Duty · Fun With Suits! · Pains in my Fifth Point of Contact · Pre Planning Your Scene

FPC: Phenomenal Phone Company

A long, long time ago, in a state capitol city not so very far from here, I was seated in the basement of The Enormous Hospital System Mothership, where She Who Would Become TDW-Mark II was undergoing surgery of some sort. I was seated next to, well, let’s simply call him my father in law.

At this point in the celebrations, the divorce from The Plaintiff had concluded, and she and I had a week-on-and-week-off child custody arrangement. My adolescent children had cell phones, and had both me and their mother on speed dial.

So, Number Three Son had occasion to call me, but I could not make out what he had to say, and my attempts to re connect with him were for naught.

I did not know if this was generic adolescent ‘gotta call dad’, or something emergent. That latter was very unlikely, but, after all, I have kinda spent my life in the “this is sort of an emergency” business, and therefore considering that possibility is an occupational hazard. Therefore, since I was NOT at home, and, should my children need me, their ability to communicate that to me in a timely manner was mission critical, well, The Phone Company, and their inability to connect a freaking call something like 12 blocks from the freaking state freaking capitol, well, to understate the thing, I found it unsatisfactory.

Father In Law offered the use of his phone, on Another Carrier. I entered the number of my son, hit “connect”, and, par miracle’!, just like that, I was speaking to my son!

We concluded our conversation, since it was a generic “ought to call dad” call, and I asked Father In Law if I could make one more call. He assented.

I then called “customer service” (spit!) of The Phone Company. I explained my problem, and how this was not acceptable. Phone Company Minion asked my location, and I described myself as being one floor down from street level, in waiting lounge of Enormous Hospital System Mothership. Minion then regaled me with a bit of RF theory, to wit: “You cannot reasonably expect a cell phone to have a reliable signal when you are underground!”

I asked Minion, do you have caller id?

Affirmative.

Could you tell me the originating telephone number for this call we are having, right now?

He read back Father In Law’s phone number.

Is that a Phone Company number? If not, what carrier services that number.

Why do you ask?, responded the Minion.

“Because, that is the carrier who is henceforth going to be receiving checks from me approximating $200/month, because my phone, my childrens’ phones, and the phone of every mo$%#r f@!%&er who will stand still long enough to hear this story, will be giving their business to this carrier, whose phone I presently hold in my hand, in this basement, as you and I converse!”

Having said that, I realized that there is no satisfying way to slam down a cell phone. I miss plain old wired phones.

Fun And Games · Fun And Games Off Duty · Life in Da City! · Pains in my Fifth Point of Contact

Gotta Scratch That Itch!

A week or two ago, my MA returned from her lunch, and showed me her parking lot find: a couple of dirty syringes, with bent needles. “I found them on the ground behind my tire”, she related.

My thoughts were, ‘what sort of fool, even among the universe of fools who inject drugs, leaves a freaking needle on the ground in a parking lot, where children come and go on their way to their own physician appointments?’

@

So, just the other day, TDW-Mark II needed to recharge her cash card. Off to her bank we went. The gentleman attending to her transaction appeared to be somewhere in his twenties, whereas I, myself, am approaching 70 (and so closely approaching 70, that 70 has started to tap his brakes, and slow down, in hopes that I would not admire his bumper so closely anymore!).

TDW was making conversation with this gentleman, and he was owning that this sort of transaction was unfamiliar to him. TDW then up and chirps, “It must be hard on poor elderly people, who don’t have computers, or know how to use them! That whole smart phone, and computer banking thing can be rough on the elderly!”

I looked at her for a moment, and spoke up. “Am I not standing right here? You CAN see me, right? Really? I. Am. Right. Here!”

Duty · Fun And Games · Fun With Suits! · Pains in my Fifth Point of Contact

Moar! Random Thoughts!

The other day, I saw some soul, who was vexed by an itchy rash. I interviewed said soul, examined, and prescribed a steroid cream to soothe the rash. My instructions, in the prescription, were “Apply thin layer to rash twice a day”

Later that day, my MA fielded a call from the pharmacy inquiring where the rash was? (as in, I suppose, where on the patient’s body). I therefore had to complete the thought that I was charting on a completely different patient, find the chart for the patient, open that chart, review my note from several hours ago, and answer the query.

Foolishly, I had assumed (…yeah, I know. AssU-ME.) that “the rash” was specific enough, but, it seems, no…

In a similar vein, I continue to receive prior authorization requests. This is maddening, because (a) I typically attempt to prescribe the exact same thing previously prescribed. For, say, asthmatics, that means I attempt to prescribe the-flavor-of-the-month of albuterol inhalers. In addition, (b) years and years ago our Fly Over State Legislature passed legislation mandating substitution of generic, equivalent, medications unless the brand is specified, with the specific instruction of “dispense as written”. Silly me, I had supposed that when I prescribed albuterol, which is the generic name, that this generic substitution law would allow the pharmacist, who has access to the “menu special of the day” that the insurance company will subsidize, could then think, so to speak, “Hmm. McFee wants albuterol, but the insurance company will only subsidize Youcallwehaul brand of albuterol inhaler. Howzabout I simply fix that, and dispense the Youcallwehaul inhaler, just as if it were not a BRAND of ALBUTEROL, but, indeed could be considered equivalent to the generic albuterol inhaler that Our Hero had indeed prescribed?”

Had that occurred, I would not get a paper note spending pages and pages to tell me that the Useless Insurance Company Inc., would not pay for the generic inhaler, but would, rather, pay for the Youcallwehaul inhaler, no doubt reflecting the proud legacy of pharmaceutical excellence that has characterized the Pashmir Valley since January of 2022!

And receive that note several days AFTER my patient encounter.

All the while telling me that they would not pay for a non preferred inhaler until two other inhalers had been employed, and had failed.

So, that means that my patient has NOT had their freaking inhaler for (lessee, now: Friday visit, Monday denial, Thursday, if they are attentive (scoff!), mailing date for the voluminous tutorial on the pharmaceutical excellence of Bagwan’s Pharmacy And Weapons Factory, which I finally see, perhaps as soon as a full week after my patient encounter.) So, something like 8 days, more or less.

Let’s paw through the old chart, and review previous prescribed inhalers, shan’t we? Lessee, there is Ventolin, and then there was that time this soul received…Ventolin, and, of course, the last time when one of my colleagues prescribed…..er, Ventolin. So, imagine my surprise when I prescribed (lessee: what was that stuff?)…Oh, yes. Ventolin!

And I receive the previously described voluminous correspondence detailing why the Behemoth Insurance Company would not pay for the prescription of….er, Ventolin.

I really try to embrace the suck, but geez, ya know…

cats · Fun And Games Off Duty · Having A Good Partner Is Very Important! · Housekeeping · Pre Planning Your Scene

TASK STACKING

Eaton Rapids Joe, proprietor of the eponymous blog, must have been an engineer in a previous life. (and, I must have been dyslexic in my previous life, as the previous 5 words, pre-auto correct, read “enbgineer in a previous lidfe.”. Sheesh! I scare me!)

In any event, I seem to recall he once explained the concept of “tolerance stacking”. As I recall, however imperfectly, the concept might translate into, say, a rifle trigger pack, wherein one would take Part One, at it’s maximal permissible dimension(s), and add it to Part Two, similarly pushing the boundaries of out-of-spec-large, and add that assembly to Part Three, (ditto), until, finally, you had, say, a trigger pack, each part in spec, yet the assembly would not function, or else would not fit into the firearm at all.

Not so very long ago, I was reminded of that when TDW-Mark II assigned me (or, maybe, I was voluntold….) the task of cleaning the piles from the dining room table. I confronted the concept of “task stacking”.

To be honest, I had several probably 12-18 inch tall piles (more about that, in a moment…) of papers, magazines (the literary kind), boxes, and assorted whatnot, that (a) I had NOT addressed appropriately, (b) in any sort of timely manner, and (c) that TDW had, at long last, grown weary of seeing.

Along the way, may I observe that I share my home with several cats? And that cats are Agents Of Entropy? My appraisal is that cats are genetically incapable of viewing an organized stack, of whatever sort of stuff, and of whatever degree of righteous organization, without feeling the overwhelming need to Tear! It! Down!.

Of course, having several days off in a row, I was, well, “willing” probably overstates my enthusiasm for this task. Still, it will do. So, I was “willing” to address this problem, but I needed to have a space to take the stack-du-jour, in order to unstack it, triage each component, and then address same.

That meant establishing subsidiary stacks, one of trash (simple: stack same in the…wait for it!…trash can!), one of things to be shredded, and one of other, kind of valuable, things. That last stack would then be the subject of a re-triage, and once suitably thinned, put away.

This process was to be repeated, until the dining room table had my computer, and one (SMALL) stack of whatever needed to be addressed in the next couple of days. And, nothing else of my bullshit.

Well, in order to accomplish THAT task, I had to clear the table in the kitchen, that had, itself, become home to (yes, he admitted, embarrassingly) several stacks of things awaiting disposition to the garage, the trash, or other longer term, somewhat organized, rest.

The trash component, here, was simpler, due to being closer to the trash can, after all. The put-this-crap-away-somewhere-not-the-kitchen-table task, elicited it’s own task-stack, as my imaginings of organized stowage in the basement, required that there be horizontal surfaces, in that basement, that were unoccupied.

Do you, as well, see a pattern here?

So, I thinned the herd of bullshit in the basement, and changed the trash can. I imposed some modest organization in that basement, and then found homes, however transiently, for the keep-this-crap-just-not-on-the-kitchen-table items.

I shredded much of the shred-able stuff, and changed the trash can. Again.

I eventually had emptied the kitchen table, which I then re-filled with dining room table stuff.

Rinse and repeat.

So, it turns out that I am not the only pile challenged soul. I get several days off in a row, that follows a stretch of many 12 and 10 and 8 hour shifts. When I am in the midst of my duty week, well, my ambitions do not particularly exceed “get up and get around”, “get to work”, and do the above in accordance with my employer’s expectations (that is, on time). So, being a geezer, after a 12 hour shift, I get home, graze a bit, and turn in.

I had requested TDW to thin the herd of home chores, so that I might kill of the remainder on my first day off, then to laze away the rest of my stretch of off days.

Hard fail. She injured her foot (neither of us has any clue how. It hurts, that limits her mobility, and that mobility is kind of mission critical to things like putting away the dishes, moving the laundry along, and so forth. In addition to nurse-maiding an ailing dog and ailing cat)(can’t say we don’t know how to have good times!)

Being the loving husband that I am, I offered to heat and deliver some supper to her.

Task stack. Be nice if I washed my hands.

Which would be helped by access to the sink.

Which would be facilitated by loading the dirty dishes into the dishwasher, thereby emptying the sink.

Which would be easier, from a no-two-objects-may-occupy-the-same-space perspective, it the dishwasher were to be emptied, and the clean dishes put away.

Which, aesthetically, ought to be performed by clean hands.

Which required soap and water, currently unavailable due to the mosh pit of our sink.

Which inspired my present blog post.

After the dish part of the foregoing had been accomplished.

Finishing the dining room table is Tomorrow’s Task.

Fun And Games · Life in Da City!

SNIPPETS

To be honest, y’all, I present snippets when the fountain of (I certainly hope…) entertaining stories has run a bit slowly, or I have collected several thought fragments which do not inspire an entire blog post. So, with that in mind, here is my latest installment of snippets.

Conversation with a child of Ghawd: “What makes your cough worse?” “What do you mean, ‘worse’?” (never mind: I now know that the answer is “nothing”.)

My mornings: I set the alarm for 0700, in order to get up, get around, and get to work. Kitty wants to play, at 0600.

I wonder if it would save me a lot of pointless conversation should I get a tattoo on my non dominant arm, saying, “Good talk! Here’s your Z-Pak! Have a nice day!”

Triaging one night as an RN, chucklehead enters bitching nonstop, “Stupid hospital! Stupid doctors! Stupid…” “Yes, ma’am, and I am likely the dumbest one here!” “But, you’re a nurse! You cannot be a nurse, and be stupid!” “Yet, ma’am, here I am, as are you! Now, what brought to us tonight?”

”I am going to prescribe an antibiotic for you. What pharmacy do you use?” “I don’t use any pharmacy. I never get sick.” (sigh) “So, what pharmacy are you going to go to, when you do go looking for your antibiotic?”

Overheard conversation among the MA staff: “So, he and I used to ride the bus together!” (I interject) “Is THAT what you kids call it, nowadays?”

When your MA starts report with, “So this guy, almost a year ago…”, you know that whatever follows is very likely to be some sort of cluster.

One day, I will snap, and I will write the following off work note: “Cletus was seen today in clinic. He is released to return to work after the heat death of the universe.”