Duty · Fun With Suits!

SURPRISE!

One day, not so very long ago, I arrived at work, and went to log into the electronic medical record (EMR). Generally, there is no drama. I power up the computer, click through the labyrinth of password prompts, web pages, and suchlike preparatory to actually accessing the charts of the patients that I would see that day.

On this day, I could not access the EMR. Since I am somewhat geezerly, computers are NOT in my wheelhouse. I assumed that I had mis keyed my password, and checked it, and re entered it. No joy. I re checked it, and re-re entered it. Again no joy. The computer steadfastly ignored me.

I finally determined that I was not going to be able to cajole the computer into opening up and allowing me entry into the charts. Therefore, I called tech support. Of course, I was electronically placed into the queue, and serenaded by somebody’s version of soothing music.

Since I try to arrive early, so as to allow me to still be on time should traffic be screwed up in my commute, I placed my call around 10 minutes prior to my start time.

Something like 40 minutes later, I spoke to a human being, who took my information, placed me on hold (again!), and soon returned. She informed me, “Oh! You cannot log in, because we changed your login name!”

Now, let us consider this. If you or I were to, oh, let’s say, figure that for some reason we needed to change somebody’s log in name, you, or I, for that matter, might wonder if it would be a good idea to, oh, gosh, lemme see….. TELL A SUMBITCH WE HAD CHANGED HIS FREAKING LOG IN!

Maybe, even, before his next duty shift, perhaps?

I shared this with the young lady. “Wouldn’t that have been useful information to share with me?”

She had no reply.

I thanked her for her time. I turned to the floor staff, and announced that I was, at last, logged in. I observed to my colleagues, “If only, if only, I had provided my personal e-mail, so somebody could change my log in, and, gosh, let me know!”

Duty · Fun With Suits! · Having A Good Partner Is Very Important! · Life in Da City! · Pains in my Fifth Point of Contact

Improvise, Adapt, and Overcome!

TINS, TIWFDASL at Medic 13, and we caught a run. Initial dispatch information suggested that this was a heart attack.

We arrived on the East Side of Da City, at the stated address, and discovered out patient was awaiting us, upstairs. The folks who were encouraging us to step right up and set to business, were pretty excited. As we arrived and entered the bedroom wherein our patient awaited us, well, we could see why.

Our initial patient survey was, to be charitable, not encouraging. The bedroom was nearly entirely filled by a double bed, and that bed was nearly entirely filled by an unbreathing human being. Unable to detect a carotid (big ass neck artery) pulse, we concluded that this soul was in cardiac arrest. Doug and I knew that there was NO WAY we were going to move this person, let alone move them down the stairs, into our ambulance, continue a resuscitation en route, and offload same at DBTCIDC.

While I started CPR, as best as I could on the bed, Doug called dispatch on the handi talkie, and brought them up to speed. “Dispatch, we need an engine company, or two, for manpower. We have a active cardiac arrest, on a patient estimated weight of 800-1000 pounds. That is a stat call.”

Dispatch acknowledged our call, and responded, “We will send you help”.

Doug and I both set to resuscitating this soul, until our help, a second MEDIC UNIT, arrived. This crew, Mariel and Don, while welcome, came nowhere near the lifting power we anticipated in ten firefighters. Doug relieved me, and I shared this insight with dispatch. “Dispatch, we need at least one full engine company, perhaps two, and we need them several minutes ago! This is a working cardiac arrest, and there is no way we can move, let alone lift, this 800-1000 pound patient!”

Dispatch informed us that that would be a chief level decision, and I was happy to buy into their decision making process. “Very good dispatch. We need our superintendent on this scene, stat. This is a patient safety issue, and our patient is in full cardiac arrest.”

The field supervisor, a captain in our division, jumped in. “Dispatch, this is shift captain (insert name here). I am on the way to Medic 13’s scene code one. They need an engine company. Please dispatch one immediately.”

Soon, a DCPD scout car arrived, disgorging two of the single tiniest female officers I had ever seen.

Right behind them came our captain. He (the captain) edged his way through the crowd of civilians (who were, helpfully enough, insisting that we simply “snatch him on up, and carry him on down to the hospital!” (while NOT climbing the stairs to lend a hand!)

Our captain surveyed the four rescuer CPR taking place, and retired to his vehicle to have a chat with dispatch.

Mariel had removed our cot from our ambulance, securing it in their rig, wisely determining that our patient, upon the floor, would fill the entire module. As she returned up the stairs, bringing every backboard strap that she could find, the first engine company arrived.

The officer of that company trotted up the stairs, took one look, and about-faced, running down the stairs. Shortly, he returned with 5 firefighters, and a salvage cover. Everybody heaved, and the cover was stuffed ½ way beneath our patient. Everybody “Ho!’-d, and it was pulled out from beneath him. Now we had a carrying apparatus, and the firefighters set themselves at each corner, Doug in one middle, me in another, Don at the head, and Mariel at the feet, and we slowly maneuvered our patient down the stairs, and into our ambulance. Mariel and I climbed in the back, Don took off to meet us at the ER, and Doug set out.

I had the walkie talkie in my pocket, and I could hear his conversation with dispatch while Mariel and I CPR’d our little hearts out. Doug suggested that another engine company ought to meet us there, and that the ER ought to be notified of our patient’s girth. Initially, they seemed unenthusiastic, until our captain suggested that either they dispatch an engine company to the ER, or the Chief of the Firefighting Division, since he, the fire chief, would be the one explaining everything to the news media.

Engine 5 met us at the ER. TBTCIDC had lashed two cots together outrigger style, and everybody moved our patient onto the cot. Once he was in the ER, our part of the show was over.

We effusively thanked our captain, as well as the fire crew.

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

“Engendering Collectivity In Nursing”

So, TINS, TIWFDASL, and I had been admitted into the BHSU College of Nursing. I had moved on from Da City’s EMF (“The ‘Mergency Muthafuggers!”, as we had been so colorfully denominated on so many occasions), and was nursing in the ED of one of the nearly dozen small (at that time, around 300 beds) hospitals dotting Da City. I went from being chief steward of the union representing the medics, to a staff peon working nights.

Another of the nurses working with me was also pursuing her BSN, and so we study buddied up. We both had been old schooled in The Wisdom Of The Student, as so found ourselves in the rear 1/3 of this cavernous several hundred seat lecture hall, where the Blue Hive State University held it’s class on “Transitions in Nursing”. This was aimed at those of us entering the BSN program. The instructor of this particular class appeared enamored of Florence Nightingale, the Victorian English woman whose work caring for wounded and ill British soldiers in The Crimean War laid the foundation of contemporary Nursing.

This infatuation was reflected as this instructor read to us all from a book of Nightingale’s life. Amusingly, from time to time, she (the instructor) would hold the book above her head, turned towards us so that we could “see” some illustration or another, and detail the citation accompanying the illustration. (“Did you bring your binoculars?”)

From our seats, some 50 or more meters away, this was not as informative as our instructor appeared to consider it.

Once she had exhausted her store of Florence Nightingale trivia, she (the instructor, not Ms. Nightingale) moved on to instruct us in the advantages to be found in group efforts to improve the workplace. She described these efforts as “engendering collectivity” (and, do we not all wonder if, forty years later, in The Enlightened Twenty First Century, if the Thought Police would allow any of us to speak in those terms?), and appeared to believe that this was an unmitigated Good! Thing!.

Let me follow a tangent, if you please, for a brief intermission. I had mentioned that I had been a steward for the union representing Da City’s EMS. Interestingly, my father in his own youthful years, had had a hand in the formation of the American Newspaper Guild, which was a union for (surprisingly) newspaper folks.

So, I kinda grew up steeped in old school, Democrat political world view (think Scoop Jackson and Jack Kennedy, Not Occasio Cortez or Gavin Newsome), including the value to be found in an organized workplace. In that world view was the “real politik” perspective of the cost paid by the organizers initially struggling to create that organization. Examples such as The Fight Of The Overpass as the UAW attempted to unionize the Ford Motor Rouge Plant, or the Homestead Steel Strike, and other struggles as folks attempted to start, and foster, unions, including organizers being blackballed, being intimidated or outright assaulted.

So, as the instructor droned about “engendering collectivity in the workplace”, I eventually let my boyish enthusiasm overcome my naturally shy nature.

I raised my hand, was called upon, and stood. “Ma’am, I was a steward for the union representing EMS in Da City. My father helped organize the American Newspaper Guild. In the professional labor circles with which I am acquainted, we have a technical term for those who seek to engender collectivity in a previously unorganized workplace. That term, is ‘unemployed’.”

I sat down. Oddly enough, I was never again called upon, for the balance of that semester!

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

PRE REQUISITE OF THE MONTH CLUB AT BHSU

As I had mentioned previously, I pursued, and earned, my BSN some time ago. Oddly enough, THAT is another occasion for one of my stories.

Living in Da Blue Hive, I elected to attend Blue Hive State University, here in The Un Named Flyover State. They had a nursing school, and, indeed, I, myself was a nurse! How convenient! In addition, I lived a mile or three away from the campus.

I therefore hied myself to the admissions office, applied, got accepted (with none of that “we don’t allow our nursing students to work” idiocy), and picked up a copy of the prerequisite courses for starting my journey to BSN-dom. Easy-peasy, I signed up for a class.

Having completed that class, I signed up for the next on my list, secure in the “knowledge” that I was making progress towards my goal. Then I attended some meeting or other that was required for prospective BSN students.

Once there, I picked up a copy (another copy, or so I thought) of the prerequisite list. Idly perusing it as the speaker droned on about whatever, I noticed a course on the required list, that I did not recall being on that list previously.

Once home, I dug out my old list, and compared the two. Yep, sure enough, the list had changed. Indeed, one of the classes that previously (like, 4 months prior) had been required, was now elective.

Fast forward a year, another two classes in my repertoire, and another “prospective nursing student meeting”. To my disappointment, there was ANOTHER evolution in the required list, and, indeed, one of the classes that had been required, that I had indeed taken and passed, was not on the list at all, any longer.

I made an appointment with the dean of the Nursing school. The secretary inquired as to the topic I wished to discuss with the dean. “Career counseling” was my reply. “I’m considering earning my BSN, and I want to discuss it with her, please.”

Okey-dokey, appointment made.

I showed up at the appointed hour, introduced myself, and made my opening conversational gambit. “Ma’am, I’m presently a medic with Da City’s EMS. I’m considering earning a BSN, or else earning a bachelor’s in chemistry. I’d like you to help me make that choice, please.”

“What sort of things are driving you to one election or the other”, she inquired.

“Well, ma’am, I enjoy science, and like knowing how stuff works. On the other hand, I enjoy health care, and seem to pretty well at it.”

She asked, again. “So, what drives you to chemistry as a major?”

“Well, ma’am, one of the attractors is that it appears that chemistry pre-requisite course list is static, in contrast to the seemingly dynamic, changing-every-semester nature of the nursing pre-requisite list.”

She pulled a catalog or something off a shelf, flipped through it, and mused. “It appears that we have changed our list a couple of times in the past couple of years. How is that a problem for you, Mr. McFee?”

“Well, this past week I learned that one class that I took last year, as a required course for entry, is no longer required. Now, I don’t really care one way or the other about your pre-requisite list. What would be very helpful would be a static required course list. Maybe something like, ‘Here’s our required list. If you start on this date, and complete the list by that date, you will be held to this list, right here, for entry to our program’. Because, to tell you the truth, the next time you folks change the pre-requisite list, I’m going to become a chemist.”

I sooner or later completed the required coursework, with satisfactory grades, and completed the program at Blue Hive State University, being awarded my BSN, and living happily ever after, fighting disease and saving lives.

And our school cheer was “Buzzzzz!” Even before marijuana legalization.

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

Hulk Angry!

Years ago, I owned a 1998 Chevy van. It worked out well for our little family, able to seat all four children, TDW-Mk I, and I, along with whatever luggage seemed needful.

After a couple of years, the side doors did not seem to close properly. I took it to the shop, and their determination was that one of the hinges had cracked, allowing one side of the door to sag.

Chevrolet replaced the hinge, and the shop repaired it. Life went on.

Another couple of years, again the hinges failed and the door did not want to close properly. Chevy did not want to pay for this repair. I appealed this decision up the Chevy chain of command, and The Word came down: It had failed because, and I quote, “You had been too rough with it”.

Okay, let’s review. I run around 5 foot seven, and weigh in at around 180# It is NOT “all muscle”. Indeed, my first impression tends to run along the lines of elderly Walter Mitty. The hinge in question is made of around ¼ inch steel. I doubt that I could make an impression on such a piece of steel, if I were to pound on it with a large hammer.

I shared this skepticism with the customer service manager at the dealership. I added, “Why don’t you talk to the decision maker, again? Ask him just how angry he wants to make a guy who can crack ¼ inch steel with his bare hands, and how any such encounter with such a soul might end, should that sort of fellow be really, really pissed off?”

The dealership CSM chuckled. “I was wondering the same thing.”

Bottom line: Chevy customer service sucks, the dealership replaced the hinge at a hefty discount, and I did not go all “Ragnarok!” on Chevrolet’s Customer “Service” hierarchy.

Fun And Games Off Duty · Fun With Suits! · Having A Good Partner Is Very Important!

The Bat Story

It must have been around 3 years ago: the animals are now due for their rabies booster.

So, TINS©, TDW-Mark II and I were lolling around in the living room, she was watching some program or other, I was reading. She nudged me, at one point, and directed me, “You ought to see what it is that has your fat cat running! You know that he never runs!”

She was referencing one of my two cats, that I had acquired as kittens, brothers, and had attached themselves to me. They would, of an evening, begin to direct me that it was time to go to bed, by sitting in the middle of the doorway to the bedroom, and yowling. If that failed to direct my attention where they wanted it, one or the other would sit on my lap, and head butt me, meowing plaintively. The one, Laurel, was, well, “calorically enhanced”, let us term it, and not the most active feline in the neighborhood. His brother, Hardy, well, he would direct me that it was time to play “fetch” wherein I would toss a yarn ball off a ways, he would retrieve it, dropping it at my feet, and then sit as if waiting for me to toss it again.

The night in question, once my Darling Wife had directed my attention from my book and towards my environment, I did, indeed, note the heavy galumphing footsteps of Laurel. She was right, he rarely ran for any reason. I got up, and found him and Hardy settled in, as if pointing, with their attention directed at a small brown furry thing huddled in a corner of our bedroom. Once it moved a bit, I saw the wings, and realized that we had a bat in our house.

I had been an ED nurse for decades at this point, and had the opportunity to administer RIG (Rabies Immune Globulin: an antibody rich solution, to arrest the ability of the rabies virus to infect you), as well as Rabavert (the vaccine, which allowed your own immune system to produce antibodies to prevent developing the disease. The protection provided by RIG is short term, only). I was familiar with the experiences of the patient receiving these medications. In most cases, an unprovoked attack by a dog “that was acting strangely” was the precipitating event. The rest were folks who had handled, been bit by, or had been asleep/intoxicated/helpless in the room with a bat.

Therefore, there was no way I was going to handle any bat for any reason. I left to retrieve my shop vac.

Upon my return, both the bat and my cats, now joined by TDW’s dogs, were collected in a different corner of the bedroom, with TDW providing over watch. I realized that KNOWING where the bat was, would considerably enhance our efforts at containing him, and so I retrieved my inspection camera. This is a camera on the end of a fiber optic stalk, such that you can twist it into a corner not readily visible, to see what is there. I had previously employed it to find, and avoid, wiring and pipes in the wall I was fixing to hammer a nail into. Now, it was my (sorry…) Bat Scope!

The animals appeared to be congregating around one end of our baseboard hot water heating radiator, so I peeked in there. With the scope. Yep, there he was! I handed the scope to TDW, and attempted to entrain him in the air the vacuum was sucking up, but no joy (for me…). I suggested that she poke him with the stalk, to see if he’d move, lose his grip on whatever he was clinging to, and wind up in the vacuum.

Well, once she did, he snarled.

THAT was unexpected!

She was ready to draw down on him, and send him to Bat Heaven on a 9 mm carriage, but I wondered if exchanging an intact (and possibly rabid) bat, for a haz mat scene of scattered bat bodily fluids, each droplet potentially rabid, was really any sort of improvement, at all.

She did not think so, either, after a moment’s reflection.

So, she poked the bat, again.

Of course, he snarled, again, but, this time, he was dislodged, and sucked into the vacuum.

Realizing that this was a good thing, I unplugged the vacuum, sealed the end of the hose with a baggie and duct tape, and secured our unwelcome guest out on the porch. In December. In The Un-Named Flyover State. Where it was around 20 degrees Fahrenheit.

The next morning, I was off, and we took the critters (the ones we wanted to keep, that is!) to the vet. He listened to the story, and agreed that updating rabies vaccination was a good thing. He asked, “You did not handle the bat, at all, did you?”

“Nope!”

“You certain?”

“Yep, damned certain.” Then I regaled him with ED nursing experience on this very topic, and my lack of enthusiasm for recreating it in my own household.

“Do you have the bat?”

“At an undisclosed location, yes.”

“Can you bring it to me, for testing?”

“Yep. See you in an hour!”

One hour later, he returned from his back office, and regaled me with his assessment of things. “It’s a good thing you sealed the end of the hose, because I found him, frozen, about halfway up the hose, as if he was trying to escape.”

The bat was sent off to whatever lab The Un-Named Flyover State employs for this sort of testing, and, shortly thereafter, Things Got Interesting.

I received an anxious phone call from TDW, on the office line (because I shut off my cell phone at work), relating the fact that she had been the recipient of NUMEROUS phone calls from the state Dept of Agriculture, the state Health Department, the Local Veterinary University, our county health department, and those were simply the ones that she had written down the number for.

All these folks were evidently quite concerned that our friend, The Bat, had turned out to be, indeed, rabid, and every one of these folks asked, multiple times, if we had had any sort of contact whatsoever with said bat. TDW had explained multiple times that, no, we had not touched the fracking thing in any way, and elaborated my clinical experience with folks who had not acted from that sort of plan.

That was all cool. What got her wound up, was one soul who had stated that her cat, the one that she had inherited when her father had died, would have to be euthanized and examined for rabies, because she, TDW, did not have vaccination records at hand for this cat.

TDW explained that this cat was NOT going to be euthanized. The caller then directed that the cat would have to be quarantined for six months (or some such). We could do that, keeping the cat indoors (no problem, she was an indoor cat in any event, not going outside at all).

Nope, said TDW’s correspondent, said cat would have to be quarantined at the vet’s office. That meant boarding the cat, for six months. Lessee: that’s six months, at, say, 30 days each, leading to 180 days of boarding. Boarding a cat costs $30/day in our neck of the woods, so that would mean spending (lessee: carry the ‘nought, ‘nought goes into ‘nought, square root of eleventeen…) !!5 thousand, four hundred dollars!!

Holy stool! I suggested to TDW that contacting the vet her father had frequented might be a pretty good idea, long about RIGHT FREAKING NOW!, and seeing if vaccination records could be forthcoming.

She got right on it.

The Patron Saint Of Inherited Cats smiled upon us, as not only did TDW find her dad’s vet, said vet had vaccination records, and said records included vaccination for (Ta-DA!) rabies. Our vet received the records, The Inherited Cat got updated rabies vaccination, and we all breathed a sigh of relief.

I subsequently called a Bat Guy, seeking extermination (er, I mean, REMOVAL!) of all bats from my domicile. When I explained the urgency of the query (ie, RABIES!), I was told that “bats never pass rabies from one to the other.”

Rreeeaaalllyyy? So, bats do not groom each other? (uh, they do) Leaving behind spit? (uh, how would they avoid doing so?) And, saliva does not carry the rabies virus? (uh, THAT would be how humans acquire rabies from bats, ya know! Bat saliva into an open wound of any sort.) Therefore, he wasn’t worried about it.

Nice. That would be one of us, not him, developing rabies.

So, nobody developed rabies, animal or human. No further bats have been seen hereabouts.

Yet.

Fun And Games · Fun With Suits!

The Boiling City Ballet, and Gaps In My Classical Arts Education.

This one time, I was nursing on nights in a Rural ED. TDW-Mark I and our little family were living “Up North” in a small town, outside of a little town outside of a middling sized town that served as the commercial center for that corner of the state. Our small town, let’s call it “Boiling City”, had a bar, a short distance from our no-stop-light town center, and their claim to fame was serving as the region’s titty bar. We locals called it “The Boiling City Ballet”, as a snide reference to the exotic dancers that were it’s main draw.

At this point, I had something like a 15 years of nursing experience, as an ED nurse, ICU nurse, nursing supervisor, all on top of my years on EMS in Da City. I was kind of proud of my “been there- done that” self image.

Remember that thought. As well as the ancient aphorism that “pride goeth before a fall”.

So, TINS©, TIWFDASL©, and registration let me know that there was a patient with a knee injury. I meandered up front, collected the chart, summoned the patient, and invited her to join me in the back. I asked her what had prompted her visit to ER.

“Well, I was doing a pole trick, and landed wrong, and fucked up my knee.”

I goggled at her. “Uh, what?”

She giggled. “I was dancing, I did a pole trick, I landed wrong, and my knee gave out on me!”

BTDT fail on my part. “Uh, what is a ‘pole trick’?”

She filled that gap in my life experience. “I dance at the Roadhouse, out side of Boiling City.”

Ahhh! The formal name for the “Boiling City Ballet”!

“And?” I prompted.

“So, a pole trick is where I do something on the pole, like spin around, and this time I just landed with my foot placed wrong, and my knee started to hurt!”

“Uh, OK. Here, here’s a gown, and I’d get the doc so we can get you examined and x-rayed and everything.”

She was having fun with my norminess. “So, you **DO** know what I do for a living, right?”

“Uh, kind of…”

“So, why do I need a gown? I’ll just whip my pants off, right here and now, just like this…”

I backed out of the room, and shut the door. “No, that’s alright! Just put on the gown, and I’ll get the doc…”

Fun With Suits! · guns · Pains in my Fifth Point of Contact

“The Gun Show Loophole!”

One year, my (very successful) brother rented a house in Some Blue Hive State, so his family could summer there. I received an invitation, that should I wrangle the time off of work, and my own transportation, I’d have a spot to stay and join in the merriment.

TDW was interested, and so I arranged vacation, and purchased plane tickets. One car rental later, and we were off!

My brother is an alumnus of an Eastern Sophisticated University, and, therefore, all of his college buddies are, as well. That trends towards them also being of the Blue Hive Borg, where, evidently, “assimilation is Mandatory!”

All these fellows are attorneys, and, generally, pretty smart. No surprise there, right? So, one evening, after consumption of Tax Stamped Beverages, well, one guy (let’s call him Bob, “not-his-real-name”) overheard The Darling Wife regaling me with her recent visit to an Unnamed Flyover State Gun Show, wherein she had purchased an AR pattern rifle, in 6.8 Rem Special. Good News: She was very excited at her selection, describing her new rifle as “Pretty!”. Bad news: Have you PRICED 6.8 Rem Spl ammo lately? Holy Stool, that is expensive ammunition. Not as pricey as H & H .375, or .416 Rigby, I’ll grant you, but pretty spendy against sixty-cent-a-round .223 ammo.

So, Bob told us what his thoughts about that were. That is, if you could characterize him as “thinking” on that subject. “Man, they ought outlaw gun shows! That gun show loophole is awful!”

I know a thing or two about guns, as does The Darling Wife. She had, after all, just the preceding month gone to a gun show, and purchased a rifle. Indeed, in terms of contemporaneous experience based knowledge, she might qualify, within the confines of that house, as a subject matter expert.

Therefore, I asked Bob, “Oh, really? What is the ‘gun show loophole’, and what is the most objectionable part of it, in your view?”

He apparently was not one to let ignorance of the subject get in the way of a good opportunity to let his “woke” flag fly. “Why, it shouldn’t be allowed that simply anyone can just walk right in to a gun show, and just buy any sort of gun that they want, and then just walk right out!”

“Say what?”

He was gonna repeat himself. “Any sort of drunken lout, or mental defective, or terrorist, or mass shooter, can just walk into any gun show, buy any sort of mass murder machine that they want, and waltz out! No background check, no permit, no nothing!”

I turned to My Darling Bride, and said, “Honey, didn’t you just buy a rifle at a gun show a couple of weeks ago? Why don’t you tell Bob, here, how that worked?”

She smiled sweetly at me, and turned to Bob. “Well, I paid my admission, I walked the aisles until I found that rifle. It looked so pretty, I thought that it ought to be my first AR. I negotiated a rice with the seller. He then needed my picture ID, as well as my concealed carry license. He called the National Instant Check System with my information, and got an approval. He recorded the approval serial number, and then I had to complete a form 4473 before we could complete the sale.”

I invited her to be more detailed in her tutorial for Bob. “So, Honey, what’s a ‘Form 4473’?”

“Well, it is a sworn statement, under penalties of both perjury as well as violation of the federal Gun Control Act, that I’m not a felon, fugitive from justice, mentally ill, an illegal alien, have never been convicted of a crime of domestic violence. There’s a couple of other reasons that I could be disqualified, but they are all listed right there on the form. No sale can move forward without that form.”

Bob could not contain his superior expertise any longer. “That’s just wrong! None of that is required!”

I turned to him. “Really? Why don’t you tell us how it went, the last time YOU purchased a gun at a gun show?”

He looked at me, surprised. “I have never bought any sort of gun, ever! I do not own a gun!”

I feigned surprise. “Really? So, just how did you come by your expertise regarding how things really happen in a gun show, such as to contradict my wife’s recent, personal experience in a gun show? Buying a gun, no less?”

“I read it in the New York Times! They said that’s how it works!”

I looked at my wife, and she at me. I continued. “So, let me see if I heard you correctly. You have never bought any gun, ever, anywhere. You read some bullshit in the New York Times, and that is canonical, for some reason. Based on some perhaps third, maybe fourth hand story, that you think you remember reading, in that noted journal of all things firearms, The New York Times, you are in a solid position to tell my adult wife, sitting right here, that things that she, in fact, and in her own direct testimony actually, really, and recently experienced, did not actually experience. Now, that means that you are either telling me my wife will lie, smiling all the while, to your face, or she is so stupid or mentally defective that she cannot tell what she actually did, at a gun show, buying a gun. Now, mind you, she successfully passed the training to qualify for, and the background check to be issued, a license to carry a concealed handgun from The Un-Named Flyover State. So, pray tell, on what basis does your superior intellect and greater knowledge in All Things Gun, lead you to accuse my wife of imbecility, or lying to your face? Please, go slowly, and show your work!”

At this point, Bob had the wit to stammer, and not answer my questions. My brother, wisely, diverted my attention with some query of firearms law esoterica.

So, therefore, I did not break a stein over Bob’s head.

Although, I still wonder if it might have improved either his manners, or his intellect. Or, perhaps, both.

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

RANDOM THOUGHTS

RANDOM THOUGHT THE FIRST:

I had seen a soul for some malady or another, and had prescribed an antibiotic. In keeping with our usual practice, I had e-prescribed this medication, sending it off to the pharmacy the patient had identified as his preference.

An hour or so later, the receptionist received a phone call FROM THE PATIENT, asserting that the medication was not covered by his insurance.

I receive these calls frequently. Simply so that you know, the mere fact that any particular medication had been covered by one or another of the hundreds and hundreds of different health insurance plans that are out there, by no means establishes that this medication will be subsidized, today. In addition, each individual health insurance plan has it’s own “formulary”, or list of what medications it will subsidize, and to what extent. These formularies differ from Medicare (and among different medicare plans, as well), to Medicaid (and, again, among various flavors of Medicaid), to assorted flavors of private health insurance. Again, formularies vary from one private insurance plan (say, one particular form of Humana insurance), to another (like, one of the insurance products from Blue Cross).

Therefore, it is not uncommon for these calls to come in. Generally, they are from the pharmacist. Then, the pharmacist, who has access to the insurance company’s formulary, can suggest another similar medication that will be subsidized. I will request it, and we all go on about out lives.

When they originate from the patient, it becomes somewhat of a time sink. What, am I gonna tell the patient what the new medication will be, and the dosing regimen, how many doses to dispense, and so forth, so that the patient can communicate this to the pharmacist? (anybody ever hear about, ya know, PRESCRIPTIONS?)

Occasionally, when I have some sort of wild hair up my ass, I am tempted, briefly, to do just that. “Why, thank you for the call, Mr. X! Please tell the pharmacist that I am changing your prescription from Amoxicillin, and instead I will prescribe Mofeen, one pound, and you are to take ad lib and prn until the heat death of the universe! And, you have a nice day!”

My filter has,thus far, worked without fail. I have never told anybody that…out loud.

Instead, what I do, indeed, say, out loud, is “Please invite the pharmacist to phone me, and he and I can discuss it.”

The Second:

I had occasion to phone another physician’s office, in order to have my patient seen that very day. I generally make this sort of call myself, when I need a same day appointment for my patient, because I can either explain all the particulars of the scenario to my MA, who can then repeat it to the other office’s MA, and then have her seek me out when, inevitably, there is some question that I have failed to explain in sufficient detail, or I can do it myself, explaining things once.

I vote for “Once!”

So, TINS©, TIWFDASL©, and on hold/ignore. Eventually, the other office’s scheduler came on the line, and we had our lovely little conversation about my patient’s malady, and why I felt the burning need that this soul be seen TODAY!

Everything proceeded swimmingly, and I noted the time and address of the particular office my patient was to report to. The scheduler asked my name.

“Reltney McFee, PA.”

“How do you spell that?”

“R-E-L-T-N-E-Y, M-C-F-E-E.”

She read back her note: “R-I-A-L-D-M-A-I, M-A-K-A-S-E-E?”

I had not really slept all that well the previous night, and had several people in the waiting room, eagerly awaiting (DYSWIDT?) my attention, so that they could get on with their own days. I quickly calculated that I could get this chucklehead to properly spell my name on the scrap of paper that she would soon discard, or get this patient the hell out of my department, and on to Higher Level Of Care, sooner.

I (unsurprisingly, I wager) went with option “B”.

“Nailed it!”

The Third Random Thought:

My home state, The UnNamed Flyover State, legalized marijuana last year, for recreational purposes. I have spoken, previously, about my rapture at this development. While I have not, completely, cataloged every single way in which I think that this is a fail of epic proportions, perhaps I have revealed just a little bit of my lack of enthusiasm for this development.

A couple of times.

I have noticed in recent months the phenomenon of idiots (er, I MEAN, children of God) evidently wandering through the world stoned. I reached this conclusion because of the numerous folks who stop by my clinic reeking of reefer fumes.

I do not mean, “Hey! If I pay attention, I can detect a waft of a smell, as if of marijuana, somewhere about this person!” Nay, I mean “Dude! Are Cheech and Chong shooting another movie hereabouts?”, or, perhaps, “Is there some sort of Rastafarian festival in town?”

Indeed, occasionally the smoke is eye wateringly intense, yet the purveyors of the fumes appear unaware of the air quality hazard that they present.

I have wondered about that. I suspect one of two things is in operation here. Either they are so stupid, either at baseline, or due to the deleterious effects of marijuana upon their mentation, (maybe, I should embrace the power of “and!”?) that they simply cannot realize what they are spreading in their wake, or else it is some sort of pheromone, at least in their minds, that attracts The Opposite Sex.

Although, to be honest, anybody who would be attracted by the olfactory cues these folks present, I would not romance with your johnston!

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

Insurance Companies and Purgatory

So, over the holidays, we were at a family gathering when TDW-Mark II’s niece (an adult) departed to go home.

Shortly thereafter she returned to inform us that, due to the poor lighting and TDW-Mark II’s petite vehicle, she, the niece, had inadvertently struck my wife’s vehicle, leaving a dent.

BFD, bent metal, no bent people, all good.

So, we went to our insurance company in order to get the bent sheet metal, unbent. We could, indeed, have our insurance pay for it, since our vehicle was parked, BUT!, we’d have a chargeable accident and likely would see our insurance premiums rise. From the currently affordable, reasonable, “Give us all the money and nobody has to get hurt!” levels we currently enjoy, that is.

THAT sounds attractive!

Or, our niece’s insurance company could foot the bill.

The niece made her report to her insurer, and shortly thereafter I had a conversation with one of their genius, script reading (Thanks, Beans on June 3 ’19), slack jawed, pompous personnel.

It seems that, let us call it “County Garden Auto Insurance”, requires that you take your broken vehicle to one of their adjusters for an estimate. In this area, the freaking capitol of the freaking Un-Named Midwestern State, the (insert pejorative here) adjuster only works freaking Wednesdays, and, into the bargain, Young Ms. Mensa informed me that, since mine is the name on the title, well, I would have to show my happy hairy ass up with the bent vehicle for the estimate.

Well, ya know, I work Wednesdays. 12 hours. Days. I told Ms. Mensa as much. “Ma’am, I will not be attending this estimate. I’m working, my wife will be there acting as my agent.”

“Reltney”, she replied (and, as an aside, I had been previously unaware that she and I were quite that chummy), “You have to be there, since the vehicle in titled in your name.”

“Well, Ma’am, I’ll be working, and so my wife will be there with the vehicle.”

“Reltney, you have to be there!”

“Ma’am, I will not be there. My wife will be acting as my agent.”

“Reltney, you have to be there for the estimate!”

“Ma’am, perhaps you should write this down. My wife will be there, I will not. She will act as my agent, and I will be working.”

“Reltney, if you are going to be hostile, I cannot continue to talk to you. I’m simply trying to tell you how this process goes.”

“That’s fine. So, tell me my options.”

“Sir, it you are going to be hostile, you will have to talk to another agent!”

(My thought, at that point, was along the lines of, “Sugar, if you think that I have been hostile, you really, really have a severe poverty of life experience, that, should you desire, I can remedy!” A thought that went unspoken.)

“Ma’am, I thought you were going to tell me what my options would be? I’m waiting for that information.”

“Please hold!”

(lengthy hold)

“Reltney, your wife can meet with our estimator, but we cannot hand her the check. Can we mail it to you, or to your selected body shop?”

“That will be satisfactory. Mail it to the shop.”

“So, Reltney, what arrangements would you like to make for a rental?”

“Ma’am, we have made satisfactory arrangements for a loaner with our body shop. I suggest that you phone them, and have that conversation with them.”

“I do not understand what you just said, Reltney.”

“Call my shop, you have the name. Talk to Bob. Tell him what you just told me about a rental. Make whatever arrangements you wish with Bob about a rental. Bob will fill me in. “

“Reltney, I do not understand that, but I will notate it in our file.”

(Correctly, I hope, but do not trust…)

“Outstanding. Anything else?”

“No, Reltney, have a nice day.”

And the call ended.

Perhaps, the anticipated cluster…er, hug (HUG! Yeah, THAT’S the ticket!) will provide fodder for a subsequent blog post.

My take home lesson, here, is that there are jobs for the dull witted, and I am fated to spend my time corresponding with them.

Damn it!