Duty in Everyday Life: A Thanksgiving Contemplation

 

Happy Thanksgiving. We live in a time of unparalleled prosperity, of unequaled safety, of plenty and a degree of freedom from honest WANT, such that the kings of centuries past could not enjoy the leisure, the security, that we, every one of us, today enjoy.

This is a gift from many sources, not the least, The Almighty. Secondarily, from our ancestors. I hope and pray that each of us continues to receive these blessings, and that we are grateful, and give thanks, for these boons that are our everyday lot.

This is a repost. From time to time I am allowed to reflect upon all the ways in which I have been blessed. This tale is among my deliberations.

I have spent a lot of time talking, directly or indirectly, about duty. I am by no means any sort of authority on the subject. I have, however, spent some time contemplating what it means to recognize DUTY, to attempt to measure up to one’s duty, to accomplish Duty, and consider what my Duty might be in this or that circumstance.

Let me tell you about a man, who went above and beyond. This is not tale of derring do, of valiant action in combat, or hazardous duty, rather it is the story of a MAN who stood up in circumstances where I could not, and went way, way out of his way to do a good deed for a stranger.

A couple of years ago, in The Maternal State, they had a sizable blizzard. Now, being in or near the northern tier of states, this should be no big deal: winter, Up North, snow, so whucking fhat, amirite?

Yeah, that is generally my go-to response. Well, lemme tell you, this was somewhat more snow, and more wind, and more nastiness than is the baseline for this part of The Maternal State. Power lines iced up, and, swaying in the wind, well, they snapped, in multiple locations. Oops, power outage.

So, my mother is in her 90’s. At this time, pretty independent, but, still, 90 plus, and on the order of 800 miles from her nearest family.

My brother had anticipated the weather, and done some internet reconnaissance. He had identified a hotel in the next town, and, calling the reservation number (remember THAT thought!), had been told that the hotel in question did have an auxiliary generator, and would be in service. He therefore had made a reservation for our mother, securing, he thought, a heated safe place for her.

He filled me in on his plan, but had no idea of how to get her from her, now unheated, house to the hotel. As you might have considered, there was NO FREAKING WAY we wanted Mom driving in this mess. I called the taxicab companies local to my mother, only to find that none of them were answering their dispatch telephones. Shit.

I phoned the local police department, and spoke with the sergeant on duty. He pointed out that while he, and the officers on duty, were certainly willing to make sure my mother made it to the hotel, well, they were kind of busy (read, “extremely”) doing, ya know, POLICE stuff occasioned by the storm, the basic level of idiocy amongst the population in general and The Maternal State in particular, and the way poor weather exacerbates the foregoing. He did not see this happening in any clinically significant time frame. Shit. Again.

I let my finger do the walking among the internet search results for “transportation services” in The Maternal State, and the Maternal County. I recalled my brother, The World Traveler (not the hotel finder) had spoken of hiring a car service to travel from The Maternal Manse to the airport, or vice versa. I called several car services, and, finally, reached one who answered his phone.

We had a lovely conversation about the weather, and how and why it seemed unlikely that I would find a taxi company who would answer their phone. He, himself, answered his own phone, only because he took this opportunity to come into the office to complete some sort of paperwork.

I told him my tale of woe, featuring my elderly mother, distant children, and so forth. He asked me for her address, and where the arrangements had been made for her accommodation. He told me that he’d swing by, check up on my mother, and give me a call with his appraisal of things. I thanked him, effusively, and awaited his call.

Something around an hour later, I received a phone call. Mom was fine. My new friend, calling me on his personal cell phone, provided me the opportunity to speak with my mother. She asked me who this guy was, and I recounted the story of my brother’s hotel efforts, and how this fellow answered his phone, which, by itself, set him apart from everybody else in her corner of the state. I told her that he could/would transport her to the hotel for heated accommodations. She thought that was a great idea, and handed to phone back to the Car Guy. Shortly, I received a call from him reporting that he had Mom, and her little dog, were on the way to The Hotel. Again, with effusive thanks, I awaited the next situation report.

I received it, and it was infuriating. It appears that the national reservation folks for The Cretin Hotel Chain (by the way, I apologize to cretins, everywhere, for maligning their good name!), (a) did not know a goddamned thing about the power status, or lack thereof, in the subject property, (b) could not possibly care less about said power status, unless somehow The Creator elected to Personally and directly intervene, in a biblical display of His power, to motivate these gormless fuckwads to pretend that they might appear to give a shit (not that they might actually do anything effective to support that pretense. Even The Creator Of All has some limitations upon His power!), (c) would happily spin any line of bullshit that might result in their establishing a reservation, and (d) if kharma actually was a thing, would spend eternity sleeping outdoors, on some forsaken ice floe, adrift on a freezing gale swept ocean of sewage, with a solitary hospital “blanket” to protect themselves from a shivering, frozen, blue demise. If Crom was merciful. Which I hoped He would not be.

You might not be surprised, at this point, to learn that the hotel had no power and no heat.

I just might, one day, tell y’all how I REALLY feel. Assholes. (and I mean no slight to assholes).

My new friend, and Mom’s chauffeur, reported his plan to personally reconnoiter other hotels in the vicinity and report back to me. He did so, and he called me: no joy. None had power, so none had heat. Shit. Again. Again.

So, my new friend drove Mom home, and, arriving and ushering her inside, put her on his phone. Mom felt OK, the house was only around 50 something which, while chilly, was only unpleasant, not life threatening. She had canned food, a Sterno stove, the food in the fridge seemed in no danger of thawing (unsurprisingly, right?), and she had several blankets for cozy sleeping.

I thanked my new friend, again, and again, and bade everybody goodbye.

I spoke to Mom later that night, when one of her neighbors, charged cell phone in hand, stopped by with a hot meal (they had a camp-stove, it seems). Mom was doing OK, the neighbor (PBUH!) came on to reassure me that his appraisal was that Mom was managing OK, and he, the neighbor, would check in on her in the morning.

The next morning, the Car Service Guy called me. He had stopped by Mom’s house, and reported that he found her reading, swathed in a blanket, drinking a cup of (Sterno stove) coffee, eating a cold bagel. He put her on the phone, and she concurred in his report. He came back on, reported that the news was predicting power would be restored in a day or two. We chatted a bit, I thanked him, again. Again. Again. And he slogged back home, driving through the ass deep snow.

I received a call the next morning. Mom was chirpily informing me that the power was on, she had had a lovely, lengthy, hot shower, was cooking a casserole to have, hot, for dinner, and presently was enjoying a hot cup of coffee, and hot muffin. Her second of the day.

So, all is well that ends well, right?

Let me tell you MY take away. God has blessed us with angels. Some we cannot see as they are spirits. Others walk among us.

One exemplar is this guy, warm and dry in his office, piddling around, grateful that he did not have to be out in the butt ugly weather afflicting his hometown. He received a phone call from Sumdood, who he had never met, from Ghawd Only knows where, spinning this tale of his mama who allegedly lived nearby, had no power, and needed somebody, NOT the caller, to chauffeur her tail to refuge. Oh, and her little dog, too!

So, did he tell me to FOAD? Did he tell me it would be a profound pain in his ass? Did he tell me it was not his job? No, no, and no. He gathered the information that would be required to conduct an in person reconnaissance of her circumstances, and promised to report back to me. He did so.

He helped Mom gather her belongings for her voyage, and drove her, her luggage, and her dog, to the local property of The Cretin Hotel Chain. Finding that my brother had been bullshitted by the dickless, hapless, shitheads at the Cretin Hotel Chain’s national reservation operation, he called me with this insight, and attempted to find alternate accommodations for my mother. Failing in this quest, he drove her home (through the awful roads associated with an awful storm in winter in the northern tier of states, mind you!), schlepped her stuff inside, attempted to assure her safety, and comfort, and called me. Again. On his personal cell phone.

Then, the next day, with the same (or worse) shitty roads, he got out of his nice warm bed, and drove to my mother’s house, again, to check on her safety. And called me with a progress report. She was chilly, but fine.

Thus far, only mentioned in passing, are the Blessed Souls that are her neighbors. She’s not their mother. They did not grow up in her neighborhood. Simply, they are NEIGHBORS, in the finest traditions of small town America. God Bless Them. They visited, in turns, several times each day the power was out, bringing hot food, visiting, offering to charge her phone (and, just so you know, it works way, way better with a charge on the battery!), and generally being guardian angels for her.

She could not have lived there alone, for as long as she in fact did, without their oversight and backup.

TL/DR summary? Somebody is setting me a good example. I resolve to try to imitate it.

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Suburban Community Hospital (or) Be Careful What You Ask For!

Another time, with dispatch whimsically sending us on a scavenger hunt all over Da East Side of Da City, we had occasion to transport sumdood to Suburban Community Hospital. This was a fairly sizable establishment, even by the standards of the day, and the ED was pretty busy upon our arrival.

We handed Mr. Dood over to the nurses, gave report, and began to prep the cot for the next lucky contestant. One of the nurses ambled over, and engaged us in conversation.

“How come you guys only bring us drunks? We can handle anything TBTCIDC can handle!”

Doug spoke up. “Uh, Ma’am? That’s kind of the majority of what we bring to TBTCIDC, ya know? Most of our runs are sick folks and drunk folks.”

She wasn’t gonna let this go. “Aw, c’mon! How come we never get any good trauma! I know you guys take all the trauma to TBTCIDC! Howzabout occasionally bringing us some of the stuff you always are taking to TBTCIDC?”

We mumbled something that maybe could have been taken as assent, and she meandered off to fight disease and save lives, or something.

As Kharma sometimes deigns, our next run was not too far from Suburban Community Hospital. Indeed, the Grin of Kharma must have been epically large, as the next call was for a very drunk, very loud, very combative inebriate.

Once we had him restrained and in the truck, we conferred. Consensus was, we were about to return to Suburban Community Hospital. After all, they had ASSURED us that they could handle ANYTHING that TBTCIDC could handle.

Well, to paraphrase Bill Engvall, “Heeerrreee’s yer patient!”

When the nurses began to chastise us about our patient selection, as well as our destination selection, our refrain was, “Well, you told us that you were perfectly capable of handling anything TBTCIDC could handle! This fine young man, right here, is completely typical of their patient population!”

And, then we scurried away……

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 remember giving 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!