Crash of a Small Plane

So, TINS©, TIWFDASL©, working a mid city house, “Power Shift” (1400 to 0200) with Doug and Ed. It was one of those shifts wherein dispatch seemed to feel compelled to send us on a magical tour of Da City. We transported folks to hospitals that I had never expected to see in person. East side, west side, all around the town, as the song goes.

So, we were SNR’d on our latest run (SNR= Service Not Required. In this case, because the nominal sick person wanted no part of going to the hospital, and was only too happy to sign the waiver and bid us goodbye.) Since we had been out to the east side of nowhere that shift, well, I figured the Patron Saint(s) of EMS wanted us to head east.

There we were, motoring northwest along Alternate Main Drag Road, when Ed, looking out my window, saw a column of smoke. I wheeled north on Major Northbound Roadway, and, paralleling the airport, radioed in to dispatch, inquiring if there had been a report of a working fire in our vicinity.

Nope, they hadn’t heard a word.

Being inquisitive sorts, we continued northbound, until, coming to the roadway that formed the northern perimeter of the airport, we turned west, since the column of smoke was indeed to our west.

We found it, two blocks over, and turned onto the street in question. I pulled up in front of the house next door to the involved structure, thinking that our friends the firefighters might feel the need to place their engines adjacent to the burning structure. I noticed a light airplane sticking out of the roof of the burning structure, and supposed that the two were related.

I had no idea of what street we were on, so I called to the civilians milling about, asking for the name. They provided it to me. Then, I paused. I could see the house number of the house I had parked in front of, but had no idea of the house number of the involved structure.

Yeah, you’re right. After 2-3 seconds of reflection, it struck me that, if I could identify the burning house from my location, the highly trained, very experienced, thoroughly professional firefighters likely could replicate my feat of high level cerebral functioning.

I radioed in to dispatch, “Medic (number) on scene of a fully involved house, aircraft crash, casualties noted in the yard. Please send fire and additional ambulances.”

Then I unassed the rig. Ed had already pulled one fellow, laying in the driveway between the involved structure and the neighboring one, around the uninvolved structure and out of the radiant heat pouring from the fire. Doug was just getting to the other patient on the ground, and we pulled him, also, into the lee of the neighboring house and into their fenced in yard.

Once relatively safe, we conferred: Ed wanted a couple of backboards so we could rapidly splint these guys and get the hell out of dodge. I hopped the fence, grabbed the requisite materiel, and tossed it over the fence.

Doug and Ed rapidly backboarded the one guy, set the head of the board on the fence, and then one of them hopped the fence, he and I finished the lift, and trotted him to the rig.

We returned, helped Doug complete boarding the second guy, and back to the truck we went.

Once both were strapped into the ambulance, we were off. Coincidentally, the first engines were about set up and beginning to flow water as we departed.

I do not remember the run to TBTCIDC. I DO remembergiving report, and the smoke smell we tried to clean out of the ambulance.

Funny thing. A couple of months later, I was visiting my brother in Alexandria, VA. Since he was working, I played tourist during the day. Now, this was 1983, around a year after the plane crashed into the 14^th street bridge. The very bridge I had to cross into DC. As The Fates would have it, an aircraft– a big passenger jet– was landing as I was crossing the bridge. I don’t want to say it was close, but….I could count the rivets on the bottom, as it passed over my head.

Yeah, I didn’t break out in a cold sweat, or anything. Except, I did.

Hazards of Immobility

So, TINS©, TIWFDASL©, working full time and going to Nursing school full time when not in the firehouse. Oh, and sleeping. When I could.

As you may have surmised from the foregoing, I was acutely-on-chronically sleep deprived pretty much entirely through school. I have previously revealed what the director of the program thought of my first pass resolution of that problem, wherein I skipped lectures and slept in, however briefly. (Review: NOT MUCH!)

Therefore, I showed my happy academic ass up for every lecture, and attempted to take notes and generally avid snoring and/or drooling. In order to assist with my camouflage, I typically sat around 2/3 of the way back in the lecture hall, and about 40 degrees off axis from the lecturer’s line of sight. One particular failure of my strategy still stands out in my mind.

The subject was “Hazards of Immobility”. Unfortunately, one of the hazards of immobility, that the instructor did not enumerate and then explain in PAINFULLY elaborate detail, is somnolence. For those sleep deprived, as I was very much so in those days, sitting still was nearly a death sentence. I was wedged into my seat, and getting more comfortable, and more comfortable, and finally felt my pen slip from my fingers. I woke up at that, and retrieved my pen, again settling myself into my wedged-upright position.

I shook myself kinda sorta more awake, and resumed taking notes. Sleep crept up on me, again, until I heard our instructor asking, “Perhaps Mr. McFee can tell us about calcium and immobility. Mr. McFee? Won’t you join us?”

Without opening my eyes, without moving, I responded, “Well, patients who are immobile long enough, began to mobilize calcium from their bones, and excrete it via their kidneys. This places them at risk of both renal lithiasis, as well as pathological fractures.”

I heard the pause. She sounded surprised. “Mr. McFee, I was convinced that you were completely asleep!”

Still eyes closed, still unmoving, I cleared things up for her. “Ma’am, I understand how you might think so. In contrast, I find myself in an advanced state of relaxed alertness. Ma’am.”

I managed to stay awake enough to take notes for the balance of that hour.


Transfer To Florida

A long, long time ago, in a county very far away, I was a nursing supervisor. I had migrated into supervision after several years as an ER nurse.

One afternoon I arrived at work, and the offgoing supervisor reported that a gentleman had been brought in and admitted for his heart attack. Now, in these far away days, there were no angioplasties, no stents. There was no TPA, no other thrombolytics (“clot busters”). Indeed, the state of the art, outside of referral hospitals, was oxygen, hydration, rest, aspirin, and pain control. We had THAT, in abundance!

So, a couple of days later, one of the CCU nurses took me aside, and informed me that this guy was, to employ her own professional and finely tuned appraisal, “acting kinda squirrely”.

It developed that the attending physician determined that this soul was both having/recovering from a MI (heart attack), but, in addition, was a florid alcoholic, and was entering into DTs. Like, classic, textbook, tachycardic, hallucinating, writhing, pre-seizure tremulous, DTs.

Simply to make everything just nice, the internal med doc that the cardiologist consulted did not believe in using benzodiazepines for alcohol withdrawal. (that would be medications like Valium or Librium, useful both for the sedating effects, as well as their efficacy in protecting the patient from convulsions that might be lethal.) No, he insisted in using antipsychotics, which weren’t altogether effective in addressing his twitching nor his restlessness. Shit.

Well, he survived all this excitement, and, eventually (like, 4-6 weeks worth of eventually) was ready to go home.

Our discharge planner discovered that our new friend was a resident of Florida which we, in The Unamed Flyover State, were not anywhere near. He had wrecked his vehicle in the initial confusion, and therefore had no vehicle to get him home. In any event, what with his MI, and his lengthy stay in Thorazine Land, was in no sort of shape to (a) drive home to Florida, nor (b) master the intellectual challenges inherent in navigating the interstate home, even if he was strong enough to physically do so, Which he was not.

Her investigations revealed that none of his family was in any sort of position to happily drive up here and retrieve him (which of course begs the question of what was he doing here, with his pleasantly confused self, something like 1200 miles from home? And alone?)

So, once the dust settled, he was still our problem, and The Suits determined that springing for a flight home would end the financial drain that he represented, since no insurance company in the Western World would pay for him to reside at the Grand Hotel De Our Little Hospital, once his medical need had resolved. I did mention that he was squirrely, right? Well, our discharge planner hypothesized that his heart attack, and DTs, had trampled his previously marginally sufficient coping mechanisms, and he was, now, fully senile. Therefore, putting him up, unsupervised, in a hotel, would not work out at all well.

So the plan was laid. Our discharge planner purchased a plane ticket. He had specifically purchased a ticket on a nonstop flight, determining that there would be fewer opportunities for him to wander off, and get lost Ghawd Alone knew where. Then, she dumped it in my lap. I called A Competing Ambulance Service, and spoke to a supervisor.

“I have this guy, and we are going to fly him home. He is not altogether there, and so he needs both supervision, and a chain of custody. The flight is at 5 pm, so I want him at the gate at 4 pm sharp. I want your crew to physically deliver him to the boarding gate, physically observe him belted into his seat, and obtain a signature as a receipt from the flight attendant who seats him. Can you do all that?”

“Sure. You just have to set it up with the airline. OK?”

“Outstanding! I’ll set it up, and call you back.”

So, I called the airline. I spoke with a supervisor, and laid out my problem, and my view of the solution. “Sure, no problem. We can do that. Anything else?”

“Yep. Can you get a receipt for my guy, from the folks who pick him up, and then call me with the fact of safe arrival, please? Then, mailing us the receipt would be wonderful!”

“Sure, can do. Gimme your name and mailing address!”

I called the Competing Ambulance Service back, and brought the supervisor up to speed. “Oh”, I added, “One more thing. We’ll hand the plane ticket to your medic, and also hand him or her the chart. That HAS to go with him, and is part of the chain of custody business. OK?”

“OK!”, was the response.

So, on the appointed day, I was at the nurses station awaiting The Competing Ambulance Service crew. Once they arrived, I reviewed all the foregoing. Both medics nodded, and one opined, “Yeah, that’s all according the the briefing we got from the supervisor. Where’s the chart, and the ticket?”

The charge nurse handed both items over. The medic made a show of placing the ticked into the inside pocket of his jacket, turning so both his partner as well as the nurse and I could see it settled deeply into it. His partner tucked the chart beneath the pillow, and they were off!

Around 1630, I got paged to pick up a phone call. “Mcfee!” was my greeting.

“Mr. Mcfee, this is Bob from The Competing Ambulance Service. My crew just radioed me to let me know that your patient is on the flight, seatbelt secured, and they have a signature form one of the flight attendants. So far, so good. That attendant has you phone number, and will phone you once he has been handed over to family at the other end.”

And, as promised, around 1930, the crew from The Competing Ambulance Service arrived, hunted me down, and handed me a copy of their trip sheet, prominently featuring the name, signature, and employee ID number of the flight attendant accepting Mr. Man for his flight.

To frost my cake of WIN!, the next day the night shift supervisor relayed via days, that our patient had successfully, and uneventfully, been handed off to his family at his destination.

Hallelujah!

HIV Transfer

So,TINS©, TIWFDASL©….well, OK. I was a nursing supervisor, and therefore, in the view of my peeps, I was, at best, not an impediment to their doing their jobs.

So, in any event, this was way, way back in The Dark Ages, Before Cell Phones (Gasp! No! There were PEOPLE, way back then?!?). This was around the time that some bright clinician noticed that there was a peculiar form of impairment of the immune system, that seemed particularly prevalent among homosexuals (currently described as MSM, for “men who have sex with men” in the clinical literature), and IVDAs (“Intra Venous Drug Abusers”). Nobody was really clear on how this was transmitted, although some sort of exposure to bodily fluids originating in one of the sufferers of this malady seemed a common feature of acquiring it.

My little hospital had a drug rehab unit, the purpose of which was to smooth the discomfort of discontinuing narcotics use, so as to help the recovering addict start to re arrange the other pieces of his/her life, into a non drug dependent direction.

So, it developed that our medical director of this unit had determined that one of his patients on the rehab unit did, indeed, have this acquired immune deficiency syndrome. (You may have already recognized the acronym “AIDS”). In these dark days, the capability of treating this disease was limited to specialty units in tertiary referral centers, and therefore we made arrangements to transfer our patient to The House of God, Local Edition.

I called the contract transfer ambulance service, and provided the needful information. All was set, I turned to my next problem. Or so I thought.

On the order of an hour later, I received a page from the drug unit. They desired my presence, pronto. I trotted on up.

Once buzzed into the unit, I beheld a pair of basic EMTs, one irritated patient, and one pissed off charge nurse. I drew the charge nurse aside, and asked WTF was happening.

“These idiots are acting like extras from “The Andromeda Strain”, and refusing to take our patient unless they and he are in full isolation garb, and they didn’t bring anything. They are insisting that we outfit them with masks, gowns, gloves, masks, and surgical hats. You’ve been to the same in-services as I have. That’s bullshit. Unless they are going to share needles in the back of the ambulance, there is nearly no risk whatsoever. Could you please talk some sense into these guys?”

I invited the ambulance crew to join me in the nurse’s lounge, and asked them what the issue was. One spoke up. “That guy has AIDS. I don’t wanna catch no AIDS. That’s why we need all that protection!”

Now, remember. This was a BASIC transfer. This guy was alert, lucid, cooperative, not bleeding not coughing up amphibious life forms, continent. All in all, not spreading any bodily fluids anywhere at all. It had, I’ll admit, been several years since I had been on the road, but my paramedic license was still current, and I was unaware of any evolutions in pre hospital care on a basic inter hospital transfer that might place these guys at any measurable risk. I told them as much.

“Yeah, well, I dunno how it was way back in your day, but nowadays, well, we gotta protect ourselves!”

Uh, yeah. “Back in my day”. So, my response was measured, and professional. “Gentlemen, please get comfortable. I’m going to chat with your supervisor, and we’ll get this all squared away, pronto!”

I lied. I talked to MY supervisor, the director of nursing, and told her my little tale. She was, to be charitable, irritated, and mused aloud about her to-do list for the morrow. Prominently featuring contracting with the Non Imbecile Ambulance Service, which, so it appeared, would NOT be the employer of the happy go lucky souls with whom I had shared our nice little chat. She suggested that I share that project with the on duty supervisor of the Incumbent Ambulance Service, with the suggestion that they may want to reflect upon how far into this project they really wanted her to get. “Yes, Ma’am!”

I called their dispatch, invited them to have their on duty supervisor call me, right stat like, and awaited the return call.

This worthy was not any sort of improvement over the dolts that he had caused to be sent to us. I smiled, reminded him that we’d be in touch, and went back to the unit.

By this time, both EMTs were garbed as if for joint replacement surgery, absent only the PAPR respirators. They had wrapped the cot with plastic, and then, standing several feet from the cot, invited my patient to “Sit!”.

Nice.

I apologized to the patient, and wished him the best of luck at the House of God, Local Edition. He shrugged, thanked me for my efforts, and gracefully in demeanor, settled in for his ride.

A couple of days later, one of the medics from A Competing Service stopped me in the hallway. “I heard you put a good word in for us, and we now have your transfer contract. Thanks!”

I corrected him. “I didn’t say one thing about you guys. Likely, my boss remembered your stellar performance with our out-of-state transfer a couple of months ago, and when the need for a new contract came up, remembered you and how smoothly you guys ran that.”

I didn’t tell him to thank The Incumbent Ambulance Service, and their crew of Laurel and Hardy.

“Little Mary Sunshine is NOT a Force Multiplier!”

Once upon a time, long ago and far away, I was nursing in an ER in a medium sized city. For some reason, I was unable to evade being placed in charge.

Lord Knows that I tried! While I have established that I can be reasonably effective in a supervisory role, I really do not like it. For one thing, it places me in overly close proximity to Suits. I do not enjoy proximity to suits. Hell, my Suit Aversion Disorder led me to work midnights, in the first place! (well, that and shift differential, as well as seven-on-and-seven-off scheduling, to be honest.)

For another, I get subjected to all the bullshit from other departments, which, invariably, appears to consist of interacting with slothlike souls who manifest only one burning desire: skate through their shifts, while expending as little effort as is needed to maintain their receipt of a paycheck. Notice, I did not attribute to these chuckleheads the desire to actually do something resembling their jobs. That wuld be different.

Finally, when in charge, I get to cope with all the malignant and ill considered decisions regarding staffing the aforementioned cursed suits have enacted.

So at this point I was working in a relatively urbanized area, with a sixteen bed ED, in a town with three total Eds of various sizes. We had been short staffed for an extended time. This, of course, made me oh, so very happy. Or, not. I had been bitching, complaining, protesting and generally making known that not only was this sort of staffing insufficient, but, into the bargain, was considerably short of their own goddamned published staffing parameters, written by the goddamned suits themselves, and for which I would be written up should I let someone go home leading to staffing short of these parameters.

Well, as it developed, one of the Junior Suits (our assistant director) was compelled to show her smiling face up to work some of the short midnight shifts. She was, let us say, “entertaining”, to work with. She would “help out” by triaging. Well, when you triage someone, it is helpful if you (1) obtain and record vitals, (2) ascertain, and document allergies, medications, medical history, as well as (3) history of present illness, typically elicited by asking something along the lines of, “So, Mr./Ms/Xr X, what motivated you to come out in the dark of night to join our happy little party?”. You did notice how much fun I seemed to think it was, to, ya know, DOCUMENT, the aforementioned items, right? Sort of like that was, oh, I dunno, a GOOD THING, or something?

So, it develops that Little Mary Sunshine did not document (or even obtain; it was difficult to sort that one out) vials, allergy/med/history, or present complaint information, at least, not consistently. In addition, it seems that an ED physician with, say, a dozen patients, really, really gets petulant if these items are not there in the chart to be found. Slows him/her down, considerably.

Then, there is the part about both bedding the patient, as well as noting such fact on the greaseboard, as well as reporting off to the the nurse who would, oh, I don’t know, maybe BE CARING FOR THAT PATIENT.

Finally, it was established practice to start the needful IVs, collect the blood, and send it to the lab, along with a requisition for the bloodwork the physician was going to be desiring to see. None of which had penetrated Little Mary Sunshine’s cranial vault.

She was no more helpful as a “floor” nurse, Which is to say, she would half ass do things, not tell anybody at what point she had grown disinterested and wandered of Ghawd alone knew where, let alone document anything that she, by some miracle of random happenstance, completed.

As my partner, Andy, opined, “Ya know, she is not really a very effective force multiplier!”

Much more nicely phrased than the tsunami of profanity that was boiling away, waiting for me to spew forth as my OWN opinion of her “efforts”!

So, visiting as she was from the warm climate of Daytime “Suitworld”, Little Mary Sunshine was chilly most of the time. (she might have been warmer, had she been moving about as briskly as the rest of us, but, then….) Andy, once again demonstrating the situational awareness that made him a fine nurse and great partner, noted this fact, and brought it to my attention one long, long night during a missing Mary moment.

He implemented a plan based upon this observation, and turned the department thermostat down to around 60, from the typically balmy 70 where it normally rested.

Well, time passed, Mary Sunshine wandered around, fucking things up, and soon the HVAC system equibrillated at the new set point. Mary zipped up her sweatshirt, and began to complain that it was cold.

Nice of her to notice.

Shortly thereafter, she loudly opined that “You guys seem to have things under control. I’m gonna go back into my office and do some paperwork. Call me if you need me!”

Once she was safely away down the hall towards her (independently heated) office, we returned the thermostat to the baseline setting.

The rest of the night passed as the typical clusterfuck of shortstaffed jackassery, fortunately not exacerbated by halfwit half assed managerial fumble fingering.

Child Rearing Tales

So, TINS, TIWFDASL….well, OK, really, this is another child rearing tale. Our oldest son, Adam, was approaching middle teen years, and, in The Unnamed Flyover State (TUFS), that meant anticipating driver’s education, preparatory to acquiring a driver’s license. At that time, the child in question had to be around 15 years of age, so, shortly after Adam’s fourteenth birthday, I sat him down for a little chat.

“So, Adam, you starting to get excited about taking driver’s ed?”

“Yep! I really can hardly wait!”

“Outstanding! Now, you do realize that, here in TUFS, you aren’t required to get my signature in order to take driver’s ed, or to get your license, right?”

He responded with a blank look. “Huh? All the kids in my class say that your parents have to sign for you to take driver’s ed, or to drive!”

“Well, they are mistaken. You do not require my signature in order to drive, or in order to take driver’s ed!”

He reflected upon this for a moment, and his face brightened. “Oh, yeah, right! I’ll just get Mom to sign!”

I sat back. “Say, I have an idea! How about you go talk to your mother, and ask her about that idea! Let’s say, for some reason, that I refuse to sign for driver’s ed, or for you to drive, ask her what her next move might be! Come on right back, and let me know what she says, OK?”

He scampered off. From another part of th house, I overheard low pitched murmurs, as of distant conversation. The murmurs ceased, and Adam made his reappearance.

“So, tell me about that ‘no signature’ thing, please, Dad.”

That told me how his conversation with his mother had gone. He had said something along the lines of “Mom, if Dad won’t sign for me to take driver’s ed or to drive, will you?” Her response had likely gone along the lines of “Have you lost your fucking mind? What makes you think your dad and I would not be on the same page regarding something like that?”

So, I answered him. “Well, Adam, in the Great and Sovereign State of TUFS, you do not require a parent’s signature in order to take driver’s ed, nor in order to drive!”

“Dad, that can’t be right! All the kids in my grade tell me that you need a signature!”

“Well, they are all wrong. Indeed, here in TUFS, you can get your driver’s license, you can take driver’s ed, without my signature, or you mother’s. Why, once you are eighteen, it is all very simple! You simply sign for yourself!”

He looked thoughtful for a moment. “But, Dad, why would I want to wait until I was eighteen to drive?”

Now, I looked thoughtful, for a second. “Adam, that is an excellent question! I am confident that your behavior between now and then will demonstrate the answer you came up with!”

So, fast forward several years. I had had this same conversation with Betty, Number Two child. She had taken, and passed driver’s ed, and acquired her license. She was driving whenever she could wheedle the loan of a car from her mother or me. She was also, as an adolescent girl, not entirely meeting behavioral standards.

Her mother TDW-Mark 1, and I, considered her transgressions, and intervened when needful. When behavior did not improve, we physically took her license, and secured it. After the “license grounding” had elapsed, she, again, could drive. More misbehavior, more license grounding.

Finally, she had demonstrated sufficient lack of grasp of acceptable behavioral standards, that we were done grounding her from driving. TDW-Mark 1 and I held a conference, featuring Betty. I reviewed past interventions.

“Betty, you did (whatever), and had been told not to. We took your license for a week, and told you that another violation would result in us taking your license for two weeks. You violated (whatever the rule in question was), again, and so we took your license for two weeks, and told you that the next time would be a month. Again, you violated (rule), and we took your license, and told you that the next time, we would simply yank your license and stop screwing around with this stuff. Well, last night you did, again, violate (rule), and so, now, your mother, and I, and you, are going to the motor vehicle office, and you are going to lose your license.”

She responded, “Well, I will just go there tomorrow, and get it back!”

I smiled at the sixteen year old. “I do not think that it works that way, Honey!”

She looked at me, and brought me up to speed (or, so she thought). “All the kids at school tell me that I can, and I just will!”

I produced her license from my pocket. “See this name here, at the bottom? Where it says Director of Department of Motor Vehicles? Read that name, please, Honey. The print is a little small for my old eyes!”

She read, “’Alyssa, M. Snodgrass’ Why do I care about that?”

“So, sweetie, which one of your classes is she in with you?”

“Huh? Nobody in any of my classes has a name like that!”

I looked at TDW Mark 1, and she looked at me. We then turned our gaze to our darling daughter. The TDW Mark 1 carried the ball. “Well, Betty, that is indeed a surprise! Since Ms. Snodgrass is the director of the department of motor vehicles, and is charged with writing, and enforcing, the rules for who gets, and who loses, a license to drive, perhaps she knows just a teensy, weensy, little bit more about how all that stuff works, than your illiterate, self absorbed, ignorant, prideful, and arrogant classmates. Doncha think?”

Betty gaped at her. Her mother smiled, serenely. “So, honey? Get your shoes, and let’s go. Now, Honey, now!”

With that, our little gaggle promenaded into the DMV office. Once our number had been called, we strolled up to the desk, and the civil servant asked, “What can I do for you?”

I smiled, my best won the jackpot smile, and proclaimed, “We are here to have this child,” and my sweeping wave indicated the glowering Betty beside me, “officially credentialed by the Great and Sovereign State of TUFS, as a pedestrian!”

The poor woman, only trying to get through her workday, looked at me blankly. After a second, she asked, “What?”

TDW Mark 1 clarified it for her. “We are here to yank this child’s license.”

“Oh, right. Please may I have the child’s license?”

I produce it. “And, your ID, please?”

We produced it.

Tap, tap, tap went the keyboard. Our new friend, the DMV Lady, then snipped off one of the corners of Betty’s license, and, looking up, asked, “Do you want this back?”

I looked at TDW Mark 1, and Betty. TDW Mark 1 looked back at me, and smiled at the DMV Lady. “Oh, yes, indeed, we want it back!” she exclaimed. “We’re gonna frame that bad boy, and hang it in the hallway, where all of us can admire it every day!”

Random Thoughts

Random Thoughts, Accumulated over a couple of weeks

(1) I know I have led a bad life (Ask The Plaintiff!). Therefore, I know that I’m going to Hell. If Dante Alighieri was correct, those of us going to Hell will experience our own personal, customized Hell.

Several times, it has occurred to me that, in my own personal Hell, I will be the clinician in Hell’s urgent care. There, I will spend endless shifts packed with trivially ill souls, who will take protractd periods of time to NOT answer my questions.

(2) I used to carry a can of CS teargas in my hip pocket, Back In The Day. Department regulations prohibited carriage of a firearm, so, what the heck, tear gas was First Runner Up in the self defense sweepstakes. So, one day I was in class, pursuing paramedic certification, and the top of the can, “safely” packed in my hip pocket, broke off. That left a puddle of corrosive tear gas in my seat. Curiously, there were no tears, which had, let us say, interesting implications for it’s efficacy as a self defense tool.

What there WERE, were sizable second degree burns on my asscheeks. That made for entertaining runs, as my ass slid to and fro while my partner drove our ambulance to emergency responses.

(3) This one time, I was working this one place (Hey! How about that RIVETING! Intro? Huh?) and they staffed the two provider clinic with two folks to work the floor, meaning they had to room patients, make appointments for followup, register and discharge patients, make referrals, answer the (incessantly ringing) phone, do procedures (breathing treatments, perform EKGs, take x rays, perform in house tests), and answer questions from random folks who walked in to ask questions about their bills or try to get their blood drawn (which happened at the lab, two doors down).

Kind of demanding, right? Well, somebody took a minute to call the office manager, suggesting that stuff either wouldn’t get done, or would get done incorrectly due to the pressure of multiple competing demands upon staff.

Her reply, as reported, was priceless. “Clinical medicine is like Zumba! You just have to keep up!”