Fun And Games · Having A Good Partner Is Very Important! · Life in Da City!

Dumpster Diving

This one schedule, Doug had elected to rotate onto day shift. Likely something about a wife, family, and wanting to spend some time with That Bright Thing all up in the sky, while he was awake, might have figured into his calculations. In any event, TINS©, TIWFDASL© on night shift at Medic 14 (let us say). I was partnered up with Johnny Wadd (not his real name), who was, even among the collection of characters that made up the crews of EMS in those halcyon days, a character. He was book smart, street wise, quick on the uptake, head on a swivel, and, despite a very crusty persona, good hearted.

So, this one time, at band camp….uh, wrong story. So this one night we were cruising around between runs, and, as commonly happens in my “sea stories”, well, we caught a run. In the misty distance of all these years, I cannot tell you what the nominal nature of this run was. I do, however, remember (a) that the police were NOT dispatched to this run, and (b) once we arrived, and began to understand what the happs were, well, item “a” began to appear to be a big, big mistake.

So, we arrived on the scene to discover not a light on in the alleged address. Calling on the scene, we verified that the house number on the house before us, was, indeed, the address dispatch wanted us to report to. Check!

I knocked upon the door, while Johnny looked around the front of the house. As he reached the edge of the house adjoining the driveway, he heard something from the back that caught his attention. We meandered back to see what was up (notifying dispatch, on the way, of our explorations).

The sounds Johnny had heard were moans, and they were emanating from a wheeled trash bin. That made sense, as my flashlight illuminated two legs protruding from the top thereof. Johnny peered inside, and beheld a gentleman curled up inside, much the worse for wear.

We figured that any conversation to be had, would be had with greater clarity should our new friend be extricated from the trash bin, and so we began to attempt to lift him by his legs.

BAD PLAN! At least, in his view. He screamed, convincing us that this was NOT the course of action we desired to pursue. I ran to the truck, and retrieved the cot, a backboard, and backboard straps. Johnny and I then slowly levered the bin onto it’s side, and tried to gently place Mr. Trash Bin onto the backboard so as to remove him from his nest with minimal discomfort (to him) as we could manage. In his opinion, we were not particularly successful.

Once he was out in the light, such as it was (MagLite light, it was!), we could discern from the angulation of his thighs that he had sustained two fractured femurs. Further evaluation revealed a couple of gunshot wounds, as well as several stabbing wounds.

We determined that further time on the scene, with our basic life support asses, would be unprofitable, and so secured our guest onto the board, strapped him onto the cot, loaded him up into the truck, and coded our happy way to TBTCIDC.

Once we had turned him over to the ED crew, and they were poking, prodding, needling, radiating,

IV-ing, and generally getting to know him far, far better than anyone else in his life ever had, we cleaned up and restocked the truck. Johnny turned to me, reflection written deeply in his eyes.

Ya know, Reltney, I wonder if someone, somehow, got a little angry at our guy there! Somebody does not seem to have had his very best interests in their heart!”

Fun And Games · Having A Good Partner Is Very Important! · Life in Da City!

Night shift lost the medic bag, a fact we discovered *AFTER* we caught a run!

So, TINS©, TIW©, all psyched up to FDASL©, chatting with the off-going crew, with my partner Doug. I had just about completed dropping my bookbag full of nursing school homework on the desk, when the phone rang with a run. Unaccustomedly, we were on day-shift, this being summer and my class load being light.

Of course, our very first run of the morning was Not a “sick person”, was not a “stomach pain”, no, indeed, it was an arrest.

It was Doug’s day to drive, so I settled into the passenger seat, buckled up, and we were away.

It was the custom, in those dark days of antiquity, to gather our immediate aid materials in a “mussette bag”, generally mil surp, olive drab, canvas. With a capacity of around six liters, we could carry several roller gauze bandages, a dozen or more sterile 4 x 4 dressings, several 5 x 9 ABDs (variously translated out of acronym into English as Army Battle Dressings, or ABDominal Pads), tongue blades, plastic oral airways (NOT endotracheal tubes: in those days, we were running an entirely basic life support operation), and, most relevant to Today’s Lesson in Life In Da City, a bag-valve-mask resuscitator.

Mostly, Da City bought the Laerdal brand of bag-mask, branded as Ambu, Therefore, of course, we referred to these as “the ‘Bu”.

You may wonder why I am assaulting y’all with these details of my far gone workaday life, amirite? Well, ya see, on this particular day, on this particular “cardiac arrest” run, as I settled my bony ass into the passenger seat, I did NOT have to step around the green bag. This caused me to look around, as we sped to the run, and NOT find the bag. I twisted around, and gazed into the module from my seat, and, again, did NOT! See our bag.

This was not encouraging.

Shortly, we arrived on scene, and, fortunately (for certain narrowly defined values of “fortunately”), our named patient was not only arrested, but, also, in rigor mortis.

Please recall that “narrowly defined values of ‘fortunately’” thing, cited above.

This soul was not going to benefit in any manner from CPR, ventilation or any other intervention in our (missing) bag of tricks. Therefore, we pronounced him on the scene, called dispatch for a scout car to take report, and went in service.

Returning to the firehouse, we examined the log entries from night shift, listed several likely locations of our errant bag (and I retrieved my personal bag from my vehicle, so, in the interval, we would not face performing mouth-to-mouth on some unlucky stranger). Then, we went visiting.

On our second or third stop, a pleasant lady answered the door. “I was wondering when you fellas were going to come back. Them nice fellas last night were in such a hurry that they left this on our living room floor!” And she handed us our bag.

I asked how her husband was doing, he being the subject of night crew’s visit last night. “Oh, he’s staying in the hospital. The doctors said his belly pain was from his appendix, and he’s gonna have an operation today, but they say he’ll be fine!”

Doug and I applauded this news, thanked her for holding our equipment for us, and bade her farewell.

And, boys and girls, THAT is why I forever afterward placed my own green bag in the ambulance, for the duration of my days on EMS!

Fun And Games · Sometimes You Get to Think That You Have Accomplished Something!

Bradycardia and The Cough

TINS©, TIWFDASL©, nursing in the ED of this community hospital in Northern The Un-Named Flyover State. A gentleman arrived, somewhere in his forties, and he told his tale of chest pain. He shortly thereafter sported the latest fashions in IVs, EKG monitoring, oxygen, and much blood drawn and sent to lab for analysis.

Two things you should know about me. I am a bottomless well of generally useless trivia, for one. For example, the relevance of which will become apparent shortly, I read a bunch of stuff, including a report, years and years and years ago which asserted that individuals undergoing a cardiac catheterization would be instructed that, should they be commanded to do so, they should cough vigorously and repeatedly. This would, or so the article asserted, increase pressure inside the chest, compress the heart, and thereby expel blood from the heart. This was important because occasionally the catheter, introduced into the heart, could produce irritation sufficient to produce fibrillation. (an uncoordinated trembling of the heart, which produces no blood flow. A Bad Thing.)

Once they drew in another breath preparatory to coughing once again, the negative pressure inside their chest so produced would encourage their heart to again fill with blood, which would be expelled with the next cough. This could temporarily produce enough blood pressure to keep things idling along, until the cath lab staff could intervene and set things right.

The other thing about me, is that I am somewhat chatty. (“No! Say it isn’t so!”). Okay, very chatty. So, there I was, chatting with this gentleman, and noting his cardiac rhythm and heart rate as displayed upon his cardiac monitor.

I noticed that his heart rate, originally in the 90’s, was trending downward. (normal is around 60-80). Once it dropped below 55, I stopped congratulating myself on wonderful patient care, and began to worry.

He began to report feeling dizzy and weak. I directed him, “When I tell you to cough, do not ask any questions, simply do it!”

He, of course, asked me why, but at that point his heart rate had dropped below 30 (Very Not So Good!), and I was a bit terse. “Stop talking, and cough!…Cough!…..Cough!….”

I repeated myself at about one second intervals. Now, I am sure that the other nurses heard me, and wondered what variety of insanity had afflicted me. Once they came in to investigate, and I waved my hand at the monitor, continuing my coxswain like commands of “Cough!….Cough!….Cough!….”, they noted his very, very slow intrinsic heart rate. That, coupled with this guy, eyes fixed upon me, coughing every time I commanded him to do so, told them everything that they needed to know, and things got considerably more active in short order.

He soon received a temporary external pacemaker and and an ICU admit.

And we all lived happily ever after!

Fun And Games · Having A Good Partner Is Very Important! · Life in Da City!

“Fittin To Throw Down!”

When I worked the road for Da City’s EMS, several of my colleagues were simpatico with the majority of our service population. So, the habits and mores of the folks on the street were not much of a novelty for several of my colleagues.

Indeed, one gentleman who was my partner for a schedule or two told a tale of a cousin of his who, exchanging words with another soul, found their conversation adjourned outside the bar in which they had crossed paths. Words grew more and more heated, in my partner’s telling of the tale, and the party of the second part drew, displayed, and announced his intent to employ, a handgun.

My partner described subsequent events. “Well, my cuz stood up tall, and challenged the other guy, saying, ‘Well, hell! SHOOT me!’. Which he did. My cousin did not survive the exchange.”

Tough crowd.

So, TINS©, TIWFDASL© with my regular partner, Doug, and we (of course) had our squelch open so we could hear radio chatter from other medic units. If one of them got into trouble, well, THAT might be a handy thing to know, so we could begin to sidle our happy asses over closer to their scene, to lend a hand should medical hands be required.

Over the radio came the memorable tones of Abbie Smith. He was able to recreate the richly evocative tones, rhythm, and nuance of the patois of the street. Partly this was due to the fact that he was of the street, and partly because he was an old hand on the job, and therefore wise in the mannerisms of the citizenry from that perspective as well.

So, anyhow, he drawled out his greeting: “Dispatch, this is Medic Nine!”

The dispatcher on duty that night was another old hand, who had been dispatching since Marconi had first dispatched “S” from Cornwall, England. He, in contrast to Abbie, was an old white boy, who was renowned for knowing off the top of his head where every ambulance was, and what they were doing, at any given time. When you are in a tense, hostile scene, is is reassuring to have a sort of radio bodyguard looking over you!

So, he acknowledged Medic Nine’s call: “Medic Nine, go!”

Dispatch, could we get the po-leece out here?”

Very good, Medic Nine. Why do you need them?”

Dispatch, these folks are all hot and bothered, and they fittin to throw down!”

Remember, our dispatcher was a white boy. He had not immersed himself in the vibrant, and ebonics speaking, culture of the street. In contrast, our friend Abbie, had. Dispatch sought some clarification.

Medic Nine, what are they going to throw down? And, from where?”

We could hear the sigh from Abbie, before he even keyed up the microphone. “Dispatch, this is Medic Nine! They fittin to throw down! You know, get it on! Fight!”

That cleared things up for our friend the dispatcher. “Are you involved in this fight, Medic Nine?”

Naw, we down the street. But, they gonna get to fighting pretty soon!”

Dispatch got it. “Medic Nine, clear that scene! Clear that scene! Police are on the way, repeat, police are on the way!”

Dispatch, this is Medic Nine! We clearin the scene!”

Again proving the importance of speaking, so that they can understand you!

Fun And Games · Having A Good Partner Is Very Important! · Life in Da City!

Sleeping With a Chainsaw

A long, long time, in a galaxy not so very far away, I was working for Da City’s EMS. Since I was in school during the daytime, I worked nights.

So, TINS©, TIWFDASL©, and it was my turn to take the detail. In those days, several of the medic houses on each shift had three medics assigned. In the event that another unit had a sick call, or somebody off injured, well, “Tag! You’re IT!”, and somebody got to pack their crap up, drive across town, and work an unfamiliar house with a (occasionally) unfamiliar partner. The night of this tale, it was my turn.

EMS, in those days, was sort of a small town. There were around 160-170 personnel on the rolls, and what with shift rotations, details, and commonly running into a couple of the dozen or so hospitals in Da City, well, nobody was an unknown quantity. For example, during several of the years I was on the road, I was dating one of my nursing school classmates. She was, let us say, “of the African persuasion”, whereas I am purely white bread. One fellow, who I was acquainted with only in passing, had occasion to work with one of my former partners, and was quoted, by that partner, as inquiring as to the status of my relationship with my classmate. The exact quote was relayed to me as “Is McFee still seeing that (‘N-word’) bitch?”

(clears throat) Uh, well, ya see, (a) the pejorative referenced nowadays by the circumlocution “The N-Word”, was not acceptable among persons of education or pretense of good upbringing, even in those benighted times. (b) My girlfriend was in no way, shape, manner or form “a bitch”. Indeed, the time we shared lifted my own life in ways that, now, nearly 40 years later, I am still discovering. And, of course, (c) My partner stood up for me, inquiring of Mr. “More Mouth Than Sense”, if his mother was still employing her skills as a practitioner of The Oldest Profession. For some reason, in my partner’s report, further conversation ended right about that point.

So, nearly everybody on the job in those days either knew everybody else, or knew of everybody else. So, it came to pass that I was detailed out to work with Lonnie Evans, let us call him. He was renowned as working two, perhaps three, full time jobs. This led to his reputation as the soundest sleeper in the department. In addition, since it seemed that he was acutely-on-chronically something like 2500 hours in arrears on his sleep allotment, well, when you add obstructive sleep apnea to that recipe, stir lightly, and allow to rise overnight, you get to observe what 40-60 seconds between breaths sounds like. And, due to the fact that he snored with a sound like a tractor trailer starting up on a very, very cold morning, well, if your 8th cranial nerve was functioning, you were not going to miss it.

I had a sleepless night, with only a few runs. (talk about mixed blessings!). The next night I reported to Medic Four, and regaled my partners, Doug and Andy, with a review of my night across town. Andy had had a similar experience, a few weeks previously.

He reported, “Yeah, Lonnie snored like a chainsaw starting up, alright. That wasn’t the bad part! Every time he stopped breathing, I snapped awake, wondering if I would have to start coding him! After considering this possibility for several minutes, I decided that I was NOT going to do mouth-to-mouth on him, so I got the bag-valve-mask, an oral airway, some tongue blades, and positioned the handie talkie where I could reach it in a hurry. While I did not sleep any better, at least I knew I wouldn’t have to wind up kissing his wrinkly ass!”

Fun And Games · Pre Planning Your Scene

Blizzard in Da South.

I did not always work for Da City. Nay, I eventually moved Up North, married, and found myself living in Cincinnati. To my disappointment, once our little family was settled in Cincinnati, I learned that they had, somehow, resolved the Nursing Shortage, raging everywhere else in our fair land.

Shit.

I contacted a travel nursing agency, and sought employment. They accommodated me, finding a placement in another, Southern city. Something like 120 miles distant from our home.

Realizing that “beggars cannot be choosers”, I gave thanks for this job, and settled in for some commuting. Conveniently, the hospital needed a unit nurse, and I had, indeed, worked as a unit nurse. In addition, adding to the convenience, TDW-Mark I worked Monday to Friday 0900 to 1700, and the hospital needed somebody to work weekends. Score!

Therefore, I motored my way to work, and worked my 12 hour night shift. They had a need on 3-11 (or, more precisely, 1500 to 0300) the following day, and I volunteered to work it, if I could avoid working until 0700.

They were agreeable, and, indeed, I could work 1100 to 2300, and go home Sunday night, around 8 hours early. Worked for me!

One weekend, I headed for home immediately ahead of a storm that swept in from the west, chasing me back to Cincinnati. I got home as the flurries materialized. I am from Northern Un-Named Midwestern State, so snow, meh? Nothing I haven’t seen before.

We awakened the following morning, and found ourselves in a low budget winter wonderland. Maybe an inch of accumulation, dusting in the trees. This being not-the-snowy-north, well, let’s just say that the snow management infrastructure was, well, lacking. They closed everything, and the evening news talking heads breathlessly filled us all in on the Horrible! Disaster! That the snow had occasioned. (yawn!)

Being an Amateur Radio Operator (“a HAM”), I listened in to the wide area repeater, taking note of the communications supporting shelters for those who could not stay home (for reasons that I did not understand), as well as other disaster relief communications.

The week passed, and my next fun filled weekend fighting disease and saving lives (betcha were wondering if I was gonna work that one in there, weren’t you?) arrived. I loaded up the truck, packed my meals, kissed the wife and kiddies goodbye, and set off into the wintry wastes.

I took just a little longer than I was accustomed to, since there were stranded tractor trailers scattered here and there on the interstate. Evidently, the snow to my west, and therefore closer to my workplace, had been more serious and more serious than atmy home. Things were not particularly better as I approached Southern City. Monitoring the local repeaters, I heard, four full days later, communications supporting shelters, (still!), as well as other, related, communications.

That malign prognostic indicator was only supported as I exited the expressway, and bunny hopped my full sized truck across nearly frame deep ruts in the frozen snow layered over the roadway.

I had lived in Da City for years on end, and had been impressed with the inattention paid to snow removal. Gotta tell you, Southern City passed them on the fly! On the other hand, the little “no snow removal infrastructure” thing might have played a role.

Fun And Games · Having A Good Partner Is Very Important! · Life in Da City!

Caught in a Snowbank with Marielle.

One schedule Doug rotated onto days, and I found myself working with Marielle. In keeping with usual practice, we rotated driver vs medic duties. One snowy night found us en route to a “heart attack” in the East Side projects. We arrived on the scene, so advised dispatch, and trudged to the indicated door. Things progressed as per usual, and our patient and Marielle seated themselves in the module.

While we were taking care of business inside, the snow had continued to fall. In addition, I had elected to park the ambulance in a snowdrift. Generally, no big thing, either drive our happy ass out of the snow, or rock things a few times, and off we go. As it happened, our truck had settled, snow had fallen in job lots, and, well, rocking that big ass truck was not about to extract us from that snowbank, at least, not tonight. I radioed dispatch to share this fact with them, requesting apparatus meet us with a wrecker. No go, they were at the scene of a multiple alarm fire across town.

Marielle and I discussed this revelation, and tried to brainstorm an escape from our snowy parking spot. I tried to rock us out, several times, and accomplished just about nothing. While I was allowing the tires to cool down, and contemplating my next move, I was startled by a knock on the driver’s window.

The gentleman who had knocked, evidently a resident of the projects, once I rolled the window down, asked me if I was stuck.

I admitted that, indeed, we were stuck. He noted that this might interfere with our transporting this patient to the hospital. (remember her? She was kind of the reason (a) we had jobs, and (b) we had come to find ourselves stuck here.) My new friend admonished me, “Don’t go anywhere!”, and I thought that I had that pretty much covered.

Minutes later I realized why he had so admonished me. This gentleman, and around a half dozen other residents gathered around our ambulance, and everybody picked their own piece of bumper, and commenced to heaving. We moved, briefly, until everything settled again, refusing to move any more.

I tasked Marielle to maneuver the vehicle, and I joined our block club meeting at the rear of the ambulance. Another maybe six or seven souls had exited their nice, warm homes, and joined us in the knee deep snow. At night. And cold as a politician’s heart (should such an organ actually exist!)

As it developed, the bumper was taken, so extra folks tugged on door handles, pushed on their fellows’ backs, and so added perhaps 12 “citizen power” to our efforts at movement.

Slowly, jerkily, gradually, the truck moved closer to the roadway, and eased out of the parking lot. Soon, we were in the middle of the street, and able to move under (the manufacturer supplied) our own power. I effusively thanked the gathering of neighbors, recognizing their irreplaceable efforts, and we set off to the hospital.

Nearly 40 years later, I remember those folks. When I hear smack talk about inner city residents, or residents of public housing, or people-who-don’t-look-like-us, I realize that, perhaps there is less sunscreen sold in those precincts, but Children of God are Children of God. Some are vermin, some are saints, and most simply want to pay their bills, raise their children and love their families, and make it from one day to the next.

Not altogether different from me.

Fun And Games · Pains in my Fifth Point of Contact · Pre Planning Your Scene · School Fun And Games

Paramedic School Stories, Part Two:

Which brings us to STORY NUMBER TWO: (remember the grading scheme outlined last week) In the fullness of time, the second semester ended. I calculated the point total for each student, compared said total to the pre established thresholds for each grade, and, based upon this calculation, assigned grades.

I posted these grades, after turning them in to the program director, who was my immediate superior.

Shortly thereafter, I received a phone call from one student, let us call her Little Mary Sunshine. She was upset at her grade.

“Mr. McFee, you gave me an A minus, and I think that I deserved an A”

“Oh?”

“Yes. I think that you should have given me an A.”

“I agree with you.”

“Oh? You are going to give me an A?”

“Nope. I agree that you think that you should be given an A. On the other hand, you earned an A minus.”

“But, I checked my scores! I only missed an A by a single point!”

I checked my grade book. Yep, needed 920 points, earned 919 points.

“I agree with your calculations. You missed it by a single point.”

“I think that you should simply give me that point!”

“How interesting. I however, do not.”

“But…but…it’s not FAIR!”

“In what way?”

“I think you should just give me that point, and then I’d have an A!”

“If I were to give you that point, you would, indeed have an A. On the other hand, you, indeed, EARNED an A minus.”

“But..but..It’s Not Fair!”

“May I ask you a few questions?”

“Uh, OK.”

“You were present in class the first day of class, correct?

“Uh-huh.”

“As well, for the midterm, and the final that first semester, correct?”

“Uh-huh.”

“Likewise, the first class of the second semester, and the mid term of that second semester, correct?”

“Uh, yeah.”

“Did you hear me talk about extra credit, on each of those 5 occasions?”

“I suppose so.”

“And, did you speak to me one solitary time about any sort of extra credit of any sort?”

“But…but…I never imagined that I’d need any extra credit!”

“Yet, here we are. Had you turned one solitary extra drug card, and the only things on that drug card that were correct were your name, the brand name of the drug, and the generic name, you would have earned that extra point. You did not do so. If you do not care about your grade that much, why should I care any more than you demonstrably do?”

Sometime later I received a call from the director of the program, who asked me about Little Mary Sunshine’s concern. I related the conversation, as related above, and summed up: “Bob, it’s your program. You run it, you are responsible for it. If YOU want to give her that A, go ahead. Simply understand that I will not be signing any other grade form for her. You want to do it, be my guest.”

I heard nothing further on that topic.

Fun And Games · Pains in my Fifth Point of Contact · Pre Planning Your Scene · School Fun And Games · Sometimes You Get to Think That You Have Accomplished Something!

More Paramedic School Stories: The First:

Years and years ago, before I left Da City’s employ as a medic, I had completed nursing school, written my boards, received my license and was living large. For certain values of “large”, that is.

I had been offered, and accepted , a position teaching pharmacology, part time, for the program that I had graduated from. The textbook we used (Nancy Caroline MD: “Emergency Care In The Streets”) was outstanding, and provided a clear template around which to build my lesson plans.

One of the innovations that I introduced, from my own nursing school days, was a particular format for drug cards. The point thereof was to have, on a 3 x 5 or 4 x 6 card, the names of the drug in question (trade and generic), the common dosing and route of administration of the subject drug, indications for using the drug, contra indications for using the drug, the mechanism of action of the drug, and the class (often, these last two overlap: a drug classified as a “Beta Blocker” worked by blocking beta agonism on the sympathetic nervous system. If you had mastered that point, you knew that the drug would serve to slow heart rate, mildly constrict arterial muscles (net effect of lowering blood pressure due to slower heart rate and decreased strength of contraction leading to diminished cardiac output), CONSTRICT bronchial muscles, and reduce intra ocular pressure. Or, you could write all that stuff out. For every beta blocker you encountered. Fun times. I simply earned what beta agonism tickled, and knew that blockade thereof reversed those effects.)

In addition, the cards noted nursing considerations (things the nurse, or paramedic, ought to have in his/her mind when employing this medication. Like, Beta blockers: check and recheck heart rate, blood pressure, and monitor the EKG, looking for slowing conduction of the elelctricity that controlled things).

Now, some of my students were first timers. They were folks who, as you might imagine, were taking paramedic classes for the first time.


In The Un-Named Flyover State, the licensing drill went something like this. You successfully completed the course, and took the exam. Pass it in one, bingo, license in hand, go out and fight disease and save lives.

If you failed the exam, then you got one chance to re take the test portion that you had failed.

If you failed the retest, you had to successfully complete a refresher course, whereupon you could re-test, again.

If you failed THIS test, you had to take the entire generic paramedic program, from step one, all over again.

As it happened, a couple of students had, indeed, found themselves taking the paramedic class, in order to qualify for a FOURTH retest.

So, TINS©, I laid out my expectations, had conjured up a 1,000 point, tow semester grading scheme, wherein around ½ of the grade (250 points each semester) would come from the midterm and final, combined. Another 25 points came from each quiz, administered each week in class. 16 weeks in a semester, no quiz on mid term or final weeks, and two other weeks off for review for the mid term and finals, 20 quizzes.

I announced at the beginning of each semester that I would consider extra credit in the event that any student came to me in advance, suggested something that would reflect additional pharmacologic study, and be pertinent to paramedic practice.

So, STORY NUMBER ONE: Somewhere around mid terms, one of the students rose in class, and delivered a pronouncement: Reltney, paramedics don’t need to know all this stuff. Nurses, yeah, I get that nurses need to know this stuff, but paramedics don’t!”

I invited him to hold that thought, and we could speak, in detail, after class. After the end of class, this fellow, along with a couple fo his work mates, all met with me, eager to set me straight.

As it happened, all of these folks were of the looking-at-a-fourth-retest group.

I invited my correspondent to state his case. He did so, as outlined above, with no new explicative material, no new rationale for his position.

I deliberated a moment, and fact checked myself. “So, you have taken the paramedic exam, correct?”

“Yep!”

“And, you failed it, is that correct?”

“Uh, yeah…”

“Then, you took it again, did you not? And, failed it, again, am I correct?”

“yeah…”

“And, again, after a refresher course, you took the paramedic exam, and, again, you failed it, is that also correct?”

(much more quietly) “yes…”

“So, I’m confused: you are not an RN, are you?”

“Uh, no…”

“So, let me see if I am understanding you: you are telling me, who has taken, and passed, the paramedic exam, and who is, also, an RN, that you are in a position to have an opinion that I ought to find persuasive, regarding what it takes to successfully take and pass the paramedic exam, based upon your experience in taking the exam, and failing it, what, three separate times?, did I hear you correctly?”

He mumbled something indistinct, and found somewhere else that he felt the need to be.

And, I did not hear THAT particular argument again.

Fun And Games · Pains in my Fifth Point of Contact · Uncategorized

Random Thoughts III

Story “A”

You may recall my delight at marijuana legalization, correct? Because, “medical marijuana” wasn’t ENOUGH of a cluster f*&k, right? Of course, there is my recurrent delight at the discretion, great judgment, and common courtesy displayed by the genuii who stroll (nay, stumble) about, reefer fumes pouring from every fold of their clothing, if not every pore, in a nigh overpowering display of Poor Life Choices On Parade.

So, TINS©, TIWFDASL© when this braniac arrived, spawn in tow. My poor clerk registered the Named Patient (actually, plural, as in both kids), and then let me know that the chart was ready for me to lay some healing upon them. As if.

So, my first clue that Things Were Not Right, was when the nominally 3 year old child, named Adam, was sitting upright reading some (non picture) book. My second clue was that the nominally 12 year old child, was around 36 inches tall, and appeared to be around 40 pounds. And, did NOT appear critically malnourished.

I asked the reading child, “Please, tell me how old you are?”

The reply was “I’m 12!”

“How old is your brother?”

“Oh, he’s 3!”

I excused myself, and asked my clerk, “Did you know that Adam is 12, and Brady is 3?”

She looked at me, and informed me, “I asked the mother, and asked her twice, which child was which, and who had what birthday. It did not look right to me, but she repeated herself, same birthday both times, for each child. That is what I put down.”

“Well, it is wrong. Please, fix it, and double check it, all over again. Please try to sort out what else she fucked up in registering the kids, please.”

Once the clerk asked the 12 year old for his school id, the mystery was resolved.

My new Life Rule! If you are so stoned that you cannot remember your own gorramned childrens’ birthdays, and you successfully mix the TWO of them up, either stay the Fenomenon home, or WRITE IT DOWN!

Story “B”

Have you heard about Homeopathic Medicine?

What Is Homeopathy?

“Homeopathy, also known as homeopathic medicine, is a medical system that was developed in Germany more than 200 years ago. It’s based on two unconventional theories:

*“Like cures like”—the notion that a disease can be cured by a substance that produces similar symptoms in healthy people
*“Law of minimum dose”—the notion that the lower the dose of the medication, the greater its effectiveness. Many homeopathic products are so diluted that no molecules of the original substance remain.

(from: https://nccih.nih.gov/health/homeopathy )

Let’s keep “The Law Of Minimum Dose” in mind for a moment. So, I work in an urgent care clinic in The Un-Named Flyover State. It’s….quirky. Yeah, let’s go with that. So, our cleaners are some folks who are NOT from some national housekeeping chain. I do not know where the owners hired these folks from, but, well, they are, in keeping with the theme of the organization, quirky themselves.

Over the past several weeks, I have been noticing that the hand soap dispensed from pump bottles, has been appearing clearer, and clearer. Similarly, it has seemed less viscous, and less viscous, from week to week.

In keeping with these observations, it has started to require more and more pumps to elicit enough soap to, ya know, WASH MY HANDS!

One of the MA s clued me in to what is happening.

“The cleaners never pour more soap into the dispensers, they just add water. It’s free, unlike the soap that costs.”

I wondered, out loud, “What happens when it is simply only water in the “soap” dispenser?”

She told me, “I dunno, maybe, finally, they’ll buy more soap?”

I corrected her. “NOPE! We will be told, that this is the latest public health innovation! Homeopathic soap!”

Story C

A long time ago, in a county far, far away, I was working as an ER nurse. I overheard one of the clerks engaged in a telephone call.

Now in this agency, at that time, Administration did not want us providing “medical advice” over the phone. I was on board. My stock spiel, when I was trapped into answering some such call, was along the lines of “If you think you have an emergency, you ought to come to the emergency department. If you do not think that you have an emergency, perhaps your problem could wait until (the morning)(Monday), at which time you could arrange for your family doctor to address it. If you do not think that your problem can wait until (the morning)(Monday), well, at this time of night, your only option is to come in to emergency.”

I, myself, often would be the recipient of some query at that point, along the lines of “Well, how do I know if it is an emergency/can wait until Monday?”

My answer would be “You are there, you have sense (Yeah, I was lying through my teeth!), and only you can make that determination. I am not there, and I cannot see what you can see, since you are on the scene, and I am not.”

So, I heard the clerk speaking to some Brain Truster. Attempting to explain, repeatedly, how and why she could not tell him whether his laceration needed stitching. Mr. Telephone was persistent, and I could tell, from my clerk’s responses to him, that he was saying stuff like “Well it’s (insert length here) long, and about (insert depth here) deep, and it’s (insert some indicator of severity, like bleeding or suchlike here), so why can’t you tell me if it needs to be stitched?”

She finally had had her fill of his idiocy. “Sir, what color blouse am I wearing?”

“How the hell would I know what color blouse you are wearing?”

“So, how am I supposed to have any opinion worth anything about your cut?”