Milton always seemed to have a bit of a conflicted relationship with his mother. She had abandoned him and his brothers when Milton was 8 years old and he didn't see her again until he was 13. When we lived on Waller Street in 1985, he paid for her to fly out to visit us in San Francisco for a week. During her visit, I took some video and "interviewed" her. This video is in two parts because, at the time I uploaded it to youtube, because of their limitations, I had to divide the movie.
I know it was in 1985 that I went to Hawaii for the first, and so far, my only trip to Hawaii. Milton was supposed to come with me. We had talked about a trip to Hawaii and he was going to come. We had only been together a couple of years or a few years at that time and we kept all of our finances separate as we would continue to do through most of our lives together. He was working in housekeeping at Holiday Inn. He had finished the program to become a Licensed Psychiatric Technician about the same time that I finished my program to become a Registered Nurse. He took the California State Board for Psychiatric Technicians and like many people, did not pass it on the first try. He decided that he hated the idea of working in psychiatry and wanted to continue his less stressful and less financially beneficial job at Holiday Inn. He was not able to come up with the money for the trip to Hawaii, so I was left to go by myself.
I had never been to Hawaii before. I bought a low cost package from Pleasant Hawaii Vacations. My room was just a few blocks from the beach. I was quite satisfied with the accommodations. I was shocked by the humidity as it hit me in my face as I de-boarded the airplane. I had never encountered that kind of humidity before and it took me a little time to adjust to it.
I think it was the second day after my arrival that I came across an offer of a free rental car in exchange for attending one of those time share condo presentations. I had never attended one before so I had no clue what I was in for. It never occurred to me that it would be as bad an experience as it was! By the end of the presentation, I told them that I didn't care anymore about the free car, I just wanted to know how to get out of the building!! It was an extreme high pressure kind of sales with multiple salesman coming at you pushing you to sign a contract. I just don't respond well to high pressure sales. I finally did escape and did get the car for several days and was able to tour the island.
Milton and I had been together for a couple of years by this time, living on Waller Street. He is cooking something at the beginning of this video. Then it cuts to a birthday cake that looks like it probably came from the original Just Desserts, when they had their store on Church Street. They made an incredible raspberry-walnut-carrot cake.
Midnight Caller was a t.v. drama that aired from 1988-1991, starring Gay Cole as Jack Killian, that took place in San Francisco. Gary Cole's character had been a former San Francisco police detective and was now working as a talk show host.
I don't think Milton and I even watched it initially. I think the first time in came into my consciousness was when my old friend,
Junko, called and asked if I could take some pics for her to submit to the casting department for the television series. The way I remember it is that she was somewhere downtown San Francisco, where they were filming the series and she spoke with someone that gave her the contact information for "extras." I took some pics of her but also decided to submit my own pics. As it turned out, I don't think Junko ever followed through but I was in two episodes. In one episode, I played an FBI agent as an "extra" which means no lines. In the other episode, I played a doctor as an "extra," also with no lines. It was fun to be in the two episodes but minimal pay and unpleasant conditions. You had to show up at the location for shooting very early in the morning. You would sit around most of the day. I remember being very cold at one location.
I really don't remember the names of the episodes I was in but here is a video of clippings from the one in which I played the FBI agent. I have never seen the episode where I played a doctor. I think it is possible that the episode in which I played a doctor might have been a controversial episode of the time, called "After it Happened," in which a bisexual man with AIDS intentionally infects a straight woman.
In 1980 I was still working at Saint Francis Hospital 4-East, a locked adult psychiatric unit in San Francisco. One of the nurses I worked with was named Judith and she knew about my interest in film making. She was dating a filmmaker named Jerry Stein. She told me about a movie that he was making about Reggae. He had shot a lot of sixteen millimeter film in Jamaica and was preparing to edit it. I volunteered to help with the caveat that I would get a screen credit.
When I arrived at the editing suite, there were pieces of film hanging everywhere. My job was to take all these pieces of film and edit them together physically with tape for that purpose. I would trim the end of one piece of film and butt it up next to the next piece and then take them together. It was tedious but I enjoyed the process as I was always interested in anything having to do with film making, photography and later video. It was great experience and I appreciated the opportunity to participate in putting the movie together. I did get my credit but misspelled!
The movie had it's premiere at The Castro theater and Milton and I attended. It was much fun.
Judith and Jerry were very into the whole reggae scene and were always listening to reggae when I was with them. I never really got into it to that level. Occasionally I have heard reggae songs that I like but have never been to a reggae concert and don't follow reggae music.
After the film project was finished, I only saw Jerry a couple of times while he was still with Judith. Over the years I lost contact with Judith as well. The last I heard, she had moved to Oregon.
When I had been living in San Francisco in my late teens, I remember being destitute and walking around San Francisco with only 25 cents to my name. I ate at the "missions" sometimes where you would get soup and a sermon. There were a couple of times that I was desperate enough for a few dollars that I would sell my body for a few bucks to eat. I would go to the unemployment office but could only get sporadic, temporary, minimum wage jobs. On one of those visits, I saw a flyer about a training program that would pay you while you attend classes to become a Licensed Psychiatric Technician. It wasn't long after Kenny had drank drano and killed himself and immediately after Jim Archiquette sent me and Louise suicide notes, that I fled back to Washington State. I worked for my dad at the Brunswick in Toppenish until my mom called or sent a letter to ask if I wanted to come to Upland to participate in a vocation program to become a Licensed Psychiatric Technician. I jumped at the opportunity, feeling like it might be my last opportunity to do something to get on my feet and finally have some independence and security.
After the year long program, I passed the California State board and got my license to work as a Licensed Psychiatric Technician. I had missed San Francisco so much during that year of Southern California suburban freeways. I would spend my weekends driving an hour to West Hollywood where there was a gay community and went to the bars and baths there but it was not the same as San Francisco at all. Gay people in San Francisco had seemed like an extension of the Haight Ashbury hippies, while the gay scene in West Hollywood seemed scattered and plastic by comparison. I returned to San Francisco as soon as I could.
I lived in the hotel over the Rainbow Cattle Company at the corner of Valencia and Duboce streets. I had a $10/week room with a bathroom down the hall and everyone on my floor shared a kitchen and a pay phone. I went out to all the hospitals in the area that had psychiatric units and even hitchhiked down to Agnew's State Hospital, about an hour South of San Francisco, which would eventually become the campus for Sun Microsystems. Then, one day, someone came to get me in my room to say that I had a call on the pay phone. It was Saint Francis Hospital.
Initially, when I first started working at Saint Francis, I would tuck my long pony tail, which went to the middle of my back, up under a synthetic short haired wig. I think I had purchased it at Macy's with Louise one day. I can not fathom why Macy's would have been selling short haired wigs at the time but it looked real enough that I could pass as someone much more conservative. The Director of Nursing at Saint Francis at the time, Doris Weber, was very conservative. I wore that short haired wig for the first six months or so that I worked at Saint Francis.
Since I was 6'4" and male, I was often called upon to manage out of control patients. Registered Nurses were the ones that were in charge and the ones who gave out the assignments and that would direct the activities of the staff. It often felt like I was put into tenuous situations by the R.N.'s. They seemed to have all the power. I wanted some of that.
I started taking pre-requisites at City College of San Francisco and it wasn't long until I had accumulated quite a few credits. It was difficult but I was determined to get through these classes. I had been derailed too many times by drama in my late teens and twenties and I was determined not to be derailed again. Along the way, I met Ron Greene.
Ron was gay and around the same as me but almost entirely bald. He was outgoing and friendly while I was more shy and reticent. Ron initiated our friendship and it was very lucky for me that he did. I had never had the best study skills and had never been one to create study groups. Ron had great study skills and had no problem pulling others into study groups. I really don't know that I would have ever made it through the pre-requisites and nursing school without Ron. When it came to cutting up a frog in Biology, Ron took the knife. I took notes. When it came to handling cadavers in Anatomy, Ron would pull them out of storage. I would observe.
It was the early eighties and gay men had been dying in droves from AIDS. In some of our clinical rotations, we were giving care to those dying of the disease. There were many times that I thought I couldn't do something and then it turned out I could. I always hated needles and giving shots but I had learned to do that as a Psychiatric Technician. Now, there were many other things that were extremely difficult to do that would raise my anxiety, but I found I could overcome my anxiety and actually do these things that seemed so impossible. One night before I clinical rotation where I knew I would have to, I couldn't imagine myself giving stoma care for a patients colostomy. Yet, the next day when confronted with the situation, I was able to step up and do what was necessary. We really are capable of so much more than many of us think!!
We had some great instructors at San Francisco City College. Down through the years, I would hear the misnomer "two year nurse." The fact is, there is no such thing as far as I have ever been able to find. The real fact is that most four year nursing programs include most of the general education courses and the pre-requisites in their "four years." There are some higher level courses of course, but generally geared toward management. For front line nursing, there is no more rigorous a program than what City College offered. The "two year" nursing program was on top of two years of pre-requisites.
On either a summer break or a semester break, as we approached the last semesters of the nursing program, Ron took a vacation to Mexico. He came back sick, complaining of open sewers that drained onto the beaches of Acapulco. He had also traveled on buses into remote regions of Mexico and had drank the water. He received treatment but just seemed to get sicker and sicker. Finally, he was diagnosed with AIDS and would never return to the nursing program. He would die at the V.A. hospital in San Francisco shortly before the rest of us graduated. I owe so much to him but he continued to give and left me his old car, which Milton and i continued to drive for another year or so after that.
I was working as a Registered Nurse at Western Psychiatric Center within Saint Francisco Memorial Hospital in San Francisco the evening of October 17, 1989. At that time, WPC was divided into a locked unit and an open unit. I believe I must have been working on the open unit that evening. I remember being in the open unit's "day room" where some of the patients were watching a baseball game at Candlestick Park. Suddenly there was a strong jolt that shook everything that lasted only a second. The lights went out briefly and elevator alarms started going off. It was not entirely clear at first what had happened other than it must have been an earthquake.
I believe Saint Francis must have been built on some bedrock as there was very little shaking. Soon we would discover that this had actually been a major earthquake and there had been extensive damage in the rest of San Francisco. Part of the East Bay double decker Nimitz Freeway, the Cypress Street Viaduct on Interstate 880 in West Oakland had collapsed and 42 people were killed. This would come to be known as the "Loma Prieta Earthquake, named after a peak in the Santa Cruz Mountains which was close to the epicenter. Ultimately there would be 63 deaths and 3,757 injuries.
I tried calling Milton and got through on that first call and told him to call my mom and let her know we were alright. He told me there was damage in our flat and the computer monitor we had at the time fell over into a chair. I tried calling again after that but by that time, the lines were jammed and I couldn't get through.
The patients on the psych unit remained calm. I was asked to evaluate a woman that had come to the Emergency Room from one of the hotels downtown. She had been emotionally upset but was not injured.
I wasn't sure for a few hours whether I would be allowed to go home at the end of my shift. In emergency situations, nurses and other medical persons are expected to come in to work or stay at work if they are already there. By 11:30 that night, things on Western Psychiatric Center were under control and was using emergency generators for electricity. I was eager to get home to see if Milton was okay.
I had ridden by scooter to work that day and driving home was eerie. All of the street lights and traffic lights were off. There was very little traffic and everyone was driving cautiously. The streets were eerily dark. When I arrived home, Milton was fine but was shaken. We had quite a bit of damage in the Waller Street flat. There were cracks in the plaster in the kitchen and living room but nothing structurally.
We made a bed at the top of the staircase that led from the front door to our second floor flat. We tried to sleep but the aftershocks kept us awake. We were surprised when the phone rang since it had been out previously. The call was from Peter and Allen in England. They had seen footage of the fires in San Francisco's Marina district which made it appear that all of San Francisco was burning. Milton and I were not even aware of the fires at that time as there was no t.v. and we didn't have a transistor radio either. After a while, we decided our best option was to throw some clothes in the car and head to Sacramento.
Since the Bay Bridge was closed due to damage, we headed out of The City across the Golden Gate bridge. Milton looked back toward The City as we crossed the bridge and could see The Marina District still burning. We would spend the next couple of nights in Sacramento.
I think that many of us that lived in San Francisco during the eighties will remember that decade as the decade of AIDS and seeing many of our friends pass away.
The seventies had been an incredible party for gay men in San Francisco. The sexual revolution for both gay and straight people had started in the 1960's. "The pill" had allowed women to take control of procreation in a way they had never been able to in the past. This liberated both women and men from anxieties about pregnancy. Antibiotics had made sexually transmitted diseases more of a nuisance than a worry and many considered diseases like gonorrhea about as bad as a mild cold. There would be some irritation or discharge from the urethra and sometimes pain with urination that let us know something was amiss.
There were multiple bathhouses and sex clubs throughout San Francisco. It was called "the gay mecca." Gay men were everywhere in The City but especially in the Polk Street area, The Castro Street area and the Folsom Street area. Each of those areas was teeming with gay bars and gay businesses including bars, sex clubs, peepshows and bathhouses. There were "glory holes" in many public restrooms throughout San Francisco and you could walk into almost any park after dark for sex. Sixty minutes did an expose of gay promiscuity and focused on Buena Vista Park in The Haight/Ashbury neighborhood but Lafayette Park and Alamo Square were almost as busy. Anonymous, no strings attached promiscuity was the norm. Hardly a day would go by without at least one new sexual partner but several new sex partners in a day was not unusual. Sex had become a recreational pastime. It was everywhere. By the end of the decade, many of us had hundreds, if not thousands of gay partners.
Most of us made frequent visits to the V.D. clinic, (called the City Clinic), for testing. A cotton swab culture of the urethra or a urine test would confirm either gonorrhea or "non-specific urethritis." I was told years later that at that time, the test for chlamydia had not been developed so a lot of the "non-specific urethritis" was actually chlamydia. The City Clinic was full of hot young men and sometimes you could meet your next sexual partner here before you even got done with your testing. Nobody was that concerned about a little "clap."
If one had been a bottom, you were asked to spread your cheeks so a swab could be taken of the rectal area. Often you would be ordered antibiotics whether you were positive or negative as rectal gonorrhea was harder to confirm. After the swabs were done, you would then get some blood drawn to check you for syphilis. I don't think I had even heard of herpes until the very late seventies and it was something that was not tested for at the time.
At first in the seventies, STD's just seemed innocuous but then gradually started getting more complicated as the decade progressed. There was an epidemic of amoebas, parasites, giardia and shigella at one point. At that time, I was seeing a straight physician. I had been having mild diarrhea for about a month and the straight doctor I was seeing had no clue what was the underlying cause. Finally, I went to see Dr. Paul Isakson in San Francisco, who was located in The Castro and had a primarily gay practice. He was pretty sure what the underlying cause was because he was aware of the current epidemic and sent me to the University of California in San Francisco's "tropical disease" department to get my stools tested. Sure enough, the cultures for ova and parasites came back positive and I was treated.
Amoebas and parasites were being transmitted through feces. Gay men were especially prone due to anal sex and sex practices such as "rimming." Most of us were young and naive and didn't know the consequences of some of our actions. As we experienced new diseases, many of us began modifying some of our behaviors and sexual practices.
In 1974 I had contracted hepatitis b and was in the hospital for a couple of weeks. Apparently it had been contracted through body fluids but it didn't impress me as something that should curtail my sexual proclivities. My understanding was that I was now immune to future bouts of hepatitis b so one less thing to worry about. I recovered fully and became involved in the City Clinic study which would eventually lead to the hepatitis b vaccine that is available today.
Around 1980 my mom sent me an article about something called "gay cancer." A lot of us wondered if this was some ruse by the media the scare gay men. Then we started seeing friends with mysterious lesions. People were not sure if it was connected with sexual activity or something else. Poppers were one of the possibly culprits discussed. Poppers are an inhalant used at the time by most gay men and many heterosexuals during sex but also used on the dance floor. You inhaled some from a small bottle or other devices made specifically for this purpose and you would get a rush of excitement and energy through your body. The smell was familiar to anyone that went to a sex club or dance club during the seventies.
The first person I knew that died of AIDS was a guy I worked with named Paul. He had contracted an unusual type of pneumonia, called pneumocystis. Within a few weeks of his calling in sick at work, he was dead from what was called "gay pneumonia" at the time.
Mysterious illnesses were everywhere very quickly. The Bay Area Reporter, a local gay newspaper that had been heavy on sex ads, now published obituaries of the men dying in droves.
By 1984, San Francisco's Public Health Director ordered 14 bathhouses and sex clubs catering to gay men to close. By this time, scientists still didn't understand the disease that was killing gay men and more and more rapid rate but it was obvious that there was some connection to gay activity. Since 1981, there had been 723 cases of AIDS reported.
Rock Hudson, a famous leading man in Hollywood, was diagnosed with AIDS in 1984. He had lost a lot of weight and looked sick and gaunt when he appeared with Doris Day, an actress with whom he had starred in several movies, at her press conference. On October 2, 1985, Rock Hudson's death from AIDS shocked the world and rocked the gay community in San Francisco.
It was about this time that many in the gay community began using condoms and practicing what was being called "safer sex." Poppers disappeared from dance floors. Sex clubs were closed and safer sex was less sex and fearful sex. A lot of us were reading Kubler-Ross' "On Death and Dying" and books by Louise Hay which seemed to tell the dying that they could "heal their lives' through meditation. Of course, the HIV virus didn't care about anything like meditation and ultimately nothing would be able to stop it for years to come.
My ex-boyfriend's, John and Stanley were both diagnosed in the eighties. Both were dead by the 90's.
I was still working as a Licensed Psychiatric Technician on the psychiatric unit at Saint Francis Hospital and going to San Francisco City College to become a Registered Nurse. I was living with Milton on Waller Street and he was also going to City College too.
The first patient I dealt with that had AIDS was when I was still in nursing school with our clinical rotation at the Veteran's Administration hospital in San Francisco. The patient had Kaposi's Sarcoma, which was what had initially been called "gay cancer" at the beginning of the epidemic. He was very sick and in isolation. It was pretty well established by this time that you could not catch HIV or AIDS from touching patients. Many had insisted on wearing gloves when doing any care of an AIDS patient but now we knew that wasn't always necessary and only impeded physical contact. Housekeeping at the V.A. apparently refused to clean his room out of fear of the disease. Besides caring for this early AIDS patient as a student nurse, it also fell on me to do what should have been the hospital's housekeeping department. I cleaned the room. I gave him a bed bath and a massage which was typical care for a student nurse to do. I washed his lesions and made pleasant conversation.
My best friend in nursing school was Ron Green. He was outgoing and friendly where I was more aloof and shy. He got me involved with other students at school and always made me part of his study groups. I don't think that I would have ever got through nursing school if it hadn't been for Ron. During the summer break, he had gone to Mexico and had fallen ill during his visit to Acapulco. Upon return, he continued to be sick and was eventually diagnosed with AIDS before our final semester. He would die at the same V.A. hospital where I had experienced my first AIDS patient as a nursing student.
In 1982, computers disguised as game machines were just starting to become a consumer product. Atari was popular for it's games like Donkey Kong and Pac Man. The Commodore 64 was also becoming popular. I bought an Atari but was more interested in it's word processing capabilities than I was the games. The games didn't hold my interest very long at all. I have never understood why one would think it was an accomplishment to win a game when the same energy could be applied to some real accomplishment in life.
As I was going through nursing school, I was becoming more interested in the early computers. A new company named Apple, with it's founders Steve Jobs and Steve Wozniak had released their revolutionary computer called the Apple II and IBM soon came out with their personal computer which quickly became the standard of the time. By this time, I was following computer development in the news and news magazines related to their development and getting on line with the first on line service called Compuserve. I had grown tired of the Atari's limitations and was interested in something more powerful. I remember reading in a magazine about something new that was coming out from Apple, which they called Macintosh.
The early IBM PC's were not really "user friendly" at all. Everything was done by typing in arcane commands on a command line in something called DOS which had been created by a young company called Microsoft and it's founder Bill Gates. This was fine for business users but not really much fun. The new Macintosh that was coming out was the first computer for consumers that would use a graphic user interface, (GUI), and something called a "mouse." Instead of typing in codes, one just clicked on little pictures called "icons." You could do everything on a Macintosh that you could do on a PC but in addition to the word processing and spreadsheets, you could also do something new called desktop publishing. The Macintosh had enormously more appeal for artists and other creative types as well. It was the computer for "the rest of us." It was released with the iconic George Orwellian 1984 Super Bowl commercial. Computing would never be the same.
At about this same time, in my nursing program, we wanna-be nurses were learning how to write "care plans." A care plan is a document that describes a patients problems and the goals for those problems and the interventions to reach those goals. It is a kind of roadmap of patient care for the bedside nurse. While we were studying how to write care plans in my classes, we were having a hard time keeping the same kind of documents updated at my job on 4-East at Saint Francis Hospital. Patients would get admitted and the nurse would sometimes do all the paperwork involved in the admission except for the care plan or the care plan was written quickly and often incomplete. The Joint Commission on Accredidation of Hospitals were emphasizing care plans about that same time and so the managers at my job were nagging staff to write better care plans and keep them updated.
I got tired of hearing management nagging the staff to do care plans without coming up with any realistic plan or means for getting them done and I figured out a way to write some standardized care plan templates that one could just use a copy machine to copy onto our forms. Although this technique for doing care plans was a big time saver and staff and management loved the idea, the problem with that was that the care plans were not specific to the patient and could not be easily editable. This caught my imagination and in a staff meeting one day with our medical director, Dr. Anderson, I suggested that we could "computerize" care plans.
I explained that from what I had been reading about computers and something called databases, care plans would be a great project for computerization. Dr. Anderson seemed intrigued by the idea. I let him know that the Macintosh was supposed to be something that anyone could use. He encouraged me and actually got funding for a new Macintosh computer. There was a little confusion as to ownership initially as he had also told one of the Social Workers, who had their office elsewhere that she could use the Macintosh. Once the computer had been purchased, I felt like it was my responsibility to see that it warranted the outlay of funds which came to about three thousand dollars if I remember correctly and I saw to it that it stayed on the psychiatric unit where the entire nursing staff would have access to it rather than just one Social Worker.
When the Macintosh arrived, I was excited by the graphical user interface. The screen was only about nine inches and black and white but it used something new for computers, called icons, to navigate through commands. I read everything I could find in my spare time about using the machine and searched for software that would help me do care plans. Almost every day that I could, I would clock out after my shift and then stay on the unit to work on the Macintosh.
At first, I just tried putting the same standardized care plans I had written earlier into a word processing program. The problem was that we were using pre-printed forms and it was difficult to get the text to line-up on the pre-printed forms. The only solution in my mind was to actually put the pre-printed forms onto the computer. One of the programs I experimented with early on and which worked well initially was Filemaker. The forms could be put into the database and the nurse could select a standardized care plan but they were still not able to customize it completely. Eventually I read about a new relational database program called 4th Dimension made by a company called ACIUS. I could create separate databases that would relate to one another. I could creaate a database of nursing problems that could merge with a database of patient information.
By this time, I had gone into debt to buy my own Macintosh. I had gotten a copy of the database software, 4th Dimension, which came with several thick manuals and I would sit up all night at the computer, trying to get it to work. In the beginning, 4th Dimension itself was a little buggy and it made it difficult to know when it was me that was making programming errors or if problems were being caused by the initial bugs in 4D. As the bugs got worked out in 4D and I got better in my programming skills, what I would eventually call "MacNursing" started coming together.
The database was developed initially for the needs of Western Psychiatric Center at Saint Francis hospital and eventually almost all of the written forms for the admitting process were transitioned into the computer database. The nurse would enter the patient data and then select patient problems specific to the patient and then could edit those problems and truly customize the care plan to each individual patient. The forms were put into the official medical record and passed inspection by Joint Commission. Even the California State 5150 and 5250 forms were approved and printed from the MacNursing database.
When the Western Psychiatric Center budget got tight, a new position was created around my computer program and the admitting process as it became more efficient for a nurse with typing and computer skills to admit patients using my computer program. An admitting process that had been slow, cumbersome and ineffecient, now became much faster and thorough.
Western Psychiatric Center would continue to use my program for admitting patients for the next ten years. Although Saint Francis never compensated me for the hours of work I had done on my own time to develop the program up to that time, I was okay with that since there was never any question as to who owned the rights to the MacNursing. After I had resigned and left Saint Francis, they did hire me to come back and customize a new version of the program for them and I was compensated for that work.
Meanwhile, one of the nurses and a social worker at Saint Lukes hospital across town heard about my program and contacted me and made arrangements to come and see what I had acomplished at Saint Francis. They got their own Macintosh computer and raised funds to pay me to customize a program for their use. The problem at Saint Lukes, I believe, was that they did not have a "MacNursing" evangelist there as Saint Francis had in me. In those days, nurses most often did not type and most felt intimidated by computers. There were very few hospitals that even used computers in those days and if they used them at all, they were primarily for billing purposes rather than nursing purposes. Once Saint Lukes had paid me for their own version of "MacNursing," I don't think that the staff were willing to adapt to the program. Change is always difficult and nurses that were used to writing everything out by hand found it easier to do things in the way they had always done them rather than learn a new way of doing things. The learning curve would take time and most nurses were not willing to put in that time and I don't think they were given any extra time to do so.
By this time, I was getting visits from from others in the healthcare field that heard what I was doing at Saint Francis. I received visitors from Kaiser Permanente. I was more than willing to show anyone and everyone what I was doing as I truly was an evangelist for computers in nursing, especially Macintosh computers in nursing as I believed the Macintosh was actually user friendly and so it was nurse friendly.
I rented at booth at the California Nurses Association, nursing Convention in Oakland sometime in the late eighties and showed my program there. I rented an extra Mac and an overhead projector so that people walking by could see the program on a big screen. There was some interest but it did not lead to any new consulting jobs or sales.
At one point in the 80's, Apple contacted me and invited me, to their offices at One Post Street in San Francisco for a meeting of developers that were using Macintosh computers in health care. There were probably 10 or 15 entrepreneurs at the meeting. The only company I remember, though, is A.D.A.M. which had developed an anatomy application that ran on the Mac. After this first meeting with Apple, I was invited to a small conference of Macintosh healthcare developers where we could show our work to business persons and venture capitalists that might be willing to invest. I had no business background and a terror of public speaking. I had not been informed that there was going to be an opportunity to show my product to a group and had not prepared for that. When an Apple representative came and asked if I was ready to do my "presentation," I answered that I had not prepared a presentation and did not want to try to improvise one. This is probably one of my greatest regrets in life- a missed opportunity.
Apple continued to be supportive though. When Apple moved from black and white to color monitors, they loaned me a color Mac to rewrite my program to add color to it. Milton and I drove down to the Cupertino headquarters to pick up the loaner Mac and I was able to keep it long enough to re-write MacNursing.
A year or two after I had been at the C.N.A. convention in Oakland, I signed up for a booth at the American Nurses Association's convention in Boston. That was My sister, Donna, took a train from Seattle and met me there to help with my booth that weekend. I had rented a couple of Macs and had a similar set up as in Oakland. This time, there was much more interest and I met Elaine Lloyd, MS, a nursing administrator for the spinal cord injury unit in Palo Alto. We made arrangements for a meeting after the convention.
In nursing, it was never necessary to wear a suit. With my MacNursing business, I had to buy a couple of suits to feel like I was in "business." I loathed wearing a suit or tie buy I convinced myself that I had to wear the costume to fit the part. "Business" was very stressful for me. I always felt like I was playing a "role." I had to attend various meetings at the V.A. spinal cord injury unit and others seemed to think at the time that my program might even be used at other V.A.'s across the country but I think my lack of business experience was evident and this was another missed opportunity.
While consulting with the V.A. in Palo Alto, Elaine and Linda Toth, MS, RN another nurse manager wrote an article called "Development and Testing of Computer Software for Nursing Assessment and Care Planning at a Spinal Cord Injury Center" which was published in the SCI Nursing, a publication of The American Association of Spinal Cord Injury Nurses. The three of us went to Las Vegas for a convention of Spinal Cord Injury nurses and they presented the findings of the paper, published August 1994.
By the time my consulting at the V.A. ended, they had a network of about 10 computers running my program and they had used my consulting services for about ten years. Eventually, it was mandated that the Palo Alto V.A. use a different program that was in use elsewhere. I was told by the charge nurses that the new program did not do anywhere near as much as my program did but that didn't matter to the bureaucrats at the time.
Over the years after that, I would see some of my ideas from those early years integrated into the programs of others. I don't really know if that was because the developers had seen MacNursing or if they had come up with similar ideas on their own.
Development and Testing of Computer Software for Nursing Assessment and Care Planning at a Spinal Cord Injury Center
E. Elaine Lloyd, MS, RN; Linda L.Toth, MS, RN; Sylvan Rogers, RN
This paper describes a pilot project using a Macintosh personal computer and customized software to computertize nursing admission assessment and care planning data. The project setting is a 47-bed Spinal Cord Injury Center with two inpatient units and an outpatient department serving approximately 1,000 patients with spinal cord injury at a Department of Veterans Affairs Medical Center in northern Califronia. The computer software development, implementaiona, and evaluation are described. This sofware was found to be a low cost, customized approach to computerizing spinal cord injury admission assessment data and care planning which reduces repetive writing and facilitates continuity of care. Personal computers and this sotware have provied the mechanism for establishing a spinal cord injury patient database.
- Commodore 64
- history of computers
- computers in nursing
- computerized care plans
- 4th Dimension
- Macintosh Nursing
- Sylvan Rogers
- Western Psychiatric Center
- Saint Francis Hospital
- history of computers in nursing
- admissions records
- Spinal Cord Injuries
- Veterans Hospital in Palo Alto
- SCI Nursing
- Elaine Lloyd, MS, RN
- Linda L Toth, MS, RN
- Registered Nurse
- Nursing Care Plans
- Hospital Admissions
- Computerized Nursing
- Computerized Nursing Care Plans
- MacNursing tm
- MacNursing trade mark
- SCI Nursing volume 11
- SCI Nursing August 1994
- Development and Testing of Computer Software for Nursing Assessment and Care Planning at a Spinal Cord Injury Center
- Computer Software for Nursing Assessment
Milton and I lived together breifly at 525 Haight but wanted a bigger place now that there were two of us and we started looking for another apartment. We walked around the neighborhood looking for signs that said "For Rent" in windows as that was the best way to find a place in San Francisco. We were walking up Waller Street when we saw a door was open and someone was shampooing a carpet in an apartment that looked empty. There was no "For Rent" sign but we asked the guy that was working in the place if it was for rent and as it turned out it was. He let us come in and take a look and we immediately fell in love with the size of the place for the bargain price of $505. Soon we were living at 465 Waller Street, between Fillmore and Steiner.
We lived at 465 Waller for about 12 years. During that period the neighborhood transitioned into a somewhat alternative neighborhood. New businesses moved in and you saw more young twenty-somethings with tattoos and piercings. There was a biker bar on one side of the street at the corner of Fillmore and Waller and at 2am every morning the neighborhood was awakened by the roar or Harley motorcycles. Across the street from that was one of the best Tai restaurants in The City.
Waller Street was a typical San Francisco flat. There was a flat below us and a flat above us. When you came up the front steps, you came to three doors. Ours was the center door. When you entered the flat, you walked up a flight of stairs and at the top of the stairs was a long hallway. At the front end of the hallwa, overlooking Waller street was a bedroom. To the right of that room when facing it's doorway was the living room. The fireplace was no longer operational but it had a nice mantel with a mirror. The living room was divided from a parlor by sliding wood pocket doors. The palor also had it's own door from the hallway as well.
Further toward the back of the flat was a doorway to the bathroom with a tub and sink and then a powder room with just a toilet. At the back end of the hallway was the kitchen and to the left of that, facing the kitchen, was the dining room. We closed off the doorway between the kitchen and dining room and made the dining room into a bedroom as it was large and quieter as it was furthest from the street.
Behnd the kitchen was a small back porch and we would eventually put a washing machine out there and also use it for storage. The kitchen had a large pantry but not many cabinets. The floor of the kitchen was linoleum but the rest of the flat had some decent carpet. Over the twelve years we were there, the landlord should have replaced the carpet but he never did and never did any maintenance he didn't absolutely have to do.
The woman that lived upstairs from us was a hold over from the hippie era and had a man living with her but it was always obvious from the loud fights they had it was her place and she was in control. There is not a lot of insulation or sound proofing in some of these old San Francisco buildings and you can definately hear loud arguments or loud music from people that are too self absorbed to be considerate of others. When our neighbors were inebriated, which they often were down through the years we lived there, we could hear all their issues.
The people below us came and went and I don't remember ever hearing much from them. There was another building with flats next door to us and our dining room/bedroom windo looked out into a lightwell that was shared by one of their windows. A black family lived there that we really never got to know in the years we lived there although we could occasionally hear them. There was a woman that lived there that would sometimes sing opera in an incredible voice. I don't know if she was a professional opera singer or not. I think that it was the first Christmas we were there that we heard that all their Christmas presents got stolen. I can't remember how it was that we would have come to know this but maybe one of them asked if we had seen anything.
Across the street from us lived some ner-do-wells that obviously drank quite a bit and were probably doing other substances as well. There was much coming and going of urban black men, and large black women that didn't seem to care much about how they looked. There was a lot of yelling over there and we would look out our front windows to see what was going on. I remeber calling the police once when I saw toddlers in diapers crying out on the steps in the middle of the night with no adult supervision.
I am not sure if it were these particular people that did it but I always suspected them of being the ones that dropped firecrackers through our mail slot around the fourth of July that first year we lived there. It was late in the evening and we were relaxing in the living room of our new flat, watching t.v. when we hear some noice out in the hallway that sounded like someone was coming through our front door downstairs. Then we started hearing loud pops like gunfire and we thought someone was actually coming up the steps shooting guns. We quickly locked the ourselves in the living room and with adrenaline pumping and fingers shaking, I called 911.
The popping of what sounded like gunfire ceased as soon as I had finished calling 911 and we stepped out into the hallways and could smell gunpowder but when we looked downstairs, we saw that the smell was coming from a pack of firecrackers rather than guns and the front door was still closed and just as the police arrived outside the door, we relaized what had happened- that someone had dropped a pcak of firecrackers through the mail slot. The police saw what had happened too and left. The people across the street were out on their steps observing it all and I always had a feeling that this was their way of welcoming us to the neighborhood.
As I said previously, I was still in therapy when I met Milton. I had gone to "therapy" intermittently down through the years and felt that I had benefitted from it. After my experience with John, and that relationship being so tumultuous, and his resistance to working on issues, I asked Milton if he would be willing to see my therapist in "couples counseling." Although he was obviously not eager to do so, he was willing to go for my sake. We had already started having a few problems during the first year we were together. We were still young and drinking alcochol and had an "open relationship," which meant that we had permission to have sex with other men. This was not an uncommon arrangement in those days as many gay men had not desire to duplicate the heterosexual model. It was accepted that you could love someone and want to live with that one person, but it was not necessary that this one person satisfy all of your sexual needs. Sex was not seen as something serious like a relationship was. Sex could be recreational. You could have sex outside the relationship that really didn't have any emotional strings. It was only for fun.
When Milton and I first met, before the AIDs epidemic came along and shut down the baths, we would sometimes go to the baths together for recreational sex in the same way that I had done with previous lovers. It was my first lover, Jim, that introduced me to bathhouses in the first place when I was about eighteen. Milton and I would go together or go separately. It didn't really matter. But life is interesting in how you can have beliefs about this or that and think you are so liberated and free and able to create new lifestyles, and then jealously comes along and raises it's ugly head. Trying to navigate an "open relationship" with no real roadmap could sometimes be difficult. Anonymouose bathhouse sex was not so much of a problem but ultimately, there were other liaison's found in the streets or at work or elsewhere, in which there was actual conversation and chance for intimacy. Those were the threats to security. The imagined resolution seemed to be an agreement that one could have such encounters as long as one were careful not to intrude these into the relationship. Many people in relationships, especially women, will overestimate and over rate the power of honesty. There are many advantages to the agreement between two people for deception. Of course, it does require agreement, though.
But even then, we agreement to deceive, there is still the requirement for consideration. Now, as anybody knows, if one person is at home, making dinner and expecting the other person at six in the evening, and that other person doesn't show up until nine in the evening, and there is no phone call to explain the delay, the first person cooking said dinner is gong to be a little upset. It's just about the word "consideration." It is not about who or what the other person is having sex with. It is about the other person being considerate enough not to be delayed when someone is waiting dinner for them. Young men are easily distracted, though by their testosterone driven brains and can sometimes be quite inconsiderate. All that is usually required is a phone call but back then, there was no such thing as cell phones and so one would have to find a pay phone that worked and have enough change to make the call, and if one had a man at hand standing by, heated and ready to go, a phone call just seemed like it could be such an inconvenient delay and anything you was going to do, you didn't plan on taking so long anyway. So this became a source of some conflicts. If you made plans for dinner or something else and had expectations, it would be pretty aggravating to have to stand by, wondering when diinner would be. If your going to have sex with somebody else, please don't make me go hungry while your doing it!!
Now, add to those unpleasant, inconvenient delays on dinner, a little alcohol while waiting. Alcohol and frustration and immature insecure men are a terrible mix. This was becoming more and more the situation with Milton and I. The therapist had his work cut out for him to help us sort through all of these issues.
I have a lot of great memories from Waller Street. I was in my thirties and still working part time at Saint Francis. As I mentioned previously, the males on the unit were often the ones that were called upon to handle the violent patients. Over the years, female R.N.'s would put me into dangerous situations repeatedly. Registered Nurses were the ones that were usually in charge and could give orders to the Licensed Psychiatric Technicians. Otherwise, there really wasn't that much difference between what the Registered Nurses did and what the Licensed Psychiatric Technicians did. The Registered Nurses made much more money though, and had much more power over their own safety and the safety of others. I came to a point where I decided to go back to school to get my R.N. license. None of the time that I had spent at Valley Vocational to get my L.P.T. license would apply to the R.N. program. Essentially I had to start over.
Although they called the nursing program at San Francisco City College a two year program, the fact was that nobody actually did the entire program in two years. Before you could even apply to the program, you had to have finished quite a few 'pre-requisites." I had a few credits from over the years when I had taken a class here or there, but I had a terrible grade point average because I had taken classes when my life was pretty chaotic and had quit going to classes without officially withdrawing from there which resulted in incompletes. Some classes, I had not done the work and had gotten low grades. The first thing I had to do to get into the nursing program was to take the pre-requisites and bring up my grade point average. The nursing program was very competitive as there was always a waiting list and they only accepted those with the best grade point averages.
A friend from work, another L.P.T., named Randy, started with me at City College in Anatomy but for some reason, he struggled more than I did. He was unable to get accepted into the program at City and eventually left and went to school at a private four year college where they hold your hand a little more through the program, but of course you pay for that hand holding. In all the years that I have been a nurse, I have never been more impressed with any nurse that went through a four year college than I was with nurses that went through the supposedly two year program at City College, although four year nurses often go into management rather than direct patient care.
Thankfully, City college was willing to remove some of the incompletes from my record if I maintained a good grade point average for a couple of semesters, which I was able to do. I was more focused and determined at this point in my life. I had been through the L.P.T. program and had a better idea of what it took to succeed academically. Early on, I met a guy named Ron Green and he and I would become good friends. We were both gay and both liked men of color. Ron was a better student that me, though. It would never have occured to me to join a study group but Ron saw to it that we were always a part of a study group with others. I don't know that I would have done nearly as well in nursing school if it had not been for Ron. Sadly, toward the end of the program, Ron contracted AIDS and died the year I graduated and got my R.N. license.
I was working toward being a Registered Nurse at City of College of San Francisco. Milton was going to school for an Associate Degree in broadcasting and working at the V.A initially in the media department and then later, my ex-lover Stanley helped get him a job where he worked at the Holiday Inn on Van Ness.
My mom came down periodically during the 12 years we were living there and would stay with us for a week or so at a time. We had a couple Christmases where Roger and Darlene and Darlene's husband Larry and Darlene's kids Chris and Misty were all there. Donna and Teddy visited with their kids as well. Everybody seemed to come to Waller street at some time or another and it was great. Milton's mom even came out from Texas and stayed with us for a week.
At one point in the late eighties(?) Darlene had moved up to Washington and was having a hard time handling Chris and Misty. Mom was going to let Misty live with her and asked if Chris could stay with us. I discussed it with Milton and, although reluctant at first, he did agree to let Chris stay with us. He would live with us for a couple of years until he was eighteen.
I did the same thing with Chris as I had with David some years before. I wrote up a "contract" of several pages outlining what my expectations were as far as his going to school and working. He accepted the contract and did get have a couple of different jobs during the time that he lived with us. He also went to school during this period. He did pretty well under the circumstances. I think that in the case of David and also with Chris, I had some leaverage because each knew no one else when they first came to live with me so there were initially no outside influences for a while. Both were from small town America and I think that living in the big city may have been a litte intimidating for each of them so they were more open to advise. They each knew that they were in somewhat of a desperate situation at the time and had to make it work. The written contracts helped as well.
Chris especially did well when he had a girlfriend. Her name was Angela. I think it is true for many heterosexual men, that they are too testosterone driven and a females influence, calms them down. If they are just hanging around other guys, they want to compete, be aggressive and fight. When a female comes into their life, they become more civilized and want to work hard to make money to spend on her. They want to impress the girl with manners and common sense.
Chris introduced me to rap and hip-hop. I hated it at first but then came to like some of the beats. He would put cardboard down over the carpet in his room and practice break dancing. He was actually pretty good at that and what he called "popping."
Milton and I had settled into our relationship and rarely had the drama that we had in the first couple of years of our relationship. I think I nagged him quite a bit about getting a better job than just working as a housekeeper at Holiday Inn and he decided to go back to school and got into a Psychiatric Technician program which lasted a little over a year. He would finish the program because he started it but it just wasn't something he liked. He eventually took the State Board but failed it, which is not unusual the first time. Most people just study some more and go back and take the test again, but Milton was done with it. He had no interest in going back to take the test again.
At one point, in the eighties, Milton decided that he wanted to take a course in electronics. Although he could have done so, through a community college, he stopped in at a private, for profit, technical school in San Francisco that had nice brochures and fast talking sales people that told him whatever they needed to tell him to convince him that he could take this program easily and get financing for the entire thing. It did seem easy at first, right up until the time that the student loan check was cashed by the school. Then it got very hard. Once they had him in debt for about six thousand dollars for a lot of hype, he felt forced to drop out.