Fun And Games Off Duty · Having A Good Partner Is Very Important! · Pains in my Fifth Point of Contact · Pre Planning Your Scene

Clem, Cletus, and Why Heavy Equipment Operators Require Functional Partners, Too

Many, many years after I had left the employ of Da City, I came to live in Small Rural Town. Our little slice of Heaven featured, among other things, a municipal water system. The town had been built out shortly after the Second World War, and the infrastructure was contemporaneous with that construction.

Apparently, the engineering lesson of corrosion occurring at the junction of dissimilar metals, had not percolated to the individuals who built the house in which we lived. This epiphany developed after I noticed one Friday morning that there was water pooling in our front yard, between the door and the street.

Side note. NEVER! call the water department with that sort of observation on a Friday. They will shut off the water. It turns out, the service line from your home to the main is YOUR problem. You will NOT get that problem resolved late on a Friday. Or on a Saturday. Or on a Sunday. Not having running water makes for a long weekend of work.

Monday, I was again working, but TDW-Mark I had successfully contacted the Knob City Excavating Company to respond and repair our service line.

This involved excavating my front yard, and, having accessed the service line, replacing it.

It appears that professional excavating practice involves having one individual operating a back hoe, with another standing by, inspecting the back hoe’s progress, apparently in an attempt to avoid engaging the service line with the back hoe’s bucket, reefing thereon, and using that service line as a leader to abruptly extricate all the plumbing from your home.

So, about that. Clem was the back hoe operator, and Cletus, evidently, was tasked with leaning upon his shovel so that neither he, nor the shovel, fell over. In that, he appeared to be successful. Clem DID notice the entanglement of his back hoe bucket with my plumbing, but only after he had begun to extract my plumbing from my house. Fortunately he had only JUST begun to do so, before he determined that Things Were Not Right, and stopped. That was about the point at which I returned home from a day of fighting disease and saving lives.

Things were at a standstill as I entered the house. TDW-Mark I was standing there, gazing into the hole adjacent to our foundation, looking decidedly unamused. Clem was there as well, while Cletus was a’holding that shovel, determined that it was NOT going to fall!

TDW pointed into the depths of the hole, calling my attention to the copper stretched out from the foundation to it’s junction with the iron pipe that, evidently, had been our service line. Another vehicle pulled up, disgorging a worthy who was, is seemed, Bob The Knob, owner and operator of Knob City Excavating. TDW beckoned me inside, where she showed me where the service shut off on our domestic water feed, formerly near our ceiling, was now located at the floor. I suggested to Bob The Knob that he might want to get somebody with plumbing expertise in to review the situation, and effect such repairs as seemed needful. On his dime. And, RFN. (Right Fucking Now)

He did not appear to think that this was particularly unreasonable, particularly if he were to consider the alternative, which would involve court, attorneys, attorney fees on both sides, and much bad Ju-Ju.

The next day, I returned home from work, and TDW-Mark I informed me that Some Dude had arrived, crawled around in our attic, and had pronounced everything shoreward of our shut off to be intact. This worthy had then replaced our shut off, and the associated piping, and Knob City Excavating had replaced our service line with copper, had installed a bimetallic junction (TDW-Mark I had asked/insisted) at the main, backfilled everything once the city building inspector had signed off, and we Now! Had! Water! (cue the rejoicing)

It turns out that Bob The Knob was satisfied with my check in the original, estimated, amount as payment in full. We did not have any leaks subsequent to this adventure, and we all lived happily, ever after.

Gratitude · Sometimes You Get to Think That You Have Accomplished Something!

Happy Anniversary To Me!

It was long ago, and far away, this 27 July 2017, when I first took keyboard in hand to begin to record these semi random blatherings, tales of my mis-spent youth.

Several folks have been kind enough to comment, suggesting that they have been kind enough to actually read my Tales Of The Dark Side. Others have actually **followed** my blog.

Thank you, one and all. While I had originally thought to immortalize these things fro my children, thinking that I had mis-remembered or entirely forgotten several of my own father’s stories, I am pleased that folks have found this blog, and appeared to enjoy the stories enough to read them, and, in some cases, come back for more.

WordPress reports that I have had over 11,000 views, and nearly 3600 visitors in 2020, from ten countries.

Thank you.

Fun And Games Off Duty · Gratitude · Life in Da City! · Sometimes You Get to Think That You Have Accomplished Something!

Splinting a Cat, And the Lesson I Learned….(Not What I Had Expected!)

A long, long time ago, in a Blue Hive not so very far from here, I was a street medic for Da City. (Gasp, NO! Say it isn’t so! I…I..never suspected!) I was working nights, attending nursing school days, and attempting ti triage my weekends between school projects, studying, sleep, and having a social life. Oh, yes. AND working.

So, TINS©, TIWFDASL©, and, having concluded a rollicking night of same, I entered my apartment. The building in which I lived had been built circa 1910, and had seen sporadic maintenance since then. This is particularly relevant given that I observed my cat, imaginatively named Mr. Cat, seated at my front window.

It was summer, and I had left my windows cracked. My cats had taken to lounging in the window, both to take in the scenery as well as to bask in an intermittent breeze. This was OK, until in one particular window, in which Mr. Cat had been loafing, the sash cord, which held the window open, failed, sending the window crashing closed.

Mr. Car’s “catlike reflexes” were sufficient to enable him to avoid being entirely trapped by the weight of the closed window, but he wasn’t quick enough to entirely extricate himself. His one front paw was held as if in a bear trap, and he greeted me with a look as if to say, “I say, old man, could you assist me? I appear to be stuck, and it is becoming tiresome.”

The cat-length semicircle of destruction spoke to his efforts to resolve his problem on his own.

I opened the window, and he promptly removed it, and began to clean his paw, as if dust were the only problem. When I observed that he did not appear to want to walk on it, I corralled him, sat down, and began my secondary survey.

I could not palpate any discontinuity in his bones in the affected paw, but he was very reluctant to have me confirm that appraisal with a repeat examination. His breath sounds were clear, and his heart sounds were rapid, but regular with no murmur. (Of course, how much “rapid” was kitty baseline, versus pain versus irritated cat, was difficult to discern.)

He continued to limp, and so I gathered up materiel, and set to fabricating The McFee Cat Splint. I cut out cardboard from a box, wrapped it about the injured limb, and secured it (or so I had thought) with roller gauze.

He, unimpressed, shook his injured limb until the splint went that-away, and he went this-away, and he limped off. Sigh.

I re-corralled him, and we wrestled him into The McFee Cat Splint Mark II. This version featured several wraps about his torso, so as to slow the shake-this-thing-into-next-week response that he demonstrated once I had released him. Good news? It did not head off into a far corner. Bad news? Well, howzabout YOU attempt to explain the concept of “no weight bearing” to a cat, and let me know how well that works?

Sigh.

So, we collaborated (for certain values of “collaborated”, particularly if those include one handedly immobilizing a non-compliant cat, placing a New! Improved! McFee Cat Splint Mark III upon said cat, and then, again, single handedly, securing same upon the same non-compliant cat) in splinting his foreleg, again. This version extended beyond his paw, so that, crutch like, the weight that he would usually place upon this paw was transferred to his chest wall/”armpit”.

Kinda like rodeo, without the clowns. Unless you included me, that is.

I began to put my crap away for the morning, but he persisted in not bearing weight upon the formerly trapped paw, and I soon determined that it was time for an assessment by someone who knew their way around a cat. Against Mr. Cat’s protestations, off we went to the veterinarian.

I had not, in all the excitement, changed out of my EMS uniform that morning. So, there I was, once I had registered Mr. Cat, and requested a “walk in” visit (“Be patient, no telling when a slot will open up.”), seated in one of the chairs, cat in lap, uniformed, sleepy (although, that was kind of my ground state in those days), next to a grandmotherly Black woman at the vet.

She asked me what had happened to my cat, noticing the splint he still wore, and (score!) pretty much as I had designed it. I told her the tale, truncated a bit for the waiting room retelling, and she made sympathetic noises. We conversed a bit about pets, and how they fare in our absences, and so forth, passing the time.

Her name was called, and she looked at me, and at the vet tech summoning her, and then she performed a no shit act of Christian charity. She said, “His kitty has been injured, please take him before me, I can wait a bit longer”.

If you have read more than a couple of my posts, you likely realize that I am generally a cynical bastard, a curmudgeon. I commonly have low expectations of people, and they commonly fail to meet them. This tale took place something on the order of forty years ago, and, retelling it now, I am tearing up. This woman, who I had never met, showed herself to be more giving, more compassionate, than I was. She showed me that individuals can be beacons of community, of respect, of sympathy, for folks that do not look like them. She took pity on a white guy, and his cat, because she could.

Because she was capable of empathizing with another, not of her “tribe”. And, being capable, did so.

My cat recovered from what the doctor determined to be a sprain, and lived a long and (cat) happy life.

I moved out of Da City, married, got divorced, remarried, watched my children grow, and have families of their own.

And, today, I offered a prayer on behalf of that woman, my neighbor-in-fact, who bathed me in her compassion, and for whom, today, I cried.

Ma’am, thank you for that lesson.

Fun And Games · guns · Life in Da City!

“Doc, am I gonna die?”

 

So, TINS©, TIWFDASL©, and we caught a run for a shooting. Being full of excitement, because, gosh, THIS was an opportunity to, ya know, SAVE A LIFE!, we coded our happy way to the scene, there to meet the police. They pointed out the named patient, who, to our surprise, was NOT hovering at death’s door. Rather, he had sustained a small caliber gsw to his lower leg, had intact pulses downstream of his injury, and no evident bony injury. We walked him to the rig, buckled everybody in, and set out for TSBTCIDC.

We had dressed and bandaged his wound, and I was busily documenting same, along with the vitals we had obtained, when he asked me a question.

“Doc, am I gonna die?”

I looked at him, and shook my head no.

“Doc, really, am I gonna die?”

Sighing, I tucked my pen away, and addressed him. “No, you are not gonna die from this wound. You may not even be admitted to the hospital overnight.”

Hearing no further inquiry, I turned, again, to my charting. But, it was not to be.

“Doc, really, I can handle it. Am I gonna die?”

Some people, and one track minds. “Sir, you are not gonna die today, and not from that wound. Really, I’ve seen hundreds of shootings, and your injury is in no way life threatening. Okay?”

He nodded, as if in understanding. I (attempted to) return to my charting.

Shortly, he spake again. “Doc, really, I can handle it. Tell it to me straight, Doc. Am I gonna die?”

I was about over the “Doc” idiocy. “Sir, I’m not a physician, I’m a medic. And, do you really think you can handle the truth?”

“Yeah, I can handle it! Give it to me straight?”

“You sure you can handle the hard, icy, no bullshit truth? Because, if you are really, really sure, I’ll tell it to you straight! No punches pulled, no bullshit, no evasions. Is that really what you are looking for?”

“Yeah, Doc! Tell me the real deal!”

(Ah, well, it appeared that ‘listening to and following directions” was not at the very forefront of my friend’s skill set.) I rubbed my forehead, as if confronting some weighty ethical dilemma. I looked skyward, as if seeking Divine Guidance. I gazed at him, and delivered my response.

“Ok, if you’re sure you can handle it, here’s the real deal! You are not going to die! Do you know why, you are not going to die?”

“No, Doc, why?”

“Because you are not going to live that long!”

The rest of the trip was in blessed silence, as he endeavored to make sense of my revelation.

Fun With Suits! · Pains in my Fifth Point of Contact

Hulk Angry!

Years ago, I owned a 1998 Chevy van. It worked out well for our little family, able to seat all four children, TDW-Mk I, and I, along with whatever luggage seemed needful.

After a couple of years, the side doors did not seem to close properly. I took it to the shop, and their determination was that one of the hinges had cracked, allowing one side of the door to sag.

Chevrolet replaced the hinge, and the shop repaired it. Life went on.

Another couple of years, again the hinges failed and the door did not want to close properly. Chevy did not want to pay for this repair. I appealed this decision up the Chevy chain of command, and The Word came down: It had failed because, and I quote, “You had been too rough with it”.

Okay, let’s review. I run around 5 foot seven, and weigh in at around 180# It is NOT “all muscle”. Indeed, my first impression tends to run along the lines of elderly Walter Mitty. The hinge in question is made of around ¼ inch steel. I doubt that I could make an impression on such a piece of steel, if I were to pound on it with a large hammer.

I shared this skepticism with the customer service manager at the dealership. I added, “Why don’t you talk to the decision maker, again? Ask him just how angry he wants to make a guy who can crack ¼ inch steel with his bare hands, and how any such encounter with such a soul might end, should that sort of fellow be really, really pissed off?”

The dealership CSM chuckled. “I was wondering the same thing.”

Bottom line: Chevy customer service sucks, the dealership replaced the hinge at a hefty discount, and I did not go all “Ragnarok!” on Chevrolet’s Customer “Service” hierarchy.

Fun And Games Off Duty · Having A Good Partner Is Very Important!

Revelations

Recently TDW-Mark II was perusing Facebook, and noticed that Number Three Son, and his wife, had posted a couple of pictures. In the first, he was dressed in a nice suit, she in a nice red dress, posed all nice and proper.

In the second, SHE was in the suit, HE was in the red dress, and they were, again, posed soberly and portrait like.

TDW-Mark II called this to my attention, allowed me a couple of seconds to deliberate over this vignette, and then opined, “He loves his wife way more than you love me! You would never do that sort of clothing swap with me!”

I considered this, and observed, “Well, now you know!”

Fun And Games Off Duty · Having A Good Partner Is Very Important!

Drinking in the Heat

When my boys were young teens, they were scouts. I was the assistant scoutmaster, and the troop required two adults to accompany the boys to camp. Since I worked weekends and off shifts, I could finagle a string of days off, and, therefore, I could take the time off for scout camp.

Being of the medical bent, I was de facto medical officer. Therefore, the scoutmaster and I (the only fellow, ever, who was more conservative, politically, than I!) got up early the first day, and, observing the hot, humid nature of the morning, and the weather forecast promising even more of the same for the day, assembled the boys for the morning briefing.

I observed that it was hot and humid. (for am I not, after all, a man gifted with a firm grasp of the obvious?) I next observed that this provided an opportunity for some preventative medicine, to whit: DRINK! DRINK! DRINK! If you (the scouts) are under the misapprehension that you are drinking enough water, you are wrong! When you stop, drink water. When you are moving, drink water. If you are wondering if you might be drinking too much water, drink water.

There appeared, among the boys, some skeptical looks. The Scoutmaster, Tom Swift, admonished the troop, that I had schooled my self for a long time, and delved ever so deeply into the mysteries of the functioning of the human body. Therefore, I likely I knew whereof I spake, and they ought to attend to my counsel.

We broke up for the day’s activities. I lingered in camp, being “on vacation”, until I roused myself to wander the camp. I eventually caught up with my partner Tom, and the gaggle of our scouts. One of these worthies appeared unfocused, with a bit of a bobble to his walk. One of the scouts took note, and directed my attention his way. I poured this scout a tall glass of ice water, and commanded him, “Drink up!”

He demurred, reporting that he was not thirsty.

“I do not recall asking if you were thirsty or not. Drink up!”

He did so. As I poured him another glass, I asked him, “How much have you had to drink since breakfast today?”

“Uh, not much?” Another scout, who had followed this scout’s schedule, chimed in, “I did not see him drink anything today!”

Finishing the glass, another poured. “Drink!”

He had just about polished off an entire liter at that sitting, and Scoutmaster Tom and I conferred. Our scout still appeared unfocused, and so we elected to change venues to the first aid cabin, wherein he could benefit from air conditioning, as well as a place to lay down.

As an oasis, the first aid cabin certainly fit the bill. Kevin, the tottering scout, appeared to like it, and slurped down several popsicles under the camp nurse’s supervision. An hour of hydration as well as temperate environmental conditions certainly seemed to perk him up.

That evening, we held a review of Heat Injuries, And The Scout Population. Using Kevin as an object lesson, for some reason the boys appeared considerably less skeptical than they had that morning.

Weird.

Fun And Games · Having A Good Partner Is Very Important! · Life in Da City!

Dumpster Diving

This one schedule, Doug had elected to rotate onto day shift. Likely something about a wife, family, and wanting to spend some time with That Bright Thing all up in the sky, while he was awake, might have figured into his calculations. In any event, TINS©, TIWFDASL© on night shift at Medic 14 (let us say). I was partnered up with Johnny Wadd (not his real name), who was, even among the collection of characters that made up the crews of EMS in those halcyon days, a character. He was book smart, street wise, quick on the uptake, head on a swivel, and, despite a very crusty persona, good hearted.

So, this one time, at band camp….uh, wrong story. So this one night we were cruising around between runs, and, as commonly happens in my “sea stories”, well, we caught a run. In the misty distance of all these years, I cannot tell you what the nominal nature of this run was. I do, however, remember (a) that the police were NOT dispatched to this run, and (b) once we arrived, and began to understand what the happs were, well, item “a” began to appear to be a big, big mistake.

So, we arrived on the scene to discover not a light on in the alleged address. Calling on the scene, we verified that the house number on the house before us, was, indeed, the address dispatch wanted us to report to. Check!

I knocked upon the door, while Johnny looked around the front of the house. As he reached the edge of the house adjoining the driveway, he heard something from the back that caught his attention. We meandered back to see what was up (notifying dispatch, on the way, of our explorations).

The sounds Johnny had heard were moans, and they were emanating from a wheeled trash bin. That made sense, as my flashlight illuminated two legs protruding from the top thereof. Johnny peered inside, and beheld a gentleman curled up inside, much the worse for wear.

We figured that any conversation to be had, would be had with greater clarity should our new friend be extricated from the trash bin, and so we began to attempt to lift him by his legs.

BAD PLAN! At least, in his view. He screamed, convincing us that this was NOT the course of action we desired to pursue. I ran to the truck, and retrieved the cot, a backboard, and backboard straps. Johnny and I then slowly levered the bin onto it’s side, and tried to gently place Mr. Trash Bin onto the backboard so as to remove him from his nest with minimal discomfort (to him) as we could manage. In his opinion, we were not particularly successful.

Once he was out in the light, such as it was (MagLite light, it was!), we could discern from the angulation of his thighs that he had sustained two fractured femurs. Further evaluation revealed a couple of gunshot wounds, as well as several stabbing wounds.

We determined that further time on the scene, with our basic life support asses, would be unprofitable, and so secured our guest onto the board, strapped him onto the cot, loaded him up into the truck, and coded our happy way to TBTCIDC.

Once we had turned him over to the ED crew, and they were poking, prodding, needling, radiating,

IV-ing, and generally getting to know him far, far better than anyone else in his life ever had, we cleaned up and restocked the truck. Johnny turned to me, reflection written deeply in his eyes.

Ya know, Reltney, I wonder if someone, somehow, got a little angry at our guy there! Somebody does not seem to have had his very best interests in their heart!”

Fun And Games · Having A Good Partner Is Very Important! · Life in Da City!

Night shift lost the medic bag, a fact we discovered *AFTER* we caught a run!

So, TINS©, TIW©, all psyched up to FDASL©, chatting with the off-going crew, with my partner Doug. I had just about completed dropping my bookbag full of nursing school homework on the desk, when the phone rang with a run. Unaccustomedly, we were on day-shift, this being summer and my class load being light.

Of course, our very first run of the morning was Not a “sick person”, was not a “stomach pain”, no, indeed, it was an arrest.

It was Doug’s day to drive, so I settled into the passenger seat, buckled up, and we were away.

It was the custom, in those dark days of antiquity, to gather our immediate aid materials in a “mussette bag”, generally mil surp, olive drab, canvas. With a capacity of around six liters, we could carry several roller gauze bandages, a dozen or more sterile 4 x 4 dressings, several 5 x 9 ABDs (variously translated out of acronym into English as Army Battle Dressings, or ABDominal Pads), tongue blades, plastic oral airways (NOT endotracheal tubes: in those days, we were running an entirely basic life support operation), and, most relevant to Today’s Lesson in Life In Da City, a bag-valve-mask resuscitator.

Mostly, Da City bought the Laerdal brand of bag-mask, branded as Ambu, Therefore, of course, we referred to these as “the ‘Bu”.

You may wonder why I am assaulting y’all with these details of my far gone workaday life, amirite? Well, ya see, on this particular day, on this particular “cardiac arrest” run, as I settled my bony ass into the passenger seat, I did NOT have to step around the green bag. This caused me to look around, as we sped to the run, and NOT find the bag. I twisted around, and gazed into the module from my seat, and, again, did NOT! See our bag.

This was not encouraging.

Shortly, we arrived on scene, and, fortunately (for certain narrowly defined values of “fortunately”), our named patient was not only arrested, but, also, in rigor mortis.

Please recall that “narrowly defined values of ‘fortunately’” thing, cited above.

This soul was not going to benefit in any manner from CPR, ventilation or any other intervention in our (missing) bag of tricks. Therefore, we pronounced him on the scene, called dispatch for a scout car to take report, and went in service.

Returning to the firehouse, we examined the log entries from night shift, listed several likely locations of our errant bag (and I retrieved my personal bag from my vehicle, so, in the interval, we would not face performing mouth-to-mouth on some unlucky stranger). Then, we went visiting.

On our second or third stop, a pleasant lady answered the door. “I was wondering when you fellas were going to come back. Them nice fellas last night were in such a hurry that they left this on our living room floor!” And she handed us our bag.

I asked how her husband was doing, he being the subject of night crew’s visit last night. “Oh, he’s staying in the hospital. The doctors said his belly pain was from his appendix, and he’s gonna have an operation today, but they say he’ll be fine!”

Doug and I applauded this news, thanked her for holding our equipment for us, and bade her farewell.

And, boys and girls, THAT is why I forever afterward placed my own green bag in the ambulance, for the duration of my days on EMS!

Protect and Serve

A different view on policing, from the prevailing media narrative

Against my will, I have been aware of the news reports of many, many protests over the circumstances surrounding death of George Floyd.
Against my will, I have been subjected to the noxious virtue signaling malarkey from many quarters, braying about how anti racist they are (“acta, non verba!”).
Again, against my will, I have been subjected to the chant of racist, violent police being The! Single! Greatest! Threat! to black men, In! Da! World! (notwithstanding the 24 fatal shootings in Chicago just the weekend of May 30-31)
( see https://chicago.suntimes.com/2020/6/1/21275944/chicago-weekend-shootings-most-violent-weekend-2020-may-29-june-1)


I request that we all keep in mind that we are all fallen, all imperfect, all in need of improvement. Police are part of that set. And, like some of our neighbors, some officers do felonious things. Mr. Chauvin appears due to get his day in court, which, should things work out as they are supposed to, will bring to light evidence supporting, or refuting, the cloud of assertions surrounding these events.

Tl: DR summary: Lotsa heat, little light, Facts will come out, and theories and bullshit will be tamped down.

Now, that I have stepped off of my soapbox, let’s hear a story of “Protect And Serve Policing”, of the sort that I have seen repeatedly myself.

Observant readers will note that this is a re-run.

Patient Care Is Everywhere!  (small town life)

I had the opportunity, a couple of years ago, to speak with an police officer who personified the
 “Protect and Serve” mindset. An elderly, very confused gentleman, with a baseline mentation 
deficit, was brought in to the hospital at the instigation of the officer. Having been dispatched 
for a "welfare check", he found this soul confused, and in the officer's estimation, "looked sick."
 We evaluated the patient, and tried to (start to) fix his medical issues.  While waiting for the lab
 results, the officer and I chatted. The officer related to me that he was an officer, “not for the 
attorney with a 150,000 dollar car and a nice house: he doesn’t need me. That guy, over there: 
he depends on me to do the right thing. He is why I took that oath.” 

Once we had finished caring for the gentleman, and were ready to discharge him, another 
officer from this same (yeah, rural) department came and took him home, seeing him safely 
into his apartment.

Another occasion, same rural police department, same officer. This time he  accompanied an 
EMS transport. This soul was in custody, so the officer parked himself outside the room, to 
keep an eye on his charge. During their stay, in the room across the hallway, was a child, who 
was very dubious about the entire "going to the hospital" thing. This officer was approached by 
the fearful child, who momentarily had his fears overcome with curiosity about a live-and-in-
person police officer. This officer was very engaged with the child, producing wide eyes 
interest as the boy lectured the officer on the ins and outs of frogs, and minutiae of their lives in 
the wild. He (the officer) offered a few frog insights of his own, and the two of them had an 
animated conversation there in my ED hallway. 

The rest of my encounter with the boy was made considerably smoother, when the officer 
asked the boy, "Are you behaving for my friend Reltney?  Yeah, he may be a doctor (well, a PA
 at this point, but, ya know...), but he's pretty nice.  Give him a chance, wontcha?"

My point? There has been come conversation of “Officer as social worker” becoming part of the
 police toolbox. This theme is not new, although it used to be called "walking the beat, and 
knowing your beat". Some officers, who are each a credit to their profession, have been 
employing that tool for a long time. And, in some regards, to steal a phrase from the American 
Nurses' Association, "Patient Care is Everywhere!"  Some of the practitioners are not formally 
licensed in health professions. And, some of us simply see it as being a good neighbor.