Cletus and the sick note

Perhaps you have heard of The Cornosvirus, aka The Wuhan novel Coronavirus, aka the WuFlu, aka The CCP Pox, aka The Shanghai Sniffles. Now known, PC-ly, as C.O.V.I.D. (sounds like a Bond villain, don’t it?). So, TINS©, TIWFDASL©, and Cletus, trivially ill, wandered in, requesting a test for the Coronavirus as well as a return to work note (he related that he had called off sick for a couple of days, and, and needed a doctor note in order to return to work). He related that he had run out of paid time off, and needed to return to work.

The next day, my registrar hunted me down, and presented me with the dilemma: his employer had called, asking what to do about Cletus. Cletus had evidently informed his employer that he, Cletus, had been tested for the WuFlu, and they (the employer) were asking what to do about Cletus returning to work?

“My note stated that he was medically released to return to work, once he had a negative coronavirus test result in hand.”

My registrar returned, “But his result won’t be reported for another 4-5 days.”

“Yep. And, once he has that negative result in hand, he can return to work.”

“I told them that. They are on hold, still asking me what to do about Cletus.”

“Lemme talk to them!”

I picked up, announced myself, and asked what I could do for them?

“We don’t know what to do about Cletus, since he does not have his test result, but your note says that he can return to work.”

“Ma’am, my recommendation is that you follow your organization policy regarding employees who have been tested for coronavirus, and pending results.”

“But, he doesn’t look sick, and we don’t know of any exposure to C.O.V.I.D.!”

“Uh-huh. So, what do you folks do about any other employee who has been tested for coronavirus, and does not have results yet?”

“They have to quarantine at home, until ten days or a negative test report.”

“Perhaps it would be a good idea to follow your organization’s policy in this regard.”

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Random Thoughts Part VI

Assessment of the elderly, sounding confused.

When I am assessing a patient, and ask, in my interview, ref location/day of month/day of week/name/etcetera, when you are not the patient, and YOU answer, talking over the patient, please realize that IDGAF about YOUR mentation, and when you coach the patient, it really, really interferes with my assessment. Plus, it is entirely likely that I myself KNOW the place/day/date/season/etcetera, because, you can bet your ass that if it were NOT Tuesday March the 41st, I would certainly be somewhere else, doing something else, other than attempting to struggle my way through your interruptions of my evaluation of your parent.

In a similar vein, when I ask Jim-Bob where he hurts, probably, when you coach Jim-Bob, admonishing him to “Tell the doctor where you hurt”, you are not really contributing any value whatsoever to the interview. If Jim-Bob indeed comprehends my question, you are only adding noise and distraction and likely, that is NOT helpful. If, on the other hand, Jim-Bob does not understand my query, your repeating it IN THE VERY SAME FREAKING WORDS, neither adds to the information that I require, so that I may care for Jim-Bob properly, nor facilitates timely implementation of that care. So, unless Jim-Bob does NOT speak Engrish, himself, please STFU, and allow me to interview the patient. Or, perhaps, go boil some water, gather a fresh newspaper and some clean shoelaces, right now, please.

Which will, of course, require you depart the exam room and allow me to complete my interview and examination.

Thank you.

Thoughts about Cost vs Price:

Lowe’s “bargain bin” AA battery powered cell phone charger: $10

Having several in your Bag-O’-Tricks at work, so you can hand one to a patient you’re sending to ED via ambulance, whose phone is dead: Kharma.

Having that guy get my cheap-o, bought-on-a-whim charger back to me, with a thank you: PRICELESS!

EMS LAW OF ALTITUDE: Patient’s weight divided by number of floors above street level equals a constant, “K”. Therefore, a 300 pound inert patient on the first floor is roughly equivalent to a 1200 pound patient on the 4th floor. With no functional elevator. And the first due engine company out on a working fire.

(redacted)’s Law: (I don’t have permission to use his name, but it’s not *MY* formulation) When responding to an EMS call, and you are pretty sure that you are on the correct block, but, for some reason, folks in this neighborhood do NOT have any house numbers, seek out the most tumbledown anonymous house on that block, and knock, Your patient awaits inside.

(redacted’s partner)’s Corollary Number One: The one house on the block with ghetto gates (bars on the doors and windows), is your call.

Corollary Number Two: Occupants of the house with the gates KNOW who is performing all the neighborhood B & Es.

Corollary Number Three: There is nothing inside the grilled house worth stealing. The decor is milk crates, cast offs, soiled mattresses on the floor. Even odds that the smell makes the place a haz mat scene.

Final Thought”

Please, please, please! If your physician has ALREADY prescribed a medication for your affliction, take the freaking med, BEFORE your come to my clinic stating that you require treatment for that selfsame affliction! Because, it could happen that my self control may lapse, and I may, indeed, ask you just how exactly I may help you, when you not only were prescribed, but physically picked up, the very medication that I would have prescribed (and, indeed, wound up prescribing) for your problem.

But, OF COURSE, you weren’t here to get a work note! Totally!

HOUSEKEEPING

For those who might be interested, I have cleaned up a post from last year, which I had found unreadable on my phone.

Hope that it is indeed an improvement.

The Fellow Who Would Not Go

Paying Attention Is Important

So, TINS (c), TIWFDASL (c), and working in Da Corridor. This was Da City’s, well, let us say, in paraphrase of the immortal words of Old Ben Kenobi, “Da Corridor: You will never find a more wretched hive of scum and villainy!” So, not the nice part of Da City.

I was working “The Corridor”, and an academy classmate, let us call him Gordon Lightfoot, was detailed in that day from another house. At this point of time, TBTCIDC was closed, as they were in the midst of moving kit and caboodle to the shiny, new, and in-the-medical-center hospital they had just opened. (Well, it had not been opened, just yet, and that little detail will figure prominently in this tale!) The hospital that was TBTCIDC’s “stand-in” was NOT generally the trauma center, but was in the medical center.

We caught call after call, transported sick (and a lot of not-so-sick) people, and generally saved lives. Our next run was on an asthma patient, and off we went. In fact, this particular address was only a block from the medical center.

We arrived, announced ourselves, and acquainted ourselves with this person’s malady. I brought the stair chair, and we wheeled this soul out to the ambulance, and settled them onto the cot. I had JUST entered the cab, preparatory to a leisurely trip to The Stand In Hospital, when Gordon stuck his head through the window connecting the cab with the patient compartment, and bellowed, “Reltney! He’s arrested!”

I hopped around to the back, and helped Gordon get set up for a spot of in transit CPR. Once he was set, I re entered the cab, and called dispatch: “Medic One, Code One, Stand In Hospital. Cardiac arrest, witnessed. Eta One Minute!”

Dispatch acknowledged. I tuned in the hospital alert frequency, and called: “Stand In Hospital, come in for Priority One traffic!”

They acknowledged, and I started my turn out into traffic, lights flashing, and siren wailing. “Witnessed cardiac arrest! CPR in progress! ETA one minute!”

The nurse on the radio was not clear on the message. “Say your ETA?”

“Open the doors! We’re here!”

Toddler Logic

When my daughter was just a toddler, she began to dress herself. Of course, it had hit and miss days. This day, she would be appropriate, that day she would be attempting to go out doors in 50 degree weather in shorts and a tank top.

So, one day, her mother was off at school, I had the day off, and Brenda came downstairs in long pants, over which she was wearing a dress. Overtop this she had a long sleeved blouse, which was peeking out from beneath a sweater.

I stopped her. “Honey, you need to dress in one outfit, not several. You look like a bag lady.”

At three, she had her own mind. “I’m NOT a bag lady!”

I agreed. “That’s true, but you are dressed like you were a bag lady. Go back to your room, take that stuff off, dress in one outfit, and put the rest of the clothes away.”

She crossed her arms, and laid down the law. “I am *NOT* a bag lady!”

I repeated myself. “honey, I realize that you are not a bag lady, but you are dressed in something like a bag lady uniform. Now, go back upstairs, select one outfit, wear that outfit, put the rest of those clothes away neatly, and come back downstairs. You cannot go out dressed like you were a bag lady!”

She set her feet, crossed her arms, cocked her head, and set me straight.

“I’m *NOT* a bag lady, you fat old man!”

PROFESSIONALISM, PART II

So, Carmen, my grand daughter, had a couple of additional Magical Mystery Tours of Peds ICU. Brenda, her mom, wound their way through the maze of physicians, and specialists, treating, and attempting to diagnose, what was underlying our recurrent Monday-evening-Grandpa-visits.

Eventually, one of the specialists determined that a surgery would mitigate Carmen’s breathing difficulties, and so a surgical date was set, in a distant Big City Medical Center. Brenda told both of her parents, and her conversation with me went along the lines of “Dad, so Carmen is going to have surgery on (date), at Big City Pediatric Hospital.”

(Dad): “uh huh. I’ll be there.”

(Brenda): “Uh, Dad? So, Mom is gonna be there, too.”

(Dad): “Uh huh. Why would there be any question about that?”

(Brenda):”Well, I know you guys are going through that divorce, and things might be…tense..if you were both in the same room.”:

(Dad):”Well, Honey, your mom is a grown up professional, I flatter myself that I am a grown up professional, and while we are there with you, for that time, what I think about your mother, or what she thinks about me, well, nobody cares. This is about you and Carmen, and nothing else is on my plate for that time. I don’t anticipate any drama coming from either of us. I know I won’t cause any drama, and I am confident that your mother will not, either.”

So, we met at the appointed time, and greeted each other. Carmen received her IV, and was pre medicated, and rested on her mother’s lap, soon falling asleep. I have a photograph, somewhere, of Carmen, relaxedly asleep, on Brenda’s lap, Brenda appearing fatigued herself.

Carmen went for her surgery, and returned, post operatively. Carmen had an uneventful post operative course, and Brenda took her child home. Today, a dozen years later, Carmen is newly adolescent, The Big Sister, and perfectly healthy.

Oh, and my pre and post op interactions with The Plaintiff? Benevolent, professional, and child (and grandchild) focused. No drama.