A Long, Long Time Ago..

.TINS (This Is No Shit), TIWFDASL (There I Was, Fighting Disease And Saving Lives)one evening. I was an RN, had not yet gone to midlevel school, and was yet employed with Da City’s EMS. On my days off, I volunteered at a free (read: STD) clinic run by one of the local charities. In those far off times, routine treatment of STDs involved 4.8 million units of WyCillin. WyCillin was a very, very, very thick preparation of penicillin, which was stored under refrigeration. As you might imagine, refrigerating it did NOT improve it’s ability to flow under pressure. For example, the pressure applied by the plunger of a syringe, should one attempt to, oh, let’s say, inject it into a person.

The PROPER way to inject this medication was to secure two syringes containing, each, 2.4 million units of the medication, warm it up (say, in one’s hands), and s-l-o-w-l-y inject it, each syringe being around 2 mls, one each, into each ventral gluteal muscle. Since these are large muscles, the injection of this volume of irritating medication is merely unpleasant, not incapacitating.

In contrast to the PROPER way of injecting this medication, one patient one time, a young gentleman, insisted that I, and I quote, “Just shoot it in, Doc!”

I admonished this soul that I was a nurse, not a physician, and, in any event, he did NOT want me to “just shoot it in”, as the correct injection technique would allow him to avoid considerable unnecessary pain.

He persisted. “Just shoot it in, Doc!”

Some people are simply resistant to instruction, I suppose. I compromised. “Sir, tell you what: you have two of these shots coming. How about I inject the first one the way you demand, and then we can talk about technique for the second?”

His reply? “just shoot it in, Doc! I ain’t gonna change my mind!”

Surprisingly enough, once I had prepped the site, established a “Z-track”, and administered the medicine, as he had insisted, rapidly, well, once I had removed the needle he commenced to hopping around, rubbing the site, and commenting upon The Almighty’s love of his children, sorrow that some of them insisted upon eternal hellfire, and His Son’s journeys among us to bring us the opportunity for Salvation.

Or, something like that.

Once he had settled down enough that he was merely vibrating in place, I asked him, “Did that hurt, some?”

He apparently thought that I had some genius for understatement. Or, something like that.

I suggested that, for his second injection, perhaps he might allow himself to benefit from my years of schooling, thousands of patient care encounters, and years upon years of academic study, and, just this once, administer his penicillin, oh, gosh, THE FREAKING WAY I HAD BEEN TAUGHT, AND PRACTICED FOR LO, THESE MANY YEARS?

He allowed that it was possible that my way might, perhaps, potentially, could result in some observable decrement in his discomfort.

Again, I selected my site (on the other gluteus), again I prepped my site, this time I DELIBERATELY injected the viscous, irritating medication, over, perhaps, 30-45 seconds. This allowed the medication to spread out, rather than remain an irritating ball of painful displacement of his muscle fibers, which would, into the bargain, smooth the way for his body to absorb it, and thereby benefit from Dr. Fleming’s discovery.

I concluded the procedure, and asked the gentleman what his opinion was of the second injection, compared to the first.

“Doc, I should have listened to you! That second shot hardly hurt, but that first one hurt really, really bad!”

Behold! (as Sarah Hoyt would say, on Instapundit) My shocked face!