that my eyes had been letting down the team through the years – but in one area, they’d always been perfect.

There was a point of focus maybe two feet in front of me, right about the place you’d hold a book, where my vision had never wavered. But as a result of the surgery, that point of focus was lost. Now, to read, I would have to wear glasses. (And I read a lot.)

Dr. Gulati takes a photo of my repaired left eye.

Dr. Gulati takes a photo of my repaired left eye.

Still, I’m nothing if not adaptable. And the advent of Kindle, with its adjustable type sizes, has made reading super easy. So my eyes and I were going along quite nicely together, although let’s face it, I no longer trusted them.

Fast forward to this past year, when I began working at UNMC (and receiving health care here), and you find me interviewing a medical student about the VISION Clinic. In the course of the interview, we talked about how people often put off their vision care.

“They don’t realize how bad it’s getting,” UNMC medical student Matt Maslonka told me. “They don’t realize that their field of vision is shrinking until they start walking into things.”

Oh, (insert expletive here). As my colleague Elizabeth Kumru – who has a corner cubicle — can tell you, I walk into things constantly – particularly her cubicle as I’m turning the corner. I used to consider this a result of my preoccupation with deep and meaningful thoughts, such as “Is anyone ordering Jimmy John’s today?” Now, I was wondering if my evil eyes were letting me down again.

Stanley M. Truhlsen, M.D., right, and Dorothy Truhlsen

Stanley M. Truhlsen, M.D., right, and Dorothy Truhlsen

So, you may not have heard, but UNMC has this really big, really new Stanley M. Truhlsen Eye Institute, with state-of-the-art equipment and internationally known ophthalmologists and all sorts of cool stuff.

Even though I hadn’t had my initial eye surgery at UNMC, I decided to amble over to the new building one afternoon to see if our UNMC ophthalmologists could tell me what was going on.

The verdict: My left eye had some buildup – “capsular haze” was the term the doctor used – on the lens. Apparently, when you have cataract surgery at a young age, it’s common for the eye to try to repair itself even though a new lens is already in place. Laser surgery would be needed to clear away the gunk that had built up behind the lens. Speaking with Vikas Gulati, M.D., who is on the faculty at Truhlsen/UNMC and a glaucoma specialist, and who would be performing the procedure, I got the impression that it would be as easy as squeegeeing slush off a windshield – with lasers!

In reality, it was even easier.

For one thing, it was an outpatient examination, and the “laser-into-my-eyeballs” machine (actual name: Nd:YAG, or neodymium yttrium aluminum garnet laser) looked just like any other eye exam equipment. Dr. Gulati had me look through the machine – why do ophthalmologists always want you to look at their ears? – and a couple of bright flashes later, I was done.

Walking back to the 4230 Building from the Truhlsen Eye Institute, I was amazed at how quickly my vision had improved, and how much.

It was something, I realized, I should have taken care of much sooner. The improvement was almost frightening – just how bad had I let my eyes become?

Maybe this time, my eyes hadn’t let me down – maybe I’d let them down.

It's my M3 and I'll cry if I want to

A few years ago, Oregon Health & Science University Ph.D. candidate Katy Van Hook wrote a blog that struck a nerve. She called it Forget baseball, there is DEFINITELY crying in science.

Van Hook, who has since earned her doctorate, was talking about the fact that she was so stressed out by the life of a student at an academic medical center that she occasionally broke down and bawled in her mentor’s office.

I’ve cried in front of my boss, the director of my graduate program … countless friends, several thesis committee members, and a couple qualifying exam committee members if I’m not mistaken.

It was a brave admission, but the response was cathartic. The comments poured in, saying she was not alone:

first year ohsu grad student here: found myself sobbing alone in the bathroom today after a humiliatingly failed experiment, feeling like my life was unraveling before my eyes – your post really goes a long way to reassure me that maybe I’m still on track after all.

Have you, as a med student or grad student, felt the same way?

Well, chances are, you have, says a study (yes, an actual study!) done by Harvard Medical School, Crying: experiences and attitudes of third-year medical students and interns.

Sixty-nine percent of students and 74 percent of interns self-reported crying for reasons related to medicine. For both, the most common cause was “burnout.” … Seventy-three percent of students and 68 percent of interns thought discussion of physicians’ crying was inadequate.

One of the conclusions was: Trainees want more discussions of crying.

So here we go.

Here’s a blog titled First day in the OR, aka crying in public:

Here’s the confession: I totally cried.

I won’t go into the details, but suffice it to say that someone with more seniority than myself (not hard to achieve that level of seniority, by the way) made a mistake, and it was blamed on me.  And the scrub nurse was not happy. Not happy at all.

So I cried. I was so upset – I knew how unfair it was, and I knew it hadn’t been my fault, but still – someone was yelling at me, and telling me I had done something wrong.

Another blog:

In med school… wow, it happened a lot. After exams, before exams, just randomly in the locker room. I remember during my surgery clerkship, we were having a workshop on tying knots, and one student was having trouble with her knots and burst into tears. I still remember what she said: “I don’t even feel that sad. I’m just SO TIRED.”

So, go ahead. Let it out. You aren’t alone. Take advantage of the resources offered by the Counseling and Student Development Center. And share some of your own “crying in science” stories in the comments. We’ll all feel better.