work work work work
The seemingly quiet engine of the older Honda CRV died down along with a disgruntled exhaust. Gerard wasn’t used to this lack of energy from his car. He recently purchased this economically efficient car off of Craigslist with the money he got from selling his all-black sleek, decked out Tacoma. Though he loved the hunk of swag, driving the monster was getting too expensive. The almost seven hundred a month truck, with many more years of payments left, had lost the dire battle to the one time payment of the four thousand dollars four-door SUV. It was okay. He rather save the money anyway. All he needed was a reasonable car to get him to and from work. He had more things important to prioritize.
He parked in the space he usually did, in the lot right in front of the clinic. He got out of the grandpa car and walked toward the back to open his trunk. He took off his tattered black Nike sandals he had on, one by one, and replaced it with his Nike Free Runs. He really needed to get some new shoes. Okay maybe he didn’t need to get them, but he was eyeing a pair of the new Fly Knit’s he saw on Nike.com so his semi-new sneakers seemed irrelevant and old. Just Like his car. But he didn’t need another pair anyway.
Gerard dug into his right front pocket of his blue scrubs and took out a fresh new stick of Camel Crush. Damn he needed to quit. He could hear Lala’s voice nagging him about quitting. He knew he had to. He was smart enough to know about the nastiness of smoking, especially working in the health field, but it was just a bad habit he formed since high school and was the one thing he couldn’t brush off. What started out as something to look cool with his friends became something to blow off steam from the pressures of life. Thinking of Lala, his loving girlfriend of three years, made him smile. She was annoying as hell at times but he loved her for it. She was always there for him, keeping his head up.
With a smile that warmed you from the inside, he killed the cigarette on the concrete as the voice of Lala faded out with. The burnt bud flicked out into the distant air as Gerard turned towards the entrance of the facility. He looked behind and up at the sky. The night was warm and cool. The dusk of dawn warmed the sky in orange and brown. Working sucked especially on warm nights like today. It was a perfect friday night for 24-year-olds to have fun, or in modern terms get “turnt”, with his friends but it wasn’t that night for Gerard. It was cool though, it didn’t faze him. He grinned as he entered inside the building where the view had a stark contrast from the outside. Instead of the dim lit glow of the sunsetting outside, he was met with the blindingly fluorescent lights reflecting off the sterile white room filled with lingering scents of pungent rubbing alcohol that seem to sanitize the air. Gerard officially clocked in for work.
When you first meet Gerard he might throw you off a bit. He is slenderly built, about 5’ 7’’ tall, though he swears that he is 5’8” while flashing a grin. He wears the newest pair of Nikes on his feet and wears black stud earrings on both ears. His skin is a light shade between tan and brown that wraps around a face shape resembling a chestnut. These aren’t the facts that surprises you. The confusing detail comes in his clothes. Instead of a SupremeTM sweater and khaki shorts or a striped Obey flannel and jeans that is often worn by guys his age, he’s rocking solid navy scrubs. Scrubs, for the few minority who might not know, is an official term used by workers in the medical fields to describe the iconic uniform they wear in the workplace. It is required by a professional dress code in the health field. But his extremely youthful countenance is the striking point that makes your head cock to the side, thinking twice about his identity. No, Gerard is not a highschool kid dressed up for a Halloween party. Gerard Gonzalez is a 24-year-old certified dialysis technician.
Gerard works at a dialysis clinic in Santa Fe Springs, California. This would be his fifth year working in the field, which is rare. Most 24-year-olds would be starting about now or have one year at most under their belt. “My cousin Benji actually introduced me to the field. I mean I have a lot of family members in the health field so it wasn’t a new world concept for me. I always wanted to be a nurse and so this job seemed like a good way to pave the road.” Gerard actually had never heard about dialysis until he took this job. After graduating high school per advice from Benji, Gerard took a 12-month program at a technical school, got his certification and dived into the field right away.
Dialysis clinics, like the one he works at, treat patients suffering from End Stage Renal Disease (ESRD) or kidney failure in laymen terms. Patients who have little to none functioning of their kidneys come to the facility for treatments. “Dialysis is not a temporary thing. It is means of survival.” The human body cannot properly survive without the functioning of the kidneys. The kidneys play a vital role in detoxifying the body and releasing unnecessary minerals that can be harmful. Through dialysis, patients get their blood cleaned by filtering out the toxins through dialyzing machines. “Kidney failure patients only have two choices to live, transplant or dialysis.” Gerard said it with a sort of authoritative tone.
As a dialysis tech, he is in charge of putting on and off patients from the dialysis machines. It is not as easy as it sounds. There are instances where patients, especially ones who are older and diabetic suddenly will pass out or convulse. “It was really scary at first but you can’t let that dominate you in this field,” Gerard says. “Whatever emotions you have you put it aside because patients come first. For us it might be control, but for them it is a matter of life and death.” He has to constantly monitor each patient’s vital signs, check their blood pressure every hour, and have to be skilled involving needles and veins.
After clocking in for work, his regular routine started right away. A loud doorbell rang as Gerard looked up at the LCD monitor hooked on the ceiling, right above the desk, where he saw the image of a short and stout man holding too many bags for his weight standing in the lobby. With confirmation of facial recognition, Gerard went ahead and pushed a small black button that automatically opened the securely shut door. It was his first patient of his shift.
“Hey Jean! How you doing?” Gerard rose out of the faux leather swivel chair as he pushed himself from the nurses desk to greet the man. Jean, was a jolly old fellow in his early-60s. “Good, good. How are you Gerard?” Jean replied to Gerard as he put his belongings down on his designated chair. His bags included his blanket and various amount of food, mostly snacks and fast food to keep him through a long night ahead of him.
Gerard calls Jean the Crumb Master because everytime he goes to sanitize Jean’s chair, after he’s done with treatment and leaves, there are food crumbs everywhere. Other than giving Gerard problems with his crumbs, Jean is never troublesome and finishes his treatment with no other issues. Like all of Gerard’s patients, Jean is part of the nocturnal shift that he works in. Unlike daytime patients who come and go in short intervals during the day, nocturnal patients come at night prepared to stay. Their machine runs about 7 hours which takes up their whole night. Ideally, they come to the clinic to sleep during treatment.
After he put his stuff down, Jean went to weigh on the automatic scale built into the wall of the building on the left side near the entrance. As Jean started doing his daily routine, Gerard continued his. Gerard would log on to the touch screen monitor, that is hooked next to the big dialysis machine next to Jean’s chair, to record preliminary data such as the patient’s weight, temperature and blood pressure.
“80.5kg, I haven’t gained much today.” Jean sat down in his chair and was ready to be put on the machine. “What there was no party on the weekend?” Gerard playfully asked as Jean chuckled in response nodding his head sideways. Gerard recorded Jean’s weight into the computer. He had to know how much fluid the patient needed pulling out. Gerard would get the present weight from the patient and then minus it by his recorded dry weight to pull out the unnecessary water the patient gained since the last treatment session. He would then add 0.6kg, the additional amount of saline given during the dialyzing process, to the difference and calculate the total amount of fluids in kilos to be pulled out by the end of treatment. “So just 0.6 today, sounds good?” Gerard reaffirmed with his patient in regards to how much to pull. “Sounds perfect.” Jean responded as he stretched out his left arm on top of the disposable dressing pad laid on the side table attached to the Jean’s chair waiting for the next step.
There are about 650,000 people per year who is affected by kidney failure and that is just in the U.S. According to the statistics, more than 100,000 people are on the waiting list for a donor and only 20,000 receive one each year due to limited donor organs. Most inevitably seek dialysis, patiently waiting for a miracle. Here at the clinic, they are in the hands of a small staff consisting of technicians, like Gerard, who overlook the treatment process of the patients inhabiting the facility.
It’s a hard knock life for dialysis patients. They have to come in three times a week and stay for 3-6 hours of treatment, depending on their prescriptions by the doctors. Instead of getting 7 days a week like normal people, they only get four. “You sacrifice three days of each week of your life to stay alive for how long nobody knows. I really have to give it to my patients.” His usual playful expression softened. “I couldn’t imagine if it was me. I thank God for my health and try to utilize it by helping people who weren’t so fortunate.”
Taking care of people comes to Gerard very naturally. He was already in the position of a caretaker even before becoming a dialysis tech. Gerard initially wanted to go to nursing school soon after he graduated but his plans didn’t go accordingly. His world was essentially turned upside down when he learned that his parents weren’t able to support him anymore.
Gerard didn’t grow up rich but his family were financially stable. Stable enough to support him through nursing school, but that didn’t happen. His dad suffered a stroke and was forced to retire. His right side of the body suffered slight paralysis inhibiting his mobility to further work. His dad was in his 70s and this took a big toll on his health. His mom had retired before his dad fell ill as she suffered from a condition called vertigo. With both of his parents unable to support him like before, he felt obliged to take care of his parents. They took care of him for 18 years and now he knew he needed to return the favor. He wasn’t forced to. Though his parents didn’t explicitly ask him to do so, his dignity wouldn’t allow him not to.
Unlike his nocturnal patients who got to sleep during their treatment, Gerard didn’t have that luxury. Gerard’s sleep schedule was pretty much nonexistent. He worked the typical 12-hour shift informally called the “Nurse Schedule.” 12-hour shifts are normal in the nursing field but they work every other day, resting in between, to sustain their irregular sleeping cycle. However, Gerard was tiring his body because he wasn’t able to. He had to work double shifts. He needed the extra money to help support his family.
Gerard’s hectic work schedule started on a Sunday where he would wake up around 9AM and spend quality time with his parents. He then headed to work at the Santa Fe Springs clinic, clocking in around 4PM. He would finish his shift at 4AM, into the wee hours of the morning, and by the time he got home in Bellflower it was about 5AM. His next shift, at his second job located in Compton, started at 8AM meaning he had to wake up by 6:30AM giving him only an hour and a half to snooze. He sometimes got to sleep through the limited amount of time but mostly he would just lie there with his eyes closed until his alarm rang.
“But sleep is overrated anyway. You sleep when you die.” He chuckled softly as he flashed his signature cheery grin.
When his shift at the Compton location ended at 8PM, he was finally allowed to get some real sleep. His next shift didn’t start until 4PM the next day so he can potentially catch up on some Z’s. This hell of a schedule continuously repeated until Friday, when he finally got his day off. Gerard’s only days off were on Fridays and Saturdays but even then he didn’t get to sleep in as much as he’d like. What time he had, he divided it to spend time with his family and girlfriend.
First, he needed take his parents around to do errands. They both cannot drive no longer due to their health conditions so he is their official chauffeur. “The grocery store, the bank, the barbershop, everything. I love it though because it allows me to spend time with them. They’re getting older by the year, you know.” His face fell for a moment as he thought about his elderly parents but resumed to lift up to his usual stance. After taking care of their needs, he would then hang out with Lala. “We go eat, drink, but mostly chill. She is a dialysis tech too so we understand each other’s need to rest. In a sense, we come to rest together.”
Gerard carried a different air to him than your normal average mid-twenties guy. He had in his words, shit together, than most of the guys his age. You didn’t need to look any closer than his close friends. Recently, one of his homeboy bought a Lexus RX. “Yeah it is a sexy car. I love cars too, what guy doesn’t? But you need to get your priorities straight. I recently sold my truck for a used Honda on Craigslist. I just realized I was paying too much for a car that I didn’t need essentially,” Gerard did make good money, better than any of his friends really by working as a tech, “but I need my money to help with the bills. I need it to save up for nursing school. Maybe even invest in a good property that comes up. A little tip by the way, if you had to invest, real estate is where’s the money at.” He flashed his signature grin. When asked if he was also saving up for marriage with Lala, he blushed and replied “No, not yet, maybe soon. I’m waiting until everything else in my life is settled.” Whenever his girlfriend Lala was brought up, he always shyly blushed and smiled. He was wise beyond his years no doubt, but when it came to his girlfriend he was no different than any other 24-year-old guy in love.
Gerard put on his disposable purple gloves, his disposable yellow mask and proceeded to tear two single use alcohol prep pads. He used the 75% ethyl propyl solution soaked pads to disinfect the small area of skin on Jean’s left arm where there were two small scabbed holes located about five inches and vertical from each other. These two holes were the cannulation points of the two needles that would connect to each vein, arterial and venous, underneath his arm. Gerard first took the cap off of one of the needle to use it’s dull pointed end to remove each of the scabs. He grabbed another alcohol prep pad to clean the freshly opened wounds. He then took a blue tourniquet and wrapped it tightly around his arm, little above the insertion area.
“Okay, here we go.” Gerard took the needle, eyebrows raised with deep concentration, and positioned it at at a 45 degree angle as he pricked through the surface of Jean’s skin and then pushed it forwards deep into the vein.
He continued this strenuous process of cannulation with all his patients and by the time he was done with his last patient he was exhausted. His eyes had dark circles that shadowed his whole complexion. It was finally time for him to go on his break. He clocked out and went outside of the clinic to the parking lot towards his car. As he leaned on his rustic van, he admired a sleek Lexus whizzing by, bumping Rihanna and Drake’s new hit song “Work.”
Work, work, work, work, work, work,
He said me haffi, work, work, work, work, work, work!
Damn nice ass car, he thought as Gerard patted down his front pocket of his navy blue scrubs. He dug out a stick of Camel Crush. He could hear the disapproving voice of his Lala again, telling him he seriously needs to quit as he lit the cigarette. He knows. He’s going to quit someday he promises. He took a long drag and breathed out a slow sigh releasing all the congested stress. Gerard looked back up to the sky, the orange sky dimmed to a onyx glow, with glitters of stars almost seeming to cheer him on. Gerard grinned a heavy smile, cracked his knuckles and neck, and closed his eyes. He didn’t want to think about anything for now. Especially the fact that in fifteen minutes he needed to clock in for work once again. That song he just heard got stuck in his head. He was humming it before he even realized it.
Work, work, work, work, work, work.