Motorcycle PI on the way to the State Park

One sunny summer day,  The Darling Wife and I were on the way to a state park one of our friends had spoken fondly of. We were motoring along on one of the divided highways, and noticed that traffic had stopped.

Indeed, it had JUST stopped. We halted next to a fellow pulling a large house trailer with his station wagon (yep, true story!). He had managed to stop, likely a near-panic-stop, without leaving his lane, and well short of the supine figure on the pavement maybe 20 meters in front of him. The spilled motorcycle nearby suggested how he came to be there. Suddenly, I was VERRRY impressed with Mr. Station Wagon’s motoring skills.

Once we had stopped, and I had parked the vehicle, I noticed other motorists creeping past us, on the shoulder or between the lanes of parked cars. TDW and I were puzzle by this, thinking that, occasionally, events happened that were more important than somebody getting to their destination without delay, and some poor schmuck supine in the roadway might qualify.

I exited the vehicle, and retrieved my medic bag. I suggested to TDW that she pay attention to traffic, and phone it in to the local sheriff/fire department/EMS/Etcetera, while I sorted out the scene. She interrupted her tirade about “stupid mother flatterers”, or something that sounded kinda like that, to acknowledge my comment, and took up the CB microphone when a trucker asked what was happening.

Once I had walked up on the scene, one individual was kneeling at the supine person’s head, immobilizing him, and announced, “I’m an off duty firefighter!”

I replied, “I’m a physician assistant, an ED nurse, and former paramedic.”, and began to size up the situation.

Another person presented herself, and announced she was an ER nurse. I suggested that vitals would be really nice, and handed her my stethoscope and BP cuff.

Yet another person arrived, asking, “Can I help?” I suggested a pen and paper would be good, to write down the vitals for the responding medics, and this soul took off, returning with a notebook and pen.

Yet ANOTHER person arrived, announced that he was a National Guard medic, and everybody introduced themselves. Again. He was detailed to arrange for scene security, so that no impatient retard could creep/blow through the scene and sweep us all up like last week’s dust. He grabbed a couple of other bystanders, and made it so.

I started a secondary survey, looking for unseen bleeding or fractures. I found none, and about that time the first firefighter/Medical First Responder arrived. The nurse and note taker provided him with vitals, and I provided my summary of the survey.

I gathered my stet and cuff, and retreated to the car, where TDW awaited. She had news for me, relating to the 18 wheeler behind us, that I now noted to be jack-knifed across all lanes of traffic. It seems that he was the trucker asking about what was happening. She told him about the “special” souls intruding into the accident scene with their cars. She quoted him as observing, “So, ya know, I can fix that!”. The next thing she beheld was this truck turning from the extreme right lane of traffic, until his cab was nosed against the median rail, and his trailer was into the right hand shoulder.

Sure slowed down the jackwagons. Nicely done!

Once the medics had packed up Mr. Dumpedhisbike, and moved along, and the fire department had moved the motorcycle, we were free to resume our journey. TDW observed, once we were mobile, “Ya know, I see again why you pack all that stuff into your trunk! Sure comes in handy, from time to time!”

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History Lessons

Long ago, and far away, I was FDASL © in Da City. On EMS, when I was partnered with Doug, things were generally smooth, as he was a great partner, had his head in the game, and we worked well together. In addition, he was a genuinely nice guy.

We took turns medic-ing, and driving. One night, Doug was driving, and I was doing patient care. Well, TINS ©, Doug and I were out on a scene, with a gentleman who was some variety of sick. For some reason, now lost in antiquity, this soul felt compelled to deliver an oration on the subject of The History Of Oppression Of People Of Color (such as himself), By The Blue Eyed Devil (that would be me).

He had pretty much completed the review of Prehistory, The Roman Empire and Oppression, and was beginning the preliminary discussion of Black Folks Being Oppressed In The Middle Ages, when he stopped for a breath. Turning to my partner, himself of The African Persuasion, our patient invited him to participate in my education. “Ain’t that right, Bro?”

Doug looked at this person, as if he had just discovered a new species of insect, and responded. “Sir, ya know, if I were you, I’d speak a little more nicely to my partner, here. Me, I think you’re an asshole, and just as soon as my partner has had enough of your shit, well, we’re out of here.”

My tutor turned to me, goggle eyed. I smiled, and (just as if I really meant it) I said, “Uh, sir? Weren’t you just about to tell us what sort of sick you were, and whether you wanted us to take you to the hospital?”

Lawdog nails it.

https://thelawdogfiles.blogspot.com/2018/03/meditations-on-death.html

READ THIS.

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?

 

 

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?”

“Yep.”

“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?”

“Yep.”

“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.”

 

 

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?”

“Yes.”

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.”