“That’s just the way we do it here! (giggle)”

While I’m regaling one and all (well, you, yeah, YOU! Over there! I see you!) with tales of the school “system”, there is the tale of Allen, Number One Son, and his transition into North Schools and their second grade.

So, in his first grade year, we had lived in another small town, several counties away. I had heard of an opening for an ICU nurse at this hospital, and had applied for, and been accepted for that position. We moved, and the children moved schools, unsurprisingly.

In the previous school, Allen had been in first grade in a Catholic school. He had brought home homework, and his mother and I had worked with him thereon. Therefore, foolishly, once we had moved and he had started second grade, I assumed that there would be homework, again.

Nope.

He came home each day, and I asked him about his homework. “No homework, Dad.”

Was he certain? “Yep, no homework, Dad.”

Did the teacher send anything home with him? “Nope.”

Had there been anything written on the board, such as, oh, I don’t know, HOMEWORK?

“No, Dad!”

This little bonding moment repeated itself day after day, until, a couple of weeks into the school year, there was parent-teacher conferences. Aha! Now was my opportunity to resolve the no-homework dilemma!

So, I arrived at the appointed hour, and introduced myself to the teacher. “I’m Allen’s father. He tells me that he is not getting any homework assigned.”

Cute, young, blond, she smiled, and nodded. “Um-hmm!”

I paused, and, no additional verbal reply forthcoming, I plowed on. “Now, Allen did get homework in first grade, at his previous school.”

Another smile, another “Um-hmm!”

I paused, again. No verbal riposte was forthcoming, and again I plowed forward. “And, I had been of the understanding that homework was important to the teaching process. It seems to me that it provides feedback to the teacher regarding how well the students in general, and each student in particular, is grasping the material.”

Another head nod, another smile, another “Um-hmm!”

I continued. “In addition, I had thought that homework also had the benefit of helping the student generalize the material away from the classroom, promoting retention as well as helping the student incorporate the material into his or her daily life.”

Another nod, another smile, another “Um-hmmm!” I was beginning to suspect that this college graduate teacher was suffering from a poverty of conversational themes. (Sigh!). I wound up my presentation, and went for my closer.

“Therefore, I’m puzzled. Allen is telling me that he is not getting homework assignments, and you appear to be confirming that. I have to confess that I’m puzzled. Can you explain the pedagogical principles that led to this particular plan of instruction, omitting homework?”

Her blonde grin widened, and she tossed her head as if she was still in the sorority house back at Wherever State Teacher’s College. “(giggle) That’s just the way we do it here!”

Outstanding.

I imagined myself, back in Nursing school, answering my clinical instructor, Dr. Smith’s, inquiry, “So, Mr. Stretcher Ape, why did you administer lasix to this patient?”, with the following:

“(giggle!) The Doctor ordered it! (giggle)”

Yeah, about that. Had THAT been my answer, and not revelations about optimizing fluid balance, and the salutary effects of diuresis upon the patient with heart failure, well, I’d still be repeating my FAVORITE! greeting in The Whole World!, which is “(knock, knock, knock!) Fire Department!”

All night long.

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CHARLIE AT KINDERGARTEN ROUNDUP

So, a couple of years previous to David’s kindergarten goat rope round up, his older brother Charlie had undergone the same appraisal. I had worked nights the preceding evening, and got off work just in time to drive into town and join the fun.

For those of y’all who HAVE worked nights, you can ignore the next little bit. For the rest of you, pay attention. Night shift workers generally NEVER are fully caught up on sleep. On days after work, they are acutely-on-chronically sleep deprived. As for me, I am NOT at my best, when poorly rested.

So, we rolled in to the cat-rodeo that is kindergarten round up. One of the tasks, among others, is the child has to print his/her name. Our darling little boy had, of course, completed this process, and another earnest young teacher was reviewing the assignments. There was the clock face, and the stick man drawing, and the colors identified. All was at baseline until she came to the print-your-name part.

“Well, you see, he printed his name as S-h-u-r-l-e-y, and that is wrong, you see…”

I couldn’t stop myself. I interjected, “Unless, of course, we had named him Shurley, right?”

The poor woman stopped in her verbal tracks. I could almost see her head spin, and she bent to the package of papers, furiously flipping pages, and examining each one, seeking verification that Charlie’s name was, indeed, Charlie. Or Shurley.

After a minute or so of paper flipping, and eyeball spinning, The Plaintiff, Charlie’s mother, patted the teacher on her arm, and reassured her, “Ma’am? My husband worked all night last night, and he sometimes thinks that he is funny. Charlie’s name is in fact Charlie, and, yes, he misspelled it. Can we continue?”

For years, his siblings teased him about being named Shurley. And in answer to the inevitable question, “Surely, you jest?”

“I’m not kidding, and stop calling me Shirley!”

“David’s a diabetic!”

One summer, long before The Plaintiff had become The Plaintiff, she had planned a vacation trip for the entire family. We would motor across the northern tier of states, camping each night in the pop up camper she would rent, and we would see Mount Rushmore, and The Dakota Badlands, among other sights along the way.

Our tow vehicle was to be her station wagon, and we did not have functioning air conditioning in this vehicle. When you plan a trip across Minnesota, and all the way across North Dakota in August, that turns out to be a bit of a problem. It was hot that summer, mighty f#¢&ing hot, to be more precise, and we all sweated abundantly en route.

Now our children, offspring of two nurses, were thoroughly steeped in Nursing Lore. Relevant to this tale, is the old Med School story of the lecturer who was teaching about clinical  assessment. He harangued the students about the necessity of being observant, because your clinical assessment will be flawed should you miss some tiny, but important, detail.

So this instructor produced a vial of yellow fluid, urine as he identified it, and noted that physicians in pre industrial societies used to assess for diabetes by seeking the taste of sugar in urine. So saying, he inserted a finger into the vial, and, once had extracted a finger from his mouth, announced, “This person is a diabetic!”

“Now, all of you try it!”

Being college students, each dipped their finger into the fluid, and, tasting it, were repulsed at the idea of tasting urine.

Once the vial had returned to the instructor’s desk, he asked the assembled scholars: “How many of you noticed that I dipped my INDEX finger into the vial, but tasted MY MIDDLE FINGER?”

My children had all heard this story several times. This factors into the following narrative.

Our youngest son, who we shall refer to as David, was all of perhaps 4 years old. As is common with children about that age, when on a journey, he simply HAD to stop, and collect more patches for his Tour Of America’s Bathrooms patch vest. At least, things had that appearance, for every time we passed a restroom, around 2 minutes later David would inform everybody in the vehicle that “I gotta PEEEE!!!”, accompanied with his version of the interpretive dance known worldwide as The Potty Dance.

This had become just a bit tedious. I had sought to resolve my fluid deficit (and fatigue from sleeping poorly in a bed not my own) by drinking Mountain Dew. My container of choice was the (at that time) wide mouthed one liter bottles. Now, conveniently enough, once emptied, these could serve as unit dose, single use, preschooler urinals. I would save my empties, and, once David shared with us The Song of His People (“I gotta PEEEE!!!”), well, the To Be Plaintiff would pass him an empty Mountain Dew bottle, David would stand in the second seat, and whizz away, into the bottle. His mother would (securely!) recap it, and that bottle would join the rest of our trash at the next stop.

So, TINS©, there I was, driving cross country and saving lives…er, well, we had stopped this one time, and everybody had trooped off to the bathrooms, while I gassed up the vehicle, and replenished my store of Mountain Dew, and water. Once everybody was seated in their seats, I reached for the (dew dropped, fresh-from-the-store’s-cooler) bottle of Mountain Dew resting in the console, and set about taking a cold refreshing swig.

My oldest two children, who had not been there when I had discarded David’s latest urinal, began to protest, and yell, and sound the alarm, thinking I was about to take a refreshing swig of child pee.

I, of course, had discarded the empty bottle and replaced it with a fresh cold bottle of soda. I tipped it up, savored it, and swallowed. The kids “Uch!”-ed and “Eww!”-ed their disgust. I smacked my lips, and turned to their mother, and remarked, “Hmm! Sweet! Looks like David’s a diabetic!”

So, fast forward a couple of years. David was part of the cat-rodeo that is kindergarten round up, as the school district assesses each prospective kindergartner for readiness for school. One nice young woman, earnest as only a new grad teacher can be, was interviewing his mother and me about myriad things, and came to the questions about medical history.

“So, does David have any medical history?”

The Plaintiff looked at me, and I looked at her, we shrugged. I replied, “No, he’s pretty healthy.”

David’s older brother began to furiously tug at my sleeve, singing the Recessional Song of children everywhere: “Dad! Dad! Dad! Dad!…”

“What, Charlie?”

“Dave’s a diabetic!”

Well, THAT ignited a minor firestorm of interrogatories, as the poor puzzled teacher could not understand how we could deny that our darling child had diabetes, a fact plainly clear to his sibling, and how we could be so placid in the face of such a life changing diagnosis.

The Plaintiff had to explain her husband’s sense of “humor” to this poor woman, and how the foregoing had become enshrined in family legend.

I’m not entirely convinced that she understood the backstory, although she appeared somewhat mollified after The Plaintiff had spun her tale of the burdens of being married to The Stretcher Ape.

Practicing Listening Skills

My father took ill, on the order of 30 years ago. He had a heart attack, and, while recovering from that excitement, was found to have cancer. Given that he was at that point in his seventies, well, it was a rough time for him, and my mother.

Now, shortly prior to these discoveries, they had moved from The Unnamed Midwest State, to The East Coast. They had been born, and met, married, and started our family in The Megalopolis. With my one brother and I living in and about Da City, and our other brother living overseas, well, my brother the contractor was not a strong candidate to help mom take care of dad, and I, the nurse, seemed better suited, occupationally, to show up out there.

So, I did so. The mortgage company did not seem likely to grant me a payment holiday. It appeared that the credit union was on this same page. Therefore, I needed to work as a travel nurse should I spend any time on The East Coast. I did so, pulling 12 hour weekend night shifts.

After I was credentialed, I was assigned to work various East Coast emergency departments, my job back at home. So, this one time, I was sent to St. Elsewhere, in some fishing town on the southern coast of The State.

I arrived early, and announced myself, asking for the charge nurse. She greeted me, and asked me if I had any ER experience.

Now, by this point, I had spent around 8 years on Da City’s EMS, and close to 7 years in ER in Da City. My answer was “Yeah, some.”

She looked me up and down, and gave me her New Kid Spiel. “This is a fishing town. We have a bunch of young guys, working hard fishing, and, when they come into port, they play hard. Now, if you get a 20 something guy, tap dancing away, can’t sit still, anxious, sweating, and complaining that he feels like his heart is about to jump out of his chest, he’s not having a heart attack. Likely, it’s cocaine.”

I nodded. “Sounds right.”

She paused. “You know anything about cocaine? Ever seen any cocaine overdoses?”

“I know some, I’ve seen a couple.”

“Where have you worked?”

“Da City, in ER. 8 years on Da City EMS before that.”

“Why am I telling you about cocaine? You were just gonna let me carry on, weren’t you?”

“Yeah. If I listened, likely I’d learn something.”

She rolled her eyes. “Here are your keys, your module is over there, get Lucy to count narcotics with you.”

Answering Machine Message

 

So, as I may have already made plain, a long, long time ago, and very far away, I was a medic for Da City. At that time, let us be generous, resources were poorly matched to demand. This was evident in every arena, from 30 minute EMS response times, to fire responses by engine companies several first alarm districts away, to police response hours after the call originated. Even the “Public Safety Answering Point” was over taxed, and under resourced.

On one occasion, I had need to call 911, myself. Imagine my surprise when the answer was a recorded message that stated, as nearly as I can recall, “You have reached the 9-1-1 emergency center. Please stay on the line! All of our operators are busy answering other calls. Your call will be answered.” Even more disturbing, this message replayed on a, seemingly, endless loop, auguring ill for the likelihood of a prompt response.

So, fast forward a couple of years. Poor Mallory, in a fit of bad judgment, had moved in with me in my house in Da City. She lived with me for several years, all the more remarkable when you consider how difficult it must have been to live with me (ask The Plaintiff!), layered upon the fact that Mallory was an exceedingly nice woman, from the suburbs of Da City. She appeared to grow accustomed to my habit of arming myself in my own home, for I had seen the results wreaked upon folks who had not done so, and had found it unappealing.

So, this was in the era of rotary dial phones, and tape home answering machines. A rotary dial phone is kind of like a cell phone, except that it did not cost you around $100/month, did not have an answering service built in, had no internet access (“Internet? What is this ‘internet’?”), and had no “apps” with which to clutter it’s screen, In fact, a rotary dial phone had no screen, simply a rotary dial (cleverly named, no?) which, when spun, turned back to the starting position and emitted a series of clicks, that by some Black Art, allowed The Phone Company (for, in these misty past times, there was only one Phone Company) to connect you with other people, with whom you could talk (kind of like texting, with annoying sounds, emotional subtleties and intonation thrown in).

This “answering machine” of which I speak, allowed the user to record a personalized message, enticing the caller to leave a message so you could know to phone them back.

Being a sarcastic sort, I recorded the following message on my personal home telephone answering machine: “You have reached the 9-1-1 emergency center. Please stay on the line! All of our operators are busy, answering other calls. Please leave a message at the tone. Your call will be answered….eventually……we hope.” (BEEP!)

Mallory was disturbed, to understate the thing, when she called me once and encountered my (I thought) clever message. She remonstrated with me, citing copyright violations among other concerns.

I responded, “Mallory, I really, really doubt that Da City wants to take this to court either as a criminal matter or as a lawsuit. Should they do so, be certain that I will do my level best to ensure that every single television station, radio station, and newspaper within hundreds of miles of Da City, knows of the court date, and is enthusiastically invited to show up. How do you suppose Da City will appear, with their transcript read aloud, under oath, in open court, against my parody thereof? That might be very, very entertaining!”

Besides the merriment it caused me, that message also had the not inconsiderable benefit of dissuading telemarketers from bothering me!

The “Heimlich remover” in Song and Legend

 

So, TINS©, TIW(after)FDASL©, having been asleep for a couple of hours after another fun filled, exciting night of EMS in Da City. I was just about hitting my sleep stride, sleeping my ass off, when a commotion on my front porch awakened me.

I had bought a two flat in Da City, and lived in the downstairs apartment, renting out the upstairs to a fellow we can think of as The Clod. The Clod had roommates, who seemed unsavory. This appraisal developed as I noted one of these folks to have what we used to call, on the street, “lobster claws”. This alludes to the fact that IVDAs (pronounced as it is spelled, “iv-dahs”), or folks who spend their recreational time injecting street drugs intravenously, develop sclerosed veins, from the damage those veins sustain from the chemical irritation of the drugs, crappy needle technique, and repeated infections of the veins due to nonsterile injectate. It tuns out that the lymphatic circulation simply is not up to the task of returning all the fluid delivered by the uninjured arterial circulation, and so fluid collects in the downstream portions of the limbs, and the hands swell. When this process has advanced sufficiently, the hand(s) resemble the claws of a lobster, hence the appellation.

Now, some folks have stated their appraisal that my years on Da Streets have left their mark upon me. Indeed, my very own cherubic, innocent daughter, aged 20 something and mother of the sweetest, most wonderful children in North America, reports that I am “the most cynical human being that I have ever known.” (I can only hope so!) So, I had taken note of the fact that unusual sounds, seldom presaged Good Things in Da City. Therefore, awake, I put on some pants and a shirt, tucked a revolver into my pants, and laid my shotgun against the wall next to the door. Then, I peeked out the window to see what was transpiring.

My peek revealed an excited disturbance, featuring several folks unknown to me, and The Clod. I slowly opened my door, hand near revolver, and asked The Clod, “What’s happening?”

All a-twitter, he announced that “Luigi (not his real name) has swallowed a sandwich! Do you know the Heimlich Remover?”

Sheesh! The Heimlich Maneuver had been taught in every CPR class I have ever taken, since Desoto himself was in short pants and wondering why the pretty lights sparkled on top of the emergency truck. I moved closer, and noted that Luigi was coughing pretty vigorously, but, since he WAS coughing, it seemed pretty clear to me that he WAS moving air. This was not something I felt particularly enthusiastic about remedying, so I kept an eye on him, and asked, “has anybody called 911?”

I was dazzled from the glare of the metaphorical light bulbs illuminating over every head on that porch, all at once. The Clod noted that this was “A great idea!”, and bounded upstairs to make the call, leaving Luigi, and me, and Ghawd alone knows who else these bastards were, on the porch. Shortly after The Clod’s run up the stairs, Luigi stopped coughing, which I thought was Not Good. I asked Luigi if he could talk, to which he shook his head negatively. Not noticing any air moving in spite of his energetic attempts to do so, I elected to perform the Heimlich Maneuver.

He was sort of crouched over, which worked well for me. I reached around him, clasping my one fist in my other hand, and, planting the thumb of that fist into his stomach (just below the xyphoid, just above the umbilicus), I briskly lifted him off his knees, and settled him back down. I repeated this gesture several times until he coughed again, and produced a glob of half chewed sandwich about the size of my fist.

At this, he began to gasp and wheeze. The crowd started to thin out, as the sirens approached. Soon, it was The Clod, Luigi, and me left on the porch.

The responding EMS crew was a couple of guys I knew, and the one chatted with me while his partner checked Luigi, and obtained his signature refusing transport.

“How long have you been working here?” I was asked.

“What do you mean?” was my response.

“Well, we all figured that this was some kind of adult foster care, because every time we drive past, there’s always a bunch of these guys hanging out. We figured that the residents had to get out of the house during the day.”

FML. Just what I wanted to hear.

 

Haldol “Seizure”

 

While I was in my two year RN program, I was working for Da City, on EMS. Once the program director had made sufficiently clear to me that, no, I could not skip lectures, and, since it was, ya know, spelled out explicitly in the program rules that I had to show my fuzzy butt up for all classes and suchlike, well, I showed my fuzzy butt up as directed.

Of course, this meant that I was acutely-on-chronically sleep deprived. I figure that, by the time I graduated, I was on the order of 2,000 hours short on sleep, maybe more. So, entertaining things happened.

Fer instance, TINS©, one day I had arranged for one of the day shift guys to arrive at around 0530, instead of 0700, because I had clinical at 0700. Imagine my disappointment when my friend did not arrive at 0530. or 0600. I called him, he apologized effusively, and rolled in around 0630. I, of course, unassed the fire house, and beat feet towards clinical.

I probably was going around 55 when I passed the patrol car in the 35 mile an hour zone that was East Vernor. He hit the lights, and initiated a traffic stop. I, no surprise, stopped.

At this time, this was the Seventh Precinct. I had caught a run with one of these crews, probably a couple of weeks prior to this close encounter with law enforcement, for a “seizure”. My partner, we’ll call him Johnny, was medic-ing that particular night. As we pulled up, one officer was excitedly directing us to “Hurry Up! She’s seizing!”

Once we made our way into the residence, there was, indeed, a woman on the floor who appeared very much like someone in the middle of a grand mal seizure. Johnny went to work, getting vitals, and I headed off to see if there were any medication on the counter, or other indications of what might be going on.

To my surprise, as I passed her head, her eyes tracked my movements. Startled, I knelt down, and asked her, “Ma’am? What’s going on?”

She spoke (surprising, as this does not happen in an individual having a seizure), saying, “I’m having a seizure!”

Since this was my semester in psych, I had been studying (again, surprising) anti psychotic medications and their adverse reactions. Therefore, I asked her, “Are you taking medicines for your nerves?”

“Yep.”

“Any new ones?”

“Yeah, on my counter over there.” (still tonic-ing and clonic- away). I retrieved a nearly full bottle of haloperidol, and asked her, “Is this the new medicine?”

“Yeah, that’s the new stuff.”

I looked at Johnny, and we nodded. “Ma’am, we’ll get you to TBTCIDC, and they will fix you right up! Some cogentin, and you ought to be as good as new!”

The cops looked puzzled. I explained. “Sometimes this sort of medicine causes this sort of reaction. There’s a shot to reverse it, and the doc will either change her dose, or her medicine.”

For the rest of that schedule, the officers in that precinct thought I could walk on water. This was A Good Thing, as I put on my 4 way flashers, put the car in park, and exited the car, hoping to make a rapid explanation, and skedaddle so I would not be too, too late for clinical.

Once I was clear of the car, still in my EMS uniform, the officer driving the car stood up, waved me off, and said, “Oh, it’s YOU. Go on, just slow it down, willya?”

“Yessir, Officer! Will do! Tenkyouberramuch!”