But I have this against you: you have let go of the love you had at first.
- Revelation 2:4
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And the store is hideously lit and infused with soul-killing muzak or corporate pop and it’s pretty much the last place you want to be but you can’t just get in and quickly out; you have to wander all over the huge, over-lit store’s confusing aisles to find the stuff you want and you have to manoeuvre your junky cart through all these other tired, hurried people with carts (et cetera, et cetera, cutting stuff out because this is a long ceremony) and eventually you get all your supper supplies, except now it turns out there aren’t enough check-out lanes open even though it’s the end-of-the-day rush. So the checkout line is incredibly long, which is stupid and infuriating. But you can’t take your frustration out on the frantic lady working the register, who is overworked at a job whose daily tedium and meaninglessness surpasses the imagination of any of us here at a prestigious college.
But anyway, you finally get to the checkout line’s front, and you pay for your food, and you get told to “Have a nice day” in a voice that is the absolute voice of death. Then you have to take your creepy, flimsy, plastic bags of groceries in your cart with the one crazy wheel that pulls maddeningly to the left, all the way out through the crowded, bumpy, littery parking lot, and then you have to drive all the way home through slow, heavy, SUV-intensive, rush-hour traffic, et cetera et cetera.
Everyone here has done this, of course. But it hasn’t yet been part of you graduates’ actual life routine, day after week after month after year. But it will be.
And many more dreary, annoying, seemingly meaningless routines besides. But that is not the point. The point is that petty, frustrating crap like this is exactly where the work of choosing is gonna come in. Because the traffic jams and crowded aisles and long checkout lines give me time to think, and if I don’t make a conscious decision about how to think and what to pay attention to, I’m gonna be pissed and miserable every time I have to shop. Because my natural default setting is the certainty that situations like this are really all about me. About MY hungriness and MY fatigue and MY desire to just get home, and it’s going to seem for all the world like everybody else is just in my way. And who are all these people in my way? And look at how repulsive most of them are, and how stupid and cow-like and dead-eyed and nonhuman they seem in the checkout line, or at how annoying and rude it is that people are talking loudly on cell phones in the middle of the line. And look at how deeply and personally unfair this is.
- David Foster Wallace, This is Water
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Heart failure means that the heart is unable to pump blood around the body properly. It usually occurs because the heart has become too weak or stiff.
It's sometimes called "congestive" heart failure, although this name isn't widely used nowadays.
Heart failure doesn't mean your heart has stopped working – it just needs some support to help it work better. It can occur at any age, but is most common in older people.
Heart failure is a long-term condition that tends to get gradually worse over time. It can't usually be cured, but the symptoms can often be controlled for many years.
Heart failure is often the result of a number of problems affecting the heart at the same time. It can happen as a result of factors that put extra strain on the heart which persist over a prolonged period of time. It can also result from a sudden traumatic injury to the heart, such as following a heart attack.
Heart failure is a serious long-term condition that will usually continue to get slowly worse over time.
It can severely limit the activities you're able to do and is often eventually fatal.
But it's very difficult to tell how the condition will progress on an individual basis. It's very unpredictable – lots of people remain stable for many years, while in some cases it may get worse quickly.
- https://www.nhs.uk/conditions/heart-failure/
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Today after a monstrous day - for various reasons I was in a foul mood - I was writing on an outlier ward ward 40 minutes after my shift had ended, 20 minutes before the last shuttle bus left, wanting just to hand over the plan and get out of there when a worried looking patient's relative approached me to tell me about her mother who had just started coughing. She wanted to know if I could have a look at her.
I wanted desperately to refuse - to fob her off onto a nurse or something - but I couldn't until I had ruled out an emergency. If the patient had aspirated or was actively choking I would need to secure her airway.
I followed the relative to the patient's room and found three other family members standing in a concerned semi-circle around her. The patient looked very unwell, about a hundred years old, frail and cachexic, sat up in bed, battling against some airway secretions with a rattly cough - not suffocating acutely as I had feared. It was then that the family revealed that she was made end of life for the past few days. However, they had noticed her being more alert these past few days. Drinking more water. They expressed that she was starting to get better, perhaps recovering against all odds, despite all active treatment being withdrawn.
The dilemma now was whether the decision should be reviewed and rescinded, if we should continue the antibiotics and supplements and cannulas and observations. Here was a woman who had ostensibly made a miraculous recovery, who had returned from the brink of death, and as I stood there at 5.45pm, listening, placing a sure, steady hand on her back, I just didn't - I just couldn't care.
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