perishable goods.

It occurs to me that if my job was more about things I like to do (such a reading and writing) and less about things I don't (life and death crisis) I would probably be better at my job.

And as for the supposed character-building, and inane, servile humility associated with the job--I find I need neither in remedial dose, or, as so often the case at work, in the prophylactic proportions in which they are doled out (liberally and generously and often, in other words). In any case, it does not pay any better to be truly insulted than falsely praised.

I find my burn-out with nursing is reaching a new, somewhat disturbing plateau of benign indifference, the sort I associate more with a desk-and-cubicle sort of job than a job in which mortality mingles precariously (as it tends to do) with the mundane. The sort of burn-out, in short, in which you've not only capitulated your hopes at becoming The Best At Whatever, but you no longer believe that if you did become the ultimate (or even penultimate) Best At Whatever, it would really matter at all, to any one.

Let me attempt to flesh out this Sweeping Statement. (If I am accused of anything at all, it is making Broad, Generic Claims-often with the certain religious conviction of the damned).

While there is a great deal of expecatation that a nurse perform under a high degree of stress, often in a severely limited amount of time, I find that less and less often do I care whether or not the patient lives or dies by our collective hand (except perhaps I care in the most self-preserving, litigious sense) or still less whether said patient has the miraculous desired outcome promised by Our New Moderne Medical Technology and Advances, or else has a dismal, lingering, liminal fate (and so many of them do).

I have even started to care less about whether or not I am ultimately perceived as a smart nurse, let alone a good one, except in a strictly egotistical way (and in that sense, I care very much about what others think of me, especially my colleagues; you'll have to forgive my flaws and inconsistencies that way. Or perhaps you do not have to forgive. Perhaps it would be better if you simply threw stones. People have a way of making you pay dearly for forgiveness; there is a reason purgatorial favors were once called indulgences. Stones, on the other hand, are quite free, at least for now.)

But, on a deeply fundamental level, I have less and less attachment to my job as a profession. In other words, I perceive it to be the vehicle through which I bide some of my time, make some of my social contacts, perseverate and lose precious sleep over, and pay my rent and bills.

I am, however, more and more disengaged with the job as a personal challenge or even a moral one, still less do I care about those those social accoutrements accorded with such lofty associations as "bettering one's self" and "going forward with one's career." Except as some self-flagellating, penitentially driven exercise in self-mortification (and unfortunately, I am prone to excessive bouts of this sort of thing) I have no desire to go back to school, obtain my master's in nursing, and be consigned, ultimately, for even longer shifts of nightmarish, endless medical tedium and the fulimant agita which comes from dealing with crisis, both imaginary and real.

The job--and the many unpleasant tasks associated with it--is less something to be engaged with and more something to be tolerated and pacified, like someone else's whining child, or a perpetually apopleptic spouse.

This sounds very navel-gazing and adolescent and whiny in the face of an economic (what's the word they're using these days?) downturn. I have steady, gainful employment, benignly endowed by the frugal but ever flowing coffers of The State. I should be thankful.

Let me explain still further, however. ( I am nothing if not gifted at the art of Detailed Excuses and Plausible Explanations. In fact, I believe I could make my living from this talent, if only I could find a way to market the skill without receiving more useless formal training or teaching. Or unnecessarily whoring myself. Although, I am not above necessarily whoring myself. Whoring is, as implied, necessary, at times. I would be far less feckless a wretch, in fact, would that my talent for whoring myself were exponentially more refined. I suppose I can whore myself, and do, occasionally, to some degree, but I also suppose by the same token, that I must do it poorly indeed. I deduce this, of course, because whores and thieves, by all accounts, do very well in this world. Select saints and the masses of menial, mediocre sinners such as myself, not so much.)

To wit:

My initial, perhaps overzealous anger and reactionary fury at The System has shifted, ponderously, but surely, into a lugubrious sort of dolor.

It is not precisely disillusionment; I never had high hopes for The Profession, nor did I ever see myself as being a martyr, patron or redeemer for The Cause; for one, I am too selfish and self-absorbed, and two, I do not believe in over-romanticizing and exaggerating one's professional disquiet to the point of public self-immolation, or, as is the popular term today refers to it, "political activism." (In private, immolation becomes an entirely different matter, of course, but that, for now, is out of bounds for discussion).

In fact, what I have found, as the pieces of self get chipped away in Prometheian fashion, is not so much an unearthing of the revelation of the Evils of Capitaliasm And The 12 Hour Work Day, and all that (because that much was made clear to me at the get-go) but is, rather, the seedling that grows through the chinks in the sidewalk, that altogether more prickly inkling that I am not cut out for the job, and yet, am fit for absolutely nothing else.

I am a Vocational Albatross in any other field, in other words.

And, I'd not only rather do something else (a sentiment which seems frivolous in a time of banks crashing stupendously, people out of home and job, etc etc) but I'd rather be doing something I'm quite sure has nothing to do with what I'm doing now.

(Again, I am a Vocational Albatross in any other field, if you skipped over that sentence the first time, thinking, rightly, that right now is not a good time for the word "albatross." )

Perhaps it is the nature of the job that has given me this festering sense of dread and dismay--a prism of tragedy through which glaring possibilities of ruin and decay never breached are now made possible.

Fundamental Truths must now be spouted. (It's part of The Spiel. These things must be said. Even proclaimed, if you must).

Shit is shit. Dead is dead.

There's nothing philosophical or poetic about it. Death, in particular, can be a nasty, brutal, and unfortunately protracted and lengthy process. Messy, in other words. Not neat and clean and full of last minute, cleansing confessionals and teary-eyed reunions with long-lost loved ones like movies and soap operas would have us believe.

But, every time I confront death on the job, I find a little more of humanity--or what passes for it in the most socially acceptable sense of the word--gets stripped away. In the beginning, I used to feel sorry for the patient. I don't any more. Now, I feel sorry for the family, if there is any. In time, I'm sure I'll lose my compassion for them, and be silently grateful when, by fateful design, they no-show . It will be one less act of contrition I'll have to fake in what is turning out to be an endless parade of fake-gasms on my part.

I've shellaced a look of benign concern on my face so many times I feel my face is going to crack. But my eyes have dulled, and my voice has that tinny, rehearsed sound that might come out of a mannequin if she could talk.

Mostly, though, I apologize.

(And thus we move on to The Confessional. Shouldn't all melodramatic and self-indulgent pieces of crap have a confessional? You are quite right if you protest they shouldn't. But, I am nothing, if not dogmatic in my application of form, however ultimately useless and outdated. We must have our relics. And perhaps some incense. Corpses tend to smell after awhile, and the hospital has quite a few of them. Then again, the more, the merrier.)

I apologize to the family: "I'm sorry he's sick." "I'm sorry, he's very sick." "I'm sorry, he's dying." "I'm sorry, he's dead."

I apologize to the patient, "I'm sorry, I have to stick you with a needle." "I'm sorry, this is going to hurt." "I'm sorry, I have to shove a tube up your ass." "I'm sorry, you're dead."

What I really want to say is, "I'm sorry, I'm too tired and have done this too many times to even want to look you directly in the eye, let alone reassure you everything is going to be okay."

I suppose in essence, I really am sorry, but not for the reasons I give to patients or their families.

I am sorry I ever chose nursing, and even sorrier I chose bedside nursing. I am sorry I failed to find a better, more suitable career for myself. I am sorry I am stuck, night after night, caught in a lassitude of indifference on one hand, and indecision as to what to do about it on the other.

To be liberated from this job would be a bit like being liberated from prison, or a loveless but reasonably financially secure marriage. (The problem being, of course, that a Hospital is not so much a Doll's House as a Shop of Horrors).

My choices aren't all that clear to me. Daydreaming about what life could be quickly becomes the stuff of nightmares, when yoked with the burden of reality.

(We are missing the Beatific Vision, as an astute reader might have noted. This is not so much because we have stopped believing in them, as much as it is we have lost the capacity to see them. There is a difference, but this is for the talkers-of-God to debate. Having lost our capacity to see, we insist on brisk discussions of our other God-granted faculties, do we not? In the beginning was not, after all, The Vision--it was The Word. )