Lawdog nails it.



Mr. Dog understands Duty, and Honorable actions. A week or two ago, I heard a police officer interviewed on the radio, talking about law enforcement response to active shooters.  It went something like this: You hear bad noises.  Go to where the noises are coming from, and make it all stop. Period.

After Sandy Hook, within my family we discussed What Should We DO? I looked at my wife, she looked at me, and we agreed:  armed hall monitors, like in Israel.  I was asked, “How are the schools supposed to afford that?”

We answered, “Well, for 4 days a week, when she and I are not at work, my grandchildrens’ school will not have to worry about that expense. ”

“Do you think you will kill an armed intruder, intent on shooting students?”

My answer, “I sure as hell hope so! In any event, said intruder will have something to worry about, other than which is the next helpless victim.  I am confident I’ll fuck up his attack plan.”

I was told, “You’ll simply get yourself killed.”

My reply:  “That is possible, may be likely.  Can I not measure up to the courage of the teacher who died, sheltering other people’s children, with her own body? If I fix him in place long enough for the responding officers to END HIM, will my death have been in vain?”

Could it be, that my wife and I are the only parents/grandparents/neighbors who would volunteer for such duty?

I cannot believe that.

Mrs. Clinton’s child was protected, in school, by men with guns.

Mr. and Mrs. Obama’s children were protected, in school, by men with guns.

They are not alone.  Politicians’ children are protected by men with guns. (d)s, as well as (r)s.

Are not your children, your grandchildren, as worthy of protection as theirs? As anyone’s?



Pains in my Fifth Point of Contact

Pain Scales Are Tools of The Devil!

“Pain level of 15/10”

For those who did not know, sometime in the eighties, The Powers That Be ([T]PTB), in their unlimited wisdom, determined that Pain Was Undertreated!, and, of course, Something Must Be Done! This, as is usual in these initiatives,  meant that the untermenschen must be thrown beneath the proverbial bus, and, not surprisingly, we were.

We Peons were instructed that “Pain is the fifth vital sign”, and that “Pain must be adequately treated!” And so, “Pain Scales” were inflicted upon us. (I leave as an exercise for the student, what the connection between the foregoing and the present PANDEMIC! ZOMG! Of DEATH! BY! OPOIDS! Happens to be.) (Of course, it is the EVIL! Drug companies, and EVIL! Physicians who are at fault. Therefore, let the Benevolent PTB ride to our collective rescue with The Answer, right?)

So, TINS©, there I was, in the emergency department at this time in my life, Nursing away, FDASL©. I was in triage one shift, and, of course, interviewing and vital signing and pain assessing the teeming millions seeking cures (and work notes) (and narcotic scripts).

Pain assessment involves asking the patient how severe his/her pain is, with zero being no pain at all, and 10 being “the worst pain in the world”. Folks are asked to scale their pain against this imaginary yardstick. Mostly, people try to be fairly straightforward, and generally rate their, say, sprained ankle, at the time of assessment as something like a “4/10”. or maybe a “7/10”. Then, there are those creative souls who try to game the system. This is my shocked face.

One night, one soul arrived, reporting back pain, or some other malarkey. Strolling into the triage room, said soul sat, and I cataloged allergies, medications, medical history, pulse, blood pressure, respiratory rate, temperature. I asked about pain, with my usual spiel.

Sir/Madam, if zero is no pain, and 10 is the worst pain in the entire world, what is your pain level at right now?”

This person, appearing for all the world to completely nondistressed, looked me steadily in the eye, and replied “15”.

I blinked. “So, if zero is no pain whatsoever, and 10 is the worst pain ever, your pain is 15 on that scale?”

My correspondent paused to take a handful of chips from the bag on his/her lap, chewed thoughtfully for a moment, and responded, “Yep.”

Again, I blinked. “And, 10, T-E-N, is the worst pain in the enitre world, right?”


And, your pain is 15, F-I-F-T-E-E-N, correct?”

Again, with the chips. “Yep.”

So, you’re telling me that your pain is one-and-a-half times as severe, as the worst pain ever, anywhere, in the whole world, right?”


So, that would make your (chip eating, non screaming, non writhing, non weeping, non wringing-wet-sweating) pain, the worst pain in the world, am I hearing you correctly?”

Rumination, in both senses of the word. “Yep.”

So, if ’10’ is the worst pain in the world, and you, right now, have the worst pain in the world, and your pain is ’15’ out of ’10’, then you’re telling me that your pain, right now, is half again as severe, as the pain that you are having right now, am I hearing you right?”

More cud chewing. “Yep”.

What could I say? “I’ll make certain that the doctor learns all of this. Please have a seat in the waiting room, we’ll call you as soon as we can.”



Life in Da City!

Medic Six: Medic in Trouble.

So, TINS©, TIWFDASL© in Da City. So, in the course of EMS in, really, any city, you occasionally encounter folks who fail to realize just how wonderful you and your partner truly are. Some of these folks, at a loss for words to articulate their world view, act out. Indeed, from time to time they seek to act out upon members of the uniformed city services, which is why cops have sidearms, firefighters travel in groups of 5 or more, and medics….well, we generally rely on good fortune. And the antipathy police officers most everywhere demonstrate, kinetically, upon those folks who lay hands on medics.

So, having taken note of the above cited occasional dilemma of the tactical variety, The Powers That Be in Da City administration, had established a radio code, to indicate that the crew employing it, was either in trouble, RIGHT NOW!, or anticipated things to get sporty, REALLY FREAKING SOON!. Since we were, by department rule, forbidden arms, we relied upon our friends at TBCPD to extract our bacon from the fire, when the occasion demanded it. In return, we paid very, very close attention to the calls of “officer (insert injury here)”. While nominally all our responses were “Code 1” (red lights and siren), there were varieties of “Code 1”. For instance, there was a “Code 1” response to the call, “man has cough, for two weeks”, and there was the “code 1” response to “Officer shot”. For only one of these, would the ambulance require brake replacement after the call, and other motorists wonder what was that orange streak that had passed them by at “Warp 8”.

Generally, EMS Dispatch was on the ball. They kept track of where you were, how long you had been there, and, if you had not cleared the scene after a suitable interval, they would radio you and check that you were alright. On (thankfully!) rare occasions, they were not. Whether this was to be laid at the feet of dispatch, or the elderly radio system we employed, is not clear.

So, this one time, several crews were hanging out at TBTCIDC, telling tall tales, conversing, and generally waiting for dispatch to decide that it was Our Time To Save Lives. Our handie talkies were on, because dispatch might NOT assume we were still hanging out at TBTCIDC. Our radios, at that time, were open, meaning that any traffic on the frequency was heard on our HT. Therefore, when Medic 6 called “Medic in Trouble”, well, the room went silent. We waited for Dispatch to respond, and heard nothing. One guy phoned dispatch, asking “Did you hear Medic Six call that they were in trouble?”

When answered negatively, he said, “Well, they just did so. What is the address of their scene?” Writing it down, he hung up. “Hey, partner! Wanna take a little drive?”

Sure. Where to?”

Medic Six’s scene.”

Abruptly, four ambulances called on the air from TBTCIDC. We sped over to Six’s scene, and (thankfully) beheld the crew strolling out of the house there. And, no police.

You guys alright?”, one of us asked. 

Yeah, but it go a little tense there, for a minute!”

Everybody drove away, and the rest of that shift passed, without making any more memories.

Thank Ghawd!


Still MORE Gun Fun in the ER!


So, after everybody heard of my rollicking good times with Mr. GottaGo and his knife, well, they were SOOO jealous. Or, not so much. In any event, subsequently, restrained folks had their clothing removed and placed in a bag, “for safekeeping”, and property inventoried so as to ensure that everything brought in, went home with them.

Soon thereafter, I was working, and our local fire department brought in this soul, who got restrained (for seemingly good reasons, although, at this distance, I could not tell you what that was). The other nurses appeared to have things under control, and so I was busy doing something else. Knowing that I am a “gun guy”, one nurse came to me, TINS©, with a revolver in one hand, and a magazine in the other.

Look what we fond in Mr. Man’s pants! Sure glad we got everything!”

I took the revolver from her, and dumped the cylinder into a specimen cup. I checked it again, and again, and, once almost convinced it was unloaded, I asked her, “It that everything you found?”

Yep! We got it all!”

Uh, no you didn’t. That (indicated magazine) does not go with this (indicated revolver).”

What do you mean? Isn’t that how he reloads it?”

Nope. Just for an experiment, why don’t you try to reload this with that?”

She took a couple of minutes poking, turning, and re arranging, but could not get the magazine to mate with the revolver. I retrieved both from her, and placed them into a property envelope, locking both in the narcotics drawer. “Let’s frisk our friend, one more time, just to be certain”.

We found nothing, but when security arrived to secure the firearm, they, too, frisked our guest again, wondering what he had done with the semi-auto the magazine went to.


More gun fun in the Emergency Department

I have to go to my car…because of my stainless steel model 59….

Another time, I was working the floor in our little hospital ER, and a gentleman arrived, and, since it was a Saturday afternoon in July, well, he had a lengthy opportunity to enjoy the hospitality offered by our waiting room. Like, hours and hours.

So, TINS©, when I finally brought this gentleman back, and read the triage note regarding his cough, I handed him one of our gowns, and asked him, “Would you please take off everything above your waist, and put on our gown so it opens in the back?”

I have to talk to my cousin.”

I was kinda busy. “Right now?”

Yes, right now.”

I was puzzled. “What could you possibly have left to say to him, after spending, what, three hours in our waiting room?”

He shrugged, and drew back the left side of his shirt. There, situated crossdraw in a belt holster, was a shiny Smith and Wesson Model 59 semi automatic pistol. Nice.

Is that what you needed to talk to your cousin about?”


Then, I asked what may be the stupidest question of my entire life. (except for the time I asked my wife how she became pregnant. She looked at me and replied, “Really? You were there!”) I asked him, “Sir, do you have a permit for that?”

He said, “Yes.”

Really? What was he going to say, “No, I’m a felon.”, or “No, but I’m gonna carry it around with me anyhow.”? And, what was I going to do with that information? Disarm him? Really?

What I did, was provide the direction I should have started with. “Uh, sir? We really don’t want pistols in our waiting room, just like we don’t really want them in our emergency department.”

He shrugged, again. “Can I go to my car?”

“Certainly! Please come right back!”

He nodded, and I walked with him to our exit door. The security officer at that post asked me what was happening. “See that car, that that gentleman is going to? Please keep a close eye on it, because he’s just now putting a stainless steel 9 mm model 59 away in that car.”

Knives · Pre Planning Your Scene

Why do ER staff frisk patients? This is why!

TINS©. Once I had left Da City’s EMS, I was an Emergency Department nurse in , surprisingly, Da City. Now, this was in the depths of the then current round of the nursing shortage, and so (a) they put me in charge (BIG mistake!), and (b) we had rent a nurses working with us. You might imagine, folks who have spent their careers working in the hospital may not be entirely as cynical as I am, and so might have a different level of urgency regarding, say, frisking a patient, than I do. Remember that thought.

So, one soul, a frequent flyer at our department, was brought in by the local fire department. This municipality was entirely within the border of Da City, but had stand alone police and fire services. These firefighters also provided EMS for the community. This particular wintry evening, they brought us an intoxicated fellow, who wanted to misbehave. Prior to my arrival, the evening staff had placed this gentleman in a vest type restraint, and settled him into a corner with a couple of blankets, and an admonition to take a nap.

So, once things had pretty much cleared out, I figured that a walk through, and placing eyes on my charges might be useful, and so I set out.

As I cleared the curtains surrounding our friend (mistake number one), I noted that he was fiddling with his vest. Closer inspection revealed that he had secured a knife (frisk fail, mistake number two!), and appeared to be attempting to cut his way free, presumably thereafter to make his escape. Acting prior to thinking this all the way thorough (mistake number three!), I grasped the hand with the knife, and extended his arm over the top of the bed, bending it, and securing it, and the knife within, with both hands.

That gave him the opportunity to consider the advantages he might enjoy, by popping me in my face with his off hand. Having considered, he tried to act, and so there we were, me holding onto the knife hand with both of mine, bobbing and weaving to avoid punches directed, drunkenly, my way by our guest, and calling for assistance.

One of the agency nurses walked over to see what the fuss was about. She stood there, motionless, for a long moment, until I suggested, “Ya know, if you could get some security in here, right stat like, that would be wonderful!”

I shit you not: she pivoted in place, and bellowed, “Security Stat To The ER!”

Sheesh! I amended my suggestion. “That was very nice. Now, if you were to open that door over there, and go out in the hallway, where our friends from security actually are, and tried it all over again, it might be just a little more helpful!”

She did earn bonus points for “Listening to and following directions”. Shortly, our friends from security piled into the room, relieved Mr. GottaGo of his knife, replaced his restraint, and frisked him, thoroughly this time. I frisked him, myself, because, well, reasons. I found no surprises. This time.

Life in Da City!

Dead man on the roof

We typically ran a three medic house, at Medic Seven, just so one of us could take a road trip in the event that somebody or other called in sick, was injured, or other wise was absent for one reason or another. I got the detail, and wound up working Medic One with (let’s call him) Roger Whitaker.

It was his house, and I therefore was the medic that day. It was mid summer in Da City, one of those days with blue skies, sunshine, and temps running high 70’s to low 80’s. Simply a great day to be alive, in your twenties, and working outdoors. We cruised along, between runs, windows open, talking about inconsequential things, and listening for our next run. And, it happened.

We were sent out on a “unconscious man”, at an address down the street from the engine company where we commonly gassed up. At one point, like 30 or more years ago, this had been a prosperous, upper middle class neighborhood. Just off Main Street, the buses (I suppose, at that time, it was trolleys, but the same effect obtains) ran to downtown and back, and north to, let us call it, Middleville, where another of the industrial empires had several of their factories. The managers and suchlike, living in this neighborhood at that time, could take public transport to and from their jobs, and the families, with domestic help, could keep the home fires burning.

Once Da City changed, and the prosperous moved to Da Burbs, well, all those 4, 5 and 6 bedroom homes became multiple apartment buildings. One of them was our destination.

We pulled up in front, called on the scene, and walked to the door. One of the residents met us there, and led us up the staircase, into one of the apartments, around a corner into the kitchen, out of the kitchen window, and onto the tarred roof of the grand porch the building boasted.

This had evolved into some sort of patio for the residents, and there were three men there, two of whom were drinking something from a brown paper bag in the sunny July afternoon, and the other lay, as if asleep, semi prone. Alumni of the old-school Red cross Advanced First Aid And Emergency Care course (yes, I AM THAT old!) might recognize this posture as “the coma position”, as it facilitated drainage of oral secretions from someone who could not manage them on their own. Like, someone in a coma, fer instance.

Roger approached the upright, actively drinking folks, in order to elicit some information regarding our presumably somnolent subject. I approached him, and, kneeling, channeled my inner “CPR Manikin”. I did not quite bellow, “Annie! Annie! Are you all right?”, but I did attempt to shake our friend, to rouse him for conversation.

It quickly became evident that no amount of shaking, nor shouting, nor any other sort of human intervention would cause this gentleman to join in our conversation, without a Ouija board. When I lifted his of arm, as a lever to roll him preparatory to sitting him up, well, he rolled as a unit, as if he was a man shaped board. Students of emergency care might recognize this as “rigor mortis”, and it occurs variably, on the order of 6-14 hours after death.

Our patient had been laying on that hot roof for a long time.

Roger asked one of the bystanders, “When was the last time any of you all talked to him?”

One looked at the other, squinted up into the sky, and answered, “I guess it was before noon when he sort of moaned, laid down, and sort of rolled over. He hasn’t moved since.” Since this was late afternoon, well, this was not going to be a successful resuscitation.

I looked at Roger, he looked at me, and we shook our heads. He retrieved the handie talkie, and called dispatch for TBCPD, and a medical examiner’s crew, and holstered the radio. The second fellow, agitated now, asked, “Is he….? Is he….? Is he….?”

Roger interrupted, “Man, he daid!”

This gentleman walked to the parapet of the porch, threw one leg over same, and made as if to leap. Roger peered over said parapet, admiring all the broken concrete piled against the foundation, and said, “Friend, if you don’t mind, kinda jump a ways out there, into the yard, why doncha? My knees are aching, and I just know I’ll wrench something if I have to pull your broken body off all those rocks!”

The guy stopped, frozen, and stared at Roger for a moment. He lifted his leg back over the parapet, re entered the building through the kitchen window, and was last seen walking down the middle of the street, gesticulating and cursing, heading westbound.