Fun And Games Off Duty · Fun With Suits! · Pains in my Fifth Point of Contact · Sometimes You Get to Think That You Have Accomplished Something!

Sometimes, You Just Gotta Talk So That They Can Understand You!

After I left Da City, I worked as a ED nurse. Eventually, I took a job up north, at Erewhon Memorial Hospital. (“Both Nowhere, and Backwards!”) In due course at work I met The Woman Who Would Become The Plaintiff, after she had been She Who Must Be Obeyed. (another story, for another time).

This woman, let us call her Annie (because “The Woman Who Would Become The Plaintiff” is simply too complex to type repeatedly!), and I began to see each other, dating and, eventually, moving in together. Annie had two children already, Brenda (age 3) and her older brother Adam (age 7). Unsurprisingly, they accompanied her.

Well. Love bloomed, and Annie and I got married. I worked, she went to school, the kids attended school, and all seemed well.

One night Annie and I were asleep. I awakened to hear wheezing from down the hall, in the direction of Brenda’s room. Being the inquisitive sort, I followed the sounds, arriving in Brenda’s room, where she was sitting upright in bed, wheezing and terrified. Annie had awakened when I left the bed, and soon joined us. I listened to Brenda’s lungs with my stethoscope, hearing wheezes. I noted her rate of respirations (42 breaths per minute. Yes, 30 some years later, I remember it), and her pulse rate (162. Yep, I remember.) I got dressed, and Annie stayed home to watch over Adam. Off we went to the ED where I was employed as an Emergency Department RN.

Once we entered the door, well, I was not alone in my assessment that This Was Not Good. Brenda was whisked into a bed, gowned, x rayed, breathing treatment-ed, had blood drawn, and an IV started, and generally auscultated/poked/prodded/imaged very thoroughly.

A couple of hours later, Brenda’s breathing MUCH improved, we were discharged with antibiotics and an inhaler, and instructions to return IMMEDIATELY if her breathing worsened. It did not.

So, several weeks later I received a letter from Erewhon Memorial Hospital, informing me that our insurance company had determined that this was not an emergency, and that therefore the insurance company would not be paying anything on the emergency department visit we recently had.

I called Erewhon’s billing department, and asked them what was up? They informed me that I had to speak to the insurance company, in order to determine what they were thinking.

I did so. It develops that our insurance company hires people who are, in short, stupid. I (finally) spoke to a representative who told me that the claim was not going to be paid, “because that visit was not an emergency.”

I asked her on what basis she had made that determination.

“It simply was not an emergency”.

I observed that, where I came from, answering a question seeking an explanation, was not adequately answered by repeating the previous, unsatisfactory, answer. Then, I asked her, “Ma’am? In which corner of the resuscitation room were you standing? I work there, I know everybody-EVERYBODY!- who works there, and I do not recall you standing there, taking notes on the non emergency nature of my child’s acute respiratory distress.”

“Oh, I wasn’t there!”

“Then, how did you determine that my child, in respiratory distress, was not emergent? The leading etiology of cardiac arrest in the pediatric population is respiratory distress, and my child was in respiratory distress, wheezing, tachypneic, tachycardic. Being just older than a toddler, she does not have much in the way of respiratory reserves, and that which she did have, was being expended rapidly. Please, explain that to me, and show your work!”

After a spell of stuttering, she told me that the charting did not support the insurance company’s criteria for an emergency, and I would have to have further conversations with the hospital.

I did so. I walked my happy ass into the billing department, and asked about my daughter’s bill.

The charming soul I spoke with told me that “It wasn’t an emergency, the insurance company would not pay for it, so the entire bill was my responsibility!”

I told her, “Uh, no. My child was an emergency. She was in respiratory distress, wheezing at a rate of 40 times a minute, and tachycardic at a rate of 160 a minute. The leading etiology of cardiac arrest in the pediatric population is respiratory distress, and my child was in respiratory distress, wheezing, tachypneic, tachycardic. Being just older than a toddler, she does not have much in the way of respiratory reserves, and that which she did have, was being expended rapidly. So, I will pay the co-pay, and the deductible, for which I am liable, but you can collect the rest of the bill from the insurance company, which owes you that money, not me.”

She puffed up. “Well, if you do not pay that bill, we will have to send you to collections!”

She saw all of my teeth, in the grin that was my response. “Ma’am, if you do that, you will libel me, and slander me, and impugn my character and reputation. You will get the opportunity to explain yourself, under oath, at trial, when I sue for damages occasioned by the torts I just enumerated that you will have performed.”

She puffed up, more. “You can’t sue me!”

I chuckled. “Ma’am, I can sue you for damages because you are ugly, and your ugliness causes me harm. Count on it. If you send me to collections, I will sue you, personally, and do everything I can to impoverish you. After I am done with you, I will sue your supervisor, personally, for failing to supervise you, and allowing you to perpetrate these offenses. Once I am done with her, I’ll sue HER supervisor, personally, and so on up the chain of command, until I’ve sued every son of a bitch here, and then I’ll go after the hospital as a corporation, and individual members of the board of directors, for breaching their duty to ensure that the hospital is not run in a fraudulent manner, which your plan is. Fraudulent, that is.”

She huffed, and puffed for a while, and then deliver what she evidently thought was her clincher. “You cannot sue me! You simply cannot!”

More wolf grin on my part. “Oh, really? Is that what your attorney told you?”

“I do not have an attorney!”

I smiled, a smile that in no way reached my eyes. “Really? You know, I will fix that. I’m pretty sure that, once you get served by my attorney, you will find an attorney of your own, right damned quick!”

She gaped at me for a moment. “You know, you are an asshole!”

“Yep! Sure am! For most folks I try very hard to conceal the fact that I am an asshole. For you, and everybody working at this shithole hospital, well, I will make an exception! I’ll be in touch! Have a nice day!”

So time passed, Annie and our children moved a couple of times (she is part Gypsy).

A couple of years later, around the middle of December, I received an Explanation of Benefits from the insurance company. I found this odd, since I hadn’t been insured by this company for a couple of years. It appeared that they had paid a claim for emergency services at Erewhon Memorial Hospital, the very claim that I had shown my ass to the billing department about.

It was as if it was our own little Christmas Miracle!

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Fun And Games Off Duty · guns · Life in Da City! · Pre Planning Your Scene

Pedicabo non est mecum

So, TINS, after a time, Mallory had succumbed to my animal magnetism, and we had begun to date. Our relationship progressed, and when her apartment lease came up for renewal, she moved in with me.

Now, understand: Mallory was a very nice woman, and had grown up and lived in one of The Suburbs. I, on the other hand, lived in Da City, right off of Elmward, known as State Highway One. In addition, I lived just south of a neighborhood renowned for arson, drug dealing, and assorted mayhem. Kind of a jakey neighborhood. Still, I could afford to buy my two flat, and the rent from the other apartment paid for my house note.

Mallory, for her part, was, to say the least, skittish. This was not helped by my insisting that she phone me as she left work at TSBTCIDC, and subsequently meeting her at the door with a pistol in my hand.

We went to the range, and she became familiar with my assemblage of firearms. She really liked my Colt Government Model in .380 caliber, and purchased one for herself.

From time to time, she’d call, and ask me if I wanted anything from a drive through on her way home. On one of these side trips, she came home, a bit more frazzled than was her baseline.

She related her story as we ate. It turned out that she pulled up and gave her order, and then pulled to the window. As she was gathering her money to pay for the meal, some character knocked upon her (locked) passenger door, and began to panhandle her.

“Go away. I have nothing for you!”, was her response.

He began to tap more insistently upon her car window, and demand a hand out.

“I told you, I got nothing you want! Go away!”

He seemed to be slow on the uptake. Now, pounding upon her window, he demanded that she give him some money.

Mallory was “dressed to impress”, for sure. She produced the little Colt, directed it his way, and admonished him, “I TOLD you that you do not want what I have for you! Now, do you REALLY want me to let you have it, or do you have someplace else to be? Like, right fucking now?”

As she recounted, “People’s eyes really do get THIS big! He never took his eyes off the pistol, as he backed up across the parking lot, stumbled on the curb stone, and, once he regained his feet, ran to wherever he abruptly realized he’d rather be!”

Then, she replaced the pistol in her purse, and turned to the (likewise wide eyed) fast food employee, and asked, “May I have my change, please? And, my sandwiches? Oh, thank so very much! Have a nice night!”

Fun And Games Off Duty · Fun With Suits! · Pre Planning Your Scene · School Fun And Games

Not Fitting The Mold

So, TINS. I decided after several years as a nursing assistant, that I wanted to be an RN when I grew up. By the time that things lined up, I had already started working for EMS in Da City. So, I set to knocking off the pre-requisite classes I had not already collected, and waited for my Nursing school application to be processed.

Now, at this time, there were very, very, very few men in Nursing. The school I applied to, a community college, had a decidedly  problematic academic tendency among the population from which they drew their students.  So, since I had attended Tremendous State University for a couple of years, it seemed that I was a good candidate to handle collegiate level studies. For these reasons, it developed that I was accepted to this school.

In the course of the intake, I had to interview with an admissions officer. We talked about coursework, and finances. She asked me about what financial aid I had lined up. I admitted that I had none, and planned to pay for school through Da City’s tuition reimbursement program, as well as my earnings.

She did not think much of that idea, for some reason. “Mr. McFee, we do not allow our students to work.”

I was surprised. This was, after all, nearly 1980, and I had thought that liberated women, and various movements to remove barriers had changed things. Simply to be certain that I had heard her correctly, I asked her, “Er, ma’am? you do not ‘allow’ your students to work?”

“That’s right, Mr McFee. We do not allow our students to work.”

“Uh, ma’am, you do realize that I am working full time, have a house, and am my own only source of support, right?”

“Mr. McFee, you need to plan for that. We do not allow our students to work while they are in school.”

“Uh, OK. Uh, ma’am, so, where do you live?”

“Why do you ask me that?”

“Well, I support myself and you are telling me that I cannot work. I suppose that means that I’m moving in with you.”

THAT got her attention! “Mr. McFee! You are NOT moving in with me!”

“Hmm. So, how about you document that you have told me that your experience is that students who work while in school do not perform as well as those who do not. You could note that I have acknowledged that warning, and the school’s extensive experience behind that warning. You could write down that I will elect to work while in school, and therefore, any failure on my part will be in spite of your vehement admonitions. Do you think that will work for you? It is a chance that I am willing to take.”

“Uh, Mr. McFee, please sign here, next to my notes to that effect. Thank you. Welcome to Un-Named Community College School of Nursing. You have selected a challenging course of action, both academically as well as because you have chosen to work. Good luck!”

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

Fun and Games In The Public Schools!

So, my daughter, Brenda, had injured her knee in gym class at middle school.  
We lived about a mile from the school, and, once she had told the teacher about
her knee injury, did that teacher, or any other official of the  school, call her 
mother, the nurse?  To quote Eddie Murphy, in his persona of The Ganga 
Teacher, "No, no, noooo, no!"

Did they phone her father, the nurse?  Again, "No, no, noooo, no!"

Did they have a teacher drive her home, so that she would not have to walk 
home on her injured knee?  As you might have anticipated at this point in my 
rant, "No, no, noooo, no!"

Did they put her on a bus, again, to prevent her walking home on her 
demonstrably injured knee?  If you have read this far, sing along with me:
 "No, no, noooo, no!"

Instead, of course, they sent her home, walking, on her injured knee, around 
a mile from school to her home. 

As you may have guessed at this point, I was not favorably impressed. Nay, 
I was pissed. 

I wrapped her knee, applied ice, elevated it, after identifying no marked 
instability.  It did hurt her with walking (which, of course, the idiots at the school 
had required her to do to get home, since they had NOT called her father, or 
her mother.  But, perhaps, I had already told you that little detail) 

I dosed her with ibuprofen, and put her to bed. I wrote her a no physical 
education note, and retained a copy for myself. I signed it, 
"Reltney McFee, RN, BSN".

In the morning she appeared  improved enough to return to school. Therefore, 
in consultation with She Who Must Be Obeyed, we decided to send her to 
school. We drove her. Ourselves. To make sure that she did not have to walk. 

So, that afternoon  I was surprised to receive a phone call from the phys ed 
teacher.  This worthy told me that he required a note FROM A DOCTOR, in 
order to keep her out of class. I pointed out that he had, in his hand, a suitable 
note, that I had written, directing him to keep my child out of gym class until 
further notice. 

He replied that, absent a note from a physician, he would require my child to 
participate in gym class. 

I gave this a second's thought, and brought him up to speed. "So, let me see if I 
am understanding you.  You have a note, in hard copy, in your physical 
possession, written by me, her father and a Registered Nurse, directing you 
to keep my child out of gym class due to an injury she suffered on school 
property, and notifying you that, should she participate in gym class she may 
sustain additional injury.  You, in your medical judgment, have determined that 
you know more of this sort of thing than I, and will contravene my explicit 
instruction, in my capacity as her father and a registered nurse of 20 years 
experience.  Cool story.  I'm certain that the jury at your lawsuit will be very 
impressed.  Perhaps impressed to the tune of several hundred thousand 
dollars."

He sputtered, "You cannot sue me!"

"Really? Is that what your attorney told you?"

"I do not have a lawyer."

"Well, what do you know?  I DO have a lawyer, and you can, too!  Once my 
lawyer serves you with the papers he will prepare to hold you personally 
responsible for my daughters crippling injury, suffered through your willful 
and wanton negligence, ignoring the specific instruction that I, her father and 
a registered nurse, have provided you. In writing. Right about that point, 
I wager you will find yourself a lawyer!"

He sputtered a while longer, and noted that he would, sooner or later, require 
a note from a physician. I told him that I would obtain one, at my earliest 
convenience. And, I'd provide him a copy. 

The call terminated. 

Once I had my daughter in my vehicle, outside the school, I asked her how 
gym class had gone.  

"Fine, Dad.  They sent me to study hall, and for some reason, the teacher 
seemed pissed about something."

I smiled, and replied, "Well, it might have been something about sending 
you, and our attorney's kid, and his attorney's kid, as well, to a very nice 
college!"

She looked puzzled at that, but, what the hell, I wasn't going to be able to 
put things over on her for very much longer, and I ought to savor the few 
remaining opportunities. 
Fun And Games Off Duty

‘Snow Joke!

A couple of years ago, I was working in Vermont on a winter locum tenens contract. (that’s kind of like travel nursing, for doctors, PAs, NPs, CRNAs and such) Since Mother Stretcher Ape resided a state or two over, I finagled a long weekend, and drove off to visit her.

Now, perhaps you had realized that Vermont, and all the states around it, are northern tier states. So, in the winter they get some snow. Nay, they receive abundant snow. With my formative years spent in Michigan, snow is no big deal. Still, even we hardened northerners need to pay attention, so as to avoid turning into corpsicles.

When I was first driving up there, the administration spoke of their concern that I understand the snow situation in their neighborhood. “So, you know, here in Vermont we get a lot of snow.”

“Yeah, I had heard that was so.”

“You *do* know how to drive in snow, don’t you?”

“You looked at my resume, right? You did notice the part about working all over Michigan, for years at a time, right? Including in the winter. My children were born in Michigan, and have grown up in Michigan. I think I know what snow looks like, and that I have driven in snow, a few times.”

(mumbling on the other end of the phone) “Oh, yeah. Right. You probably know how to drive in snow.”

“Yeah. Kinda.”

So, one wintry weekend, I set off to visit The Maternal Unit. Now, I say “One wintry weekend”, but that was by the calendar only. This particular January weekend, the temperature was in the 40-s to 50-s, low overcast, drizzle filling the air. Nice. I took off across Vermont, into The Neighboring State, and then southerly toward The Maternal State.

Once I crossed over into The Maternal State, it began to flurry, with the temperature dropping below freezing. As I continued, entering into The Megalopolis, it began to snow. Big surprise, right? January, northern states, snow. Who knew?

As I stop-and-go-ed my way across The Megalopolis, on the parking lots laughingly called expressways, the snow picked up. By the time I was on my way out of The Megalopolis, with only another hour of stop and go before me, it was snowing it’s ass off (Yes, that is a northern Michigan meteorological term). While the street department of The Maternal State in general, and The Megalopolis in particular, are no slouches in snow handling (having abundant experience), this specific storm was more muscular than the norm. Indeed, snow was collecting at such a pace that both it outpaced the highway department’s ability to plow it away, as well as limiting visibility. When you consider the fact that snowy roads lengthen your stopping distance considerably, couple that with, say, 50 yards of visibility, and you really start to feel the need to slow down. Waaayyyy down. Personally, I was going around 30 mph, and feeling daring at doing so. More high spirited souls than I were passing me, and more power to ’em. I had resolved that, should they wind up in the ditch, I was gonna drive my happy fuzzy electrician ass right on past ’em.

So, driving in the snow, transformed a three hour drive into something on the order of 6 hours. When I wasn’t wondering just what sort of fiery hell would send me to my judgment, I gradually formulated the Stretcher Ape Four Stages of Snow Emergency Scale. I share it with you, now.

Level 4: wear your damn boots

Level 3: bring a coat, bring a shovel and a scraper

Level 2: do the s#!t you have to do and go the hell home

Level 1: Ermagerd! French toast by candlelight!

I figured that I was driving at that time though a “Level Three Snow Emergency”, and resolved to arrive at The Maternal Manse, and consider myself the hell home. I really was pretty happy with that insight, and strong in my resolve in accomplishing it.

Then, roughly 30 minutes (I hoped!) from my destination, I saw flashing lights ahead. I slowed down even more. Approaching the scene, I observed flashing lights as of several police cars. Several fire trucks appeared to be in the gaggle, if their lights were as I figured them to be. Closing the distance, I noticed lights as from a highway department plow truck, although they seemed strangely out of position.

I crept past the scene, and realized why the lights appeared out of position, on the plow truck.

When a plow truck is on it’s side in the ditch, that would be a clue. Almost as if it was a Sign From Ghawd. A Sign, as if Ghawd were telling me, “slow your dumb ass down, go the hell home, and set your ass in a chair and stir not from that chair, until I tell you otherwise!”

My reply? “Sir, Yes Sir!”

My car slithered into Mother Stretcher Ape’s driveway, and settled several inches once I stopped. Looked as if the driving part of Ghawd’s admonition, would be easy to comply with.

I clumped into Mom’s house, trying not to track too much snow inside. We spent a couple of pleasant days watching the snow fall, shoveling snow (well, *I* shoveled snow!), and shoveling snow, and shoveling snow, and shoveling snow yet again. On the plus side, there was the home cooked meal part of things to enjoy, and the visit with your mother part, as well.

In summary, I leave you with two insights:

Insight The First: The Stretcher Ape Four Stages of Snow Emergency Scale.

Level 4: wear your damn boots

Level 3: bring a coat, bring a shovel and a scraper

Level 2: do the s#!t you have to do and go the hell home

Level 1: Ermagerd! French toast by candlelight!

Insight The Second:

When a plow truck is in the ditch, that would be a clue. A clue that you do NOT belong on the damned road.

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

Are We Ever, Really, Off Duty?

Are you ever off duty?

I had spent some time praying at The Altar of The Overtime Fairy, and with the proceeds had decided to take The Long Suffering Wife on a cruise. Now, one of her idiosyncrasies is that she is allergic–VIOLENTLY, anaphylaxis, throat swelling, red faced allergic, to tree nuts. Remember that. It will return to feature prominently in this “war story”.

The cruise line we selected had gotten our business previously. The personnel are unfailingly pleasant, professional, attentive, and on their game. The food is excellent, the accommodations are pleasant, the cabin stewards are magicians who ghost in and make the beds and change the linen without our seeing them. There are reasons that we are repeat customers.

We select the formal dining room each time. There are large tables, so we get acquainted with fellow cruisers, the food is outstanding: as good as, and generally superior to our own home cooking. On this cruise we joined two folks from Minnesota, a contractor and his girlfriend, and two other couples, the men both volunteer firefighters from a small town in Canada.

Firefighters are part storyteller, as am I (surprising, no?). It develops that our other two companions were storytellers, as well. So, mealtimes were fun, great food, round robins of telling tales, and no workaday cares.

Now, it seems that, for some reason, we had failed to make clear to the serving staff my wife’s allergy to nuts. (likely, because we had failed to, ya know, TELL THEM!, or something.) So, one evening, when my wife took her first bite of the chicken that she had ordered, she chewed it for a moment, then spat it out, turning to me with a peculiar look on her face.

I asked her what was the matter, and she told me, “I don’t know, but my mouth is burning as if I had just eaten a nut.”

From the corner of my eye, I noticed our firefighter companions in still life, forks immobile in mid air, as Mrs. Stretcher Ape and I had our conversation. I asked her how her breathing was, and she told me that was fine, but that the burning was concerning. I agreed.

She keeps an epi pen in her purse, which, of course, presently was in our cabin. She did have benadryl on her person, and I directed her to take two, right now. She did so, and we all watched her for a moment. I then directed her to give me a third capsule of benadryl, which I opened, and poured onto her palm, directing her to “lick that up, now!”

One of the firefighters shuffled his chair back a bit, as if clearing for lift off, and asked me if I needed any help. Our contractor friend, with whom we had gone on shore excursions, observed that I was an ex medic, ex ED nurse, and presently a Physician’s Assistant. I looked at the firefighter,  perched on the literal edge of his seat, and his partner, similarly (not so very) relaxed, and said, “It looks like things are OK for now, but I’m anticipating the possibility of that changing. Let’s give it 20 minutes to see how things develop. Thanks for the back up.”

I turned my attention back to my wife, and pasted a fake, but encouraging, smile on my face. “How you doing, Honey?”

She thought for a second, and answered, “OK so far.”

The waiter had noticed our diorama like table, and the absence of conversation, and walked over to see if he could assist us. I briefed him on the foregoing, and our suspicion that the chicken may have been cross contaminated with some sort of nut in some manner. Alarmed, he told us he’d look into it and be right back.

He was. Along with the Maitre D’. Both assured us that there were no nuts whatsoever in the recipe for my wife’s selection, although it was possible that there were some nut oils remaining on the surface upon which the chicken had been prepared. Effusively, they both asked after my wife’s well being, and apologized for this occurrence.

By this point, she reported that the burning was receding, and no swelling nor shortness of breath, as well as no itching was present.

I noticed that everybody else at the table, finally, resumed their meals.

Once I was convinced that her symptoms were, in fact, receding, and appeared likely to continue doing so, we retired to our cabin for the night. She, and I, thanked our companions for their vigilance, and reassured everyone that it appeared that her reaction was on the way to being resolved.

So, the question: are we ever REALLY off duty?

Fun And Games Off Duty · guns · Having A Good Partner Is Very Important! · Pre Planning Your Scene · Sometimes You Get to Think That You Have Accomplished Something!

I Hate Late Night Phone Calls

Many years ago, I was working midnights in a small ER in northern Michigan. One night, around 0300, the phone rang. I answered it to find my wife on the other end. Her opening conversational gambit certainly caught my attention.

“Honey, it’s me. Don’t panic.”

Sounded like good advice to me. “OK, I’m not panicking. What might make me consider panicking?”

“Well, when you hear on the scanner that the sheriff is sending a car out here, I thought you’d get worried.”

Hmmm, the hospital still has coffee. Why would the sheriff send a car out to my home, populated by my wife and (presumably) sleeping children? I asked, “Why is the sheriff on the way out there?”

She responded, as if telling me about the dog getting into the trash, “There is a guy on the porch.”

Remember the guy-on-the-porch story I told y’all recently? Yeah, I certainly did. I was beginning to very much NOT like the direction this conversation was taking, so I asked her, “What gun do you have?”

“I don’t.”

This required remedy. “I’ll wait while you fix that.”

My normally clear thinking bride seemed somewhat slow this morning. “Huh?”

“Go get a gun, right now. I’ll wait.”

“What? Why would I get a gun?”

“Because I think it would be a good thing if you had something more compelling than your girlish good looks and winning personality should Mr. Porch decide that now was the time to enter, and lay hands on you and the children. Go. Now.”

Evidently Mr. Porch had decided that he did not, really, need to enter THIS house on THIS night, because this porch guy had elected to wander off before the sheriff’s deputy arrived, and before The Darling Wife felt the need for a little show-and-tell. No loud noises, nobody got hurt, Score! Score, and SCORE!