WAR BOY (extract)

                      I'm watching Finn and Critter climb the steps into

the bus and this thought suddenly hits me and I mean upside

the head.

        They go inside each other's bodies.

        And it does seem kinda weird. It makes me wonder if I

really am prejudiced deep down. Then I remember how I felt

when I first found out my mom and dad did that and talk about

weird.

         It's impossible to stand still very long on the side walk be-

cause the crowd is like two rivers converging and going sud-

denly into rapids on the pathway through the trees. There's a

current that carries you along and we're already moving with it

when the bus pulls away but I can't help turning back to scan

the windows in case Finn and Critter switched sides. They 

didn't but the blonde did and now she's sitting where I was

and looking right at me or actually a little over my head which

means she's looking at Jonnyboy.

        Who's looking noplace but straight ahead and charging for-

ward with one hand locked around my wrist and the other

clenched above his head and I can't see his lips but I know

what they're saying which is vintage Johnny Rotten.

        As in Follow Me!

        Where the trees stop and the open field starts the sudden

heat from the people and the sun is like an airlock into another

world. Everyone slows down and there's room to move apart a

little and head for the different ticket kiosks. There's portable

chain-link fencing between them topped with blue and yellow

helium balloons instead of barbed wire and most of the people

taking tickets are Asian types in robes the color of those

crushed velvet ropes you see outside restaurants with valet

parking. We're at one end of a huge long grassy space too

narrow to really be an oval that slopes uphill toward a giant

stage built on scaffolding maybe three stories high. Bright col-

ored boxy tents with streamers and flags around the edges

make it seem like the midway of a carnival.

        Before the semis hauling the rides get there that is. Before 

the drivers discover there's no room for any rides with all the 

people. Who knows how many but all of Monterey has like

25,000 total and there must be twice that here. With more

than half of them boyz with their shirts off or else taking them

off right now the way Jonnyboy is because the field is com-

pletely surrounded by trees that shut down the natural San

Francisco air-conditioning from water on three sides and since

it's the middle of June the sun is twelve o'clock high in the sky

even though it's more like three. The film of sweat on Jonny-

boy's chest just emphasizes how built he is in a natural way

from surfing and sk8boarding and the letters of the Team Pain

tattoo on his left upper arm are distorted from climbing up the 

swell of his biceps and it almost shames me into keeping my

own shirt on but I just figure what the hey and tie mine around 

my waist too. 

- Kief Hillsbery, War Boy [Picador, 2000] pp. 41-42 

Operating Room Technique

PREOPERATIVE PREPARATION

OF THE PATIENT

Regardless of the physical setting in which an invasive or

surgical procedure will be performed, each patient should 

be adequately assessed and prepared so that the impact

and potential risks of the surgical intervention are 

minimized. This involves both physical and emotional 

preparation. Preoperative caregivers should establish a

baseline for the patient's preoperative condition so that

changes that occur during the perioperative/perianasthe-

sia care period can be easily recognized.

HISTORICAL BACKGROUND 

For centuries before the proliferation of operating rooms

(ORs) in hospitals, surgical procedures were performed

on battlefields, in barber chairs, and on kitchen tables.

Hospitals focused on the care of the poor, crippled,

chronically ill, and insane until the eighteenth and nine-

teenth centuries. Even then, and on into the early twen-

tieth century, many surgeons operated in their offices and

in the homes of their patients. Nurses were dispatched to 

the homes to prepare a suitable room and to prepare the

patient for the surgeon.

     From the late nineteenth century, the achievements in

surgery as a medical discipline can be attributed to an

increase in the understanding of physiology, the introduc-

tion of safe anesthetics and methods of blood transfusion,

the development of antimicrobials, and the management

of the patient before, during, and after invasive procedures.

As surgeons moved into the OR arenas of hospitals, nurses

became responsible for physically preparing patients for

surgical procedures. In the early 1900s, patients were

admitted 4 or 5 days before the procedure; by the late

1930s, this time was reduced to 24 hours or less.

      From around 1920, nursing leaders advocated the

importance of both the physiologic and psychologic

preparation of surgical patients. The individual needs of

patients were recognized but were not emphasized in

nursing education until the 1940s. During the 1950s

patient teaching became a limited part of preoperative

preparation as surgeons recognized the value of early

ambulation. It was not until the 1960s and 1970s that

nursing research studies validated a link between pre-

operative preparation and postoperative recovery. The

risk of postoperative physiologic complications can be 

reduced by teaching deep breathing, coughing, and leg 

exercises and by preparing the patient for early ambula-

tion. Attention to the patient's preoperative psychosocial

and spiritual needs also has important consequences for

the management of post operative pain and the promo-

tion of desired outcomes. Studies showed that the patients

who recieved structured preoperative teaching had a

smoother postoperative recovery. During those decades,

OR nurses were encouraged to visit patients preopera-

tively and prepare them psychologically for the surgical

experience by helping alleviate their fears and anxieties.

PREOPERATIVE PREPARATION OF

ALL PATIENTS

Specific activities such as the preoperative history and

physical examination are completed and documented

before the patient arrives in the OR. This process can be

performed before admission to the hospital or ambula-

tory care facility, other activities are performed when the

patient arrives. The preoperative physical preparation is 

designed to help all patients overcome the stresses of

anesthesia, pain, fluid and blood loss, immobilization,

and tissue trauma. Preparation often begins before the 

patient's hospital admission with the institution of nutri-

tional or drug therapy. An attempt is made to bring all 

patients to their best possible physical status before

surgery. Appropriate consultations, such as cardiac

workup, are sought when necessary.

                                              

- Berry and Kohn's operating room technique, pp. 364, 365

A SHORTENED SET (first movement)

All the connectives of right recall

have grown askew. I know

a child could have lived, that

my body was cut. This cut

my memory half-sealed but glued

the edges together awry.

The skin is distorted, the scar-tissue

does damage, the accounts are wrong.

And this is called 'the healing process'.

Now nothing's aligned properly.

It's a barbarous zone. The bad sutures

thicken with loss and hope

brilliant, deliberate

shaking patients in an anteroom

refusing the years, ferocious to be called.

So I'll snip through the puckered skin

to where they tug for re-aligning. Now

steady me against inaccuracy, a lyric urge

to showing-off. The easy knife

is in my hand again. Protect me.

-Denise Riley, Stair Spirit [Equipage, 1992]

The steel workers’ proposal for the decommissioning of Beaubourg

Start into sleep sleep the truism ‘frigidaire’

the emu ‘today’ kiss kiss poor plastinated Scotus:

             which gosub homesick tight to the gut projection

             fail fails to convince. Mr Bojangles eats dog,

             tap shoes. Aghast at ‘The Dead Sea Experience’,

             the number of the beast you dialed has not been

work works like a dream go to work on an edge go

pet a hairy flipchart are you receiving

over. Shame is her swimsuit-round manifesto, lime

mint soap up the wretched ball queen perfidious

             sow / up for gonzo dog treat paddle-assed

             hokum still still selling in Japan see adipose

             four. That wrecking-ball trustafarian

             guinevere trapped in the afternoon concrete

prairie flip flip six second glimpse of Duran Duran,

or the chemical wad that blinds the part-time

poodle valet. Gin and alfalfa mousse it’s for washing the

car with, or maybe Heimlich Manoeuvre’s the

             name of a German porn director.

             Are we asleep yet? How does the honeycomb

             get in the hive? Now yellow round the tree

             and trumpets shall sound (novelty goddamn

door chime funniest thing) your sheet of interests

and accumulations and multiplex whatnot kitty kitty

tube sox my but the LAPD are so

vulgar. What do you point to? Evidence

             swig say vanilla essence burn up the hissy-fit

             carpool lane like grease and slash or

             lightning. Hands turn spin thrift uptake

             inhibition every one wants to be

childlike. Script says ‘cheep cheep’, mother says

never wear diamonds to the ob-gyn we say

stow it. We saw Fanny By Gaslight it’s a

band you freakazoid. Nothing ventured nothing

             earwax everyone stay stay calm the

             millipede in the salsa what’s he doing the

             backstroke slash-fic butterball spell spell

              license as in driver’s license

as in rammed to the hilt on cranberry meth

stroke scrotal bouillabaisse up your chimney howdy

pardners. Free’s free. Free as the tawny doodad.

Free as a kite in the reckoning up of critical

              influence using avoirdupois for the

              craic dude huffing a dream from the bag the

              milk came in and we have twenty-one

              dogs and they’re all called Arson damn we

stand in the park ‘n’ shout Arson Arson

twilight verdigris thriftstore parakeet underscore

Jim Beam doobie doo Whitney’s an oreo

whore. Dionne’s wig’s on funny honey look at the 

             sky ha made you look. Let’s kick it.

             Teenage girls always slit their wrists in the bath

             week in week out you can set your

             watch and Jesus comes like a gift in the

cereal. He’s a healthcare magnate. Sure you do. Sure

you do. Sure. It’s a matter of private conscience®.

Knife. Knife. What in the picture says knife. Where

you live that goes knife. Kissing his boyfriend’s eyelids

             knife. Pride in authority / grace in deferral

             knife. The climate deranged in Kyoto

             matinee knife. Knife by the way of

             leaves that fall and the boyfriend sleeping

barely near as adrenalin when the emergency comes.

How they will face their long-lost families, dearly.

- Chris Goode, No Son House [Barque, 2004] pp. 4-5

WOUND RESPONSE (1974)

"Of particular interest in the present context are
the observations made on patients whose middle
ear had been opened in such a way that a cotton
electrode soaked in normal saline solution could be
placed near the cochlea. A total of 20 surgically
operated ears were studied. Eleven patients heard
pure tones whose pitch corresponded to the frequency of the sinusoidal voltage applied to the

electrode. . . . One patient reported gustatory
sensations."

                                        

-Touch, Heat and Pain (1966), p. 11

                      

THE IDEAL STAR FIGHTER

                           l

Now a slight meniscus floats on the moral

      pigment of these times, producing

displacement of the body image, the politic

      albino. The faded bird droops in his

cage called fear and yet flight into

      his pectoral shed makes for comic

hysteria, visible hope converted to the

      switchboard of organic providence

at the tiny rate of say 0.25 per cent

      "for the earth as a whole". And why

go on reducing and failing like metal: the

      condition is man and the total crop yield

of fear, from the fixation of danger; in

      how we are gripped in the dark, the

flashes of where we are. It pays to be 

      simple, for screaming out, the eye

converts the news image to fear enzyme,

      we are immune to disbelief. "If there

is danger there ought to be fear", trans-

      location of the self to focal alert, "but

if fear is an evil why should there be

      danger?" The meniscus tilts the

water table, the stable end-product is dark

      motion, glints of terror the final inert

residue. Oriental human beings throw off

      their leafy canopies, expire; it is

the unpastured  sea hungering for calm.

                           ll

And so we hear daily of the backward

      glance at the planet, the reaction of

sentiment. Exhaust washes tidal flux 

      at the crust, the fierce acceleration

of mawkish regard. To be perceived with 

      such bounty! To put the ring-main of

fear into printed circuit, so that from the

      distant loop of the hate system the

whole object is lovable, delicious, ingested

      by heroic absorption! We should 

shrink from that lethal cupidity; moral

      stand-by is no substitute for 24-inch

reinforced concrete, for the blind certain 

      backlash. Yet how can we dream of

the hope to continue, how can the vectors

      of digression not swing into that curve

bounding the translocal, and slip over, so

      that the image of suffered love is

scaled off, shattered to a granulated pathos

      like the dotted pigments of cygnus?

                           lll

What more can be done. We walk

      in beauty down the street, we tread

the dust of our wasted fields. The

      photochemical dispatch is im-

minent, order-paper prepared. We

      cannot support that total of dis-

placed fear, we have already induced

      moral mutation of the species. The

permeated spectra of hated dominate

      all the wavebands, algal to hominid.

Do not take this as metaphor; thinking to

      finish the last half-pint of milk,

look at the plants, the entire dark dream outside.

- J.H.Prynne, Brass [Ferry, 1971] 

Welcome

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