Fun And Games · Having A Good Partner Is Very Important! · Pains in my Fifth Point of Contact

“Speck’ ah got it figgerred out!”

So, TINS©, TIWFDASL© at Rural Community Hospital ED one fine summer afternoon, nothing exciting (for me, at least: the folks who were here for sutures, or chest pain, likely thought that their dilemmas were entirely more exciting than they would otherwise desire!).

So, this fellow trotted in, carrying a crying child. He announced that the child had cut his head. Our nurse aid escorted the gentleman to one of the carts, and started to look into the problem. I tagged along.

Quick witted, she promptly determined that stapling this child’s head would likely result in a net minima of drama and caterwauling, so she plucked up a surgical stapler, and some betadine, and began to clean up the lac.

The physician arrived, and she briefed him on her findings. Me? I occupied myself trying to get vitals, allergies/meds/medical history on the child from the (clueless) dad. Doc began to perform his own assessment, as the mother arrived.

This elicited another chorus of wailing, tears, and general drama. Predominantly from the child, although the mother contributed her own share. The physician informed the parents that he was planning to staple the wound, once my friend the nurse aid had completed her task of cleaning things up.

“Is that going to hurt him?” was the mother’s question.

My bad, I answered her truthfully. “Yeah, but it will only be 4 pokes. If we stitch it, there will be 8 or more pokes to numb it, and then another 8 or so pokes to sew it up.”

Likely, it was lost when I used the word “numb”. I suspect that she stopped listening at the word “numb”, and failed to do the math. “Oh, I don’t want him to hurt! Can’t you numb him?”

The aid tried her hand. “Well, yeah, but that will require 8 needle sticks, whereas if the doctor simply staples it, there will only be 4 pokes”.

Mom had One Thing on her mind. “I don’t want him to hurt!”

The physician tried. “Ma’am, nobody wants him to hurt. In fact, if I simply staple the cut closed, he will avoid something like 12 additional punctures, and the discomfort associated with those 12 punctures.”

“Please, numb him up! I don’;t want him to hurt!”

Resigning ourselves to our fate, I collected the lidocaine, syringe and needle, and my friend the aid swaddled the child in a blanket.

The kid promptly figured out where this was going, and he wanted NO PART of this ride. So, I set up the doctor’s suture set and lido, and joined the rodeo.

The kid screamed, and he flipped, and he flopped, and he writhed, and he twisted, and he turned. He shook his head, so I was detailed to seize his head, and immobilize it. Mom, to her credit, laid across her child’s legs, and dad laid across his torso, so the doctor only had to zig and zag over roughly 30 degrees of motion as he was injecting the local anesthetic into the margins of the wound.

Did you know that lidocaine, injected into your skin, burns? Yep, burns like a sonuvabitch, for a minute or two. Now, may I watch YOU explain to an 8 year old, that the burning will go away soon, and then things will be numb? Because, he was not listening to me at all, which, of course, assumes that any earthly creature could distinguish my speech over his screams, and cries, and shrieks, and general high volume protestations. Because, I could not.

So, once the doctor had established that the process was going to be pain free (because, of course, the anesthesia had been SO! MUCH! FUN!), the child was going to lay very still for the suturing?

Totally! And, the Democrat candidates for President are not vying to convince the electorate that they, only they, will be the BEST! At providing free stuff to non citizens, as well as college graduates who find themselves in the food industry.

Of course, no. Just, NO! More rodeo nursing, more Brahma Bull On the Suture Table.

Finally, at long last, we were done. The aid unwrapped the (limp)(sweaty)(hoarse voiced) child from the blanket, and we all stepped away, so Mom could hug the child.

She looked at us all, and said, “That was awful! Ohmigawd! I should have listened to you guys!”

I bit my tongue, and shuffled off to the nursing station, to complete my charting. The aid sat down next to me, and said, “Hey! I did my best!”

“That you did.” I replied. Then, taking on a stereotypical hillbilly voice, I continued. “Hyuck, hyuck! Ah’ve bin doin’ this here ‘mergency nursin’ thang for might’ near six, mebe seven weeks now! Speck’ ah got all figgerred out!”

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

Car Fire

So, before Mallory and I had begun to live together, I had one of my ex partners, let’s call him Adam, as my room mate. Mallory would come over from time to time, and the three of us would chat, or share dinner, or simply hangout.

One day, she came into the house, and asked us to hurry out and see what was wrong with her car. Now, this was her baby, one she had purchased because, as she termed it, “I look so good driving that car!” It had been her very first new vehicle, ever.

So, Adam and I threw on some shoes, and trotted out to see what was the matter. She had told us that it was smoking, and once we got outside, it became clear why. The smell of burning plastic emanating from beneath the hood told the tale.

Mallory was starting to get excited, hopping around and beseeching us, “Can’t you guys do something?”

Adam looked the vehicle over, and asked her, “Do you REALLY want us to do something? If we let it burn, or call the fire department, then it will be totaled, and you can get a brand new one. If we extinguish the fire, you are gonna have to get all that burned shit replaced, and it may never be altogether right, again.”

Mallory was nigh unto break dancing by now, and simply couldn’t bear to see “her baby” burn up. Adam asked her again, simply to be certain, “Are you REALLY REALLY sure you want us to do something?Again, she pleaded with us to act. Adam looked at me, I looked at him, and we charged the garden hose, donned work gloves, and sprayed it down through the grill as well as we could. Once it had dampened down, I opened the hood, and stood aside, while he blasted it (or, at least, “blasted it” as much as one is likely to be able to, with a garden hose!). It was evidently sufficient to the task, for soon the smoke stopped, the smell abated, and we were unable to identify any further burning stuff after diligent search.

Mallory called her insurance company, they sent a wrecker, and she got a loaner.

Several weeks later, her car was returned to her. She subsequently had repeated complaints about this, that, or the other thing not performing properly. Soon, she turned to Adam, and admitted, “If I had listened to you, and let it burn, I’d be driving a new car by now!”

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

My Cardiac Cath Story

I once heard the aphorism that “a man who is his own attorney has a fool for a client”. It turns out that legal matters is not the only arena in which that insight is applicable. Let me tell you a story about that.

So, several years ago, The Darling Wife and I were vacationing in Georgia. There are multiple sites, preserving locations where significant battles of The War Between The States/The War of Northern Aggression (depending upon when and where you learned of such things) occurred. I wanted to walk one of the battlefields (Chickamauga), both to stretch my legs as well as to get a feel for the closeness of the opposing forces.

I was winded by the time I finished my rambling over one section of battlefield, considerably more so than I had expected. I chalked it up to “bronchitis”. (remember that thought!) This persisted as I wandered from site to site, and paused to read the explanatory tablets set here and there.

We finished our vacation, and returned home. There, my “bronchitis” persisted, until, eventually, my Long Suffering Wife asked me about my illness. I admitted that it had not improved, which was curious since I had been having this “bronchitis” for about a month by then.

“How’s your fever?”, she asked.

I did not have a fever.

“Is that common when you see a patient who has had bronchitis for several weeks?”

No, I admitted, it was not.

“So, get your shoes.”

“Why?”

“Because, if you do not, your feet will become muddy”

“Why would they get muddy?”

“When you walk to the car.”

“Why would I be walking to the car?”

“Because I’m not going to carry you there.”

“Why do I need to go to the car anyhow?”

“Because it is too far to walk.”

“Where is too far to walk?”

“Your doctor appointment.”

“I don’t have a doctor appointment!”

“Oh, yes you do! Your wife made one for you!”

“Why did you do that?”

“Because she (my PCP) is not going to come here to see you, that is why.”

“Why do I need to see her?”

“A couple of reasons. First, to get you to stop asking dumb questions. Secondly, because you are sick some kind of way, and your plan is not working. You are going to talk to your doctor, and listen to her plan. And, then, act on it.”

I went to my doctor (actually a Nurse Practitioner, with whom I had ER nursed), who did an EKG, “because you are old and all.” “Well”, she told me, “This looks pretty OK, but, your story is concerning. I’m gonna schedule you for a stress test.”

Cool story. So, I arrived the next day in my running shoes and running shorts, and proceeded to tank the stress test. I mean, I did not even finish the first stage before the physician administering the test stopped me, repeatedly took my vitals, and called cardiology.

Next week, I’m sitting in the cardiology office, and the cardiologist is admiring my EKG, and enjoying my Tale Of The Failed Stress Test. He told me, “My partner will be waiting for you, to do a cardiac cath, at 3:30 (it was now about noon).”

Okey-dokey! So, I went in to my cath, with The Darling Wife and her BFF waving me farewell.

When I awakened, it was like a family re-union. Darling Wife, her BFF, her niece, my second son, my third son, my daughter, and something like 4 or 5 other folks, family in one way or another, who I cannot recall off the top of my head. Once I had sobered up enough for The Darling Wife to brief me on the doctor’s report, her precis was sobering: “You had 95% of your main artery in your heart blocked, but they were able to open it with a balloon and a stent. The doctor said had you waited a few more days, you would have had a big, bad heart attack, and, where that blockage was located, you heart would have stopped. Missed it by That Much!”

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

The Great Chocolate Explosion Of 2018

So, TINS©, TIWFDASL©…. Well, alright: I wasn’t FDASL© in this story, I was in my kitchen, fixing to cook some fudge.

The women in my office (where I was a mid-level in an urgent care) had been teasing me about my domestic abilities, and so I had threatened them with offered them home cooked fudge.

The recipe I selected required that I melt baker’s chocolate and butter in a double boiler. Of course, I did not have a double boiler. Instead, I selected two pans, poured some water onto the one, and settled the other into the first, and turned on the range. I noted, in passing, that the fit seemed a bit tight, but, whatthehell, I did not act on this insight.

Remember that thought.

So, I arrayed my ingredients on the counter, and then checked on the progress of my chocolate melting. Experimentally, I wiggled the top pot. At that point I noted a seemingly tight friction fit, and told my wife, washing dishes behind me, that I was starting to be a bit concerned about that. My words were, prophetically enough, “Boy! I sure hope that this top pot doesn’t suddenly loosen from where it is stuck, here! That could be messy!”

My wife came over, gave it an experimental wiggle herself, and concurred with my assessment. “Yep, might want to turn the heat off!”

Of course, I did not. Bright idea, right there!

I diddled around in the kitchen for a few minutes, and then went back to my double boiler/pressure cooker (without release valve). I was explaining to my wife how I planned to safely extricate the top pot from the lower, when my explanation was interrupted. By the top pot ABRUPTLY separating from the lower. At speed. With force. And, with a considerable “BANG!”

The next thing I knew, I was holding the handle of the top pot, with molten chocolate running down my face. I turned from the stove, depositing the pot into the sink, and noted that more liquid was running down my face. Wiping it, I discovered that it was blood. Nice. I returned to the stove, and my wife saw the blood herself.

Ohmigawd! You’re bleeding! You’re on blood thinners! We have to take you to ER!”

Let’s turn off the stove, first, ok?”

She was fixated on my bleeding. “You have to go to urgent care! You’re bleeding!”

I was still sorting out what had happened, and what ought to be done, first, and then next, etc. “Honey? I sort of do this for a living, right? Let’s sort out what’s happening, and then decide what we indeed have to do, first, okay?”

But, you’re bleeding!”

I’ve already figured that much out, thank you. Now, let me take a second to see how badly I’m bleeding, and what else, if anything, is going on, before we panic. Once we know what’s happening, THEN we can panic, Okay?”

She hustled me into the bathroom, and handed me a towel. I sponged off the majority of the blood and chocolate, and saw a superficial appearing wound in the center of my forehead, approx 2 cm long. The blood appeared to be sluggishly dripping from it, and I did not see any other injury. Palpating, I did not feel anything suggesting a depressed skull fracture. My vision was at baseline, I had no numbness or tingling. My ears were sort of ringing (some of that was not new, some of that was readily attributable to the explosion). Otherwise, aside from chocolate EVERYWHERE, I appeared to be unscathed.

I applied some direct pressure, and the bleeding stopped after a couple of minutes.

The Darling Wife and I re entered the kitchen, and set to cleaning up the largest chunks.

A day or two later, my wife and her daughter in law were detail cleaning the kitchen, and discovered a large chocolate chunk behind the stove, and another on the top of the refrigerator. How the heck did they wind up there?

guns · Having A Good Partner Is Very Important! · Life in Da City!

“Just wait a while. He’ll stop doing that!”

So, TINS ©, while I was FDASL© as a medic for Da City, this one crew had gotten a run on a jackwagon who had engaged in a shoot out with the DCPD, and had lost. The story ran that he had shot at officers, secured cover behind a utility pole, and then had exited cover to fire, again, at the officers. It seemed one of the officers had, indeed, paid attention at firearms qualification, because Mr. Gonnashootacop received a bullet in his face, that exited the back of his head and took a substantial portion of his brain along with it. Not an outcome likely to promote his long term high level wellness, in my opinion.

It seemed to appear so as well, to the EMS crew that caught the run, as they determined that he was DRD (“Daid Raht Dere!”, as we say it in Da City), and they went in service and left the cadaver to the care of the investigating officers.

Unfortunately for that crew, Mr. Gonnashootacop had not attended to that memo, for it was told that after EMS had departed, he took another (final) (agonal) breath. The officers, unsurprisingly, freaked the phenomenon out, called for another ambulance, which crew read the writing on the wall (which explained, “This Way To Department Charges And Unemployment!”) and transported Mr. Gonnashootacop to the friendly local ED, where he was pronounced (again), this time by a physician. Finally.

The story continued relating that the first crew was granted 6 weeks of unpaid time off, in order to allow them to fully deliberate upon, and repent from, the error of their ways. The rest of us recalled the aphorism that “there is no teacher like experience, and a fool will learn no other way”, and figured that OTHER PEOPLES’ EXPERIENCE would work just fine for our own educations, thankyouverymuch!

That touching little parable, leads into a tale of (nearly) my own. I was, at the time of this tale, working a three medic house, with Marielle, and Tim. Tim was a new hire, and had come to the department as a transfer from being a bus driver for Da City. It came to pass that I had/took a day off, for one reason or another, and, when I returned, I entered the firehouse to find an very, very agitated Tim.

“You sunovabitch! Where the hell were you yesterday?”

“Uh, I had the day off?”

“Yeah! And you left me with Marielle! Did you know that she is crazy?”

“Uh, she hasn’t struck me as significantly more crazy than any of the rest of us.”

“Well, let me tell you what happened, yesterday! We caught a shooting, and once we were on the scene, found that this dude had been shot in the head. Pretty bad, most of his cranium had been emptied. It was my day to drive, and so she was on the bag (doing the patient care). So, she sauntered up to this dude, looked him over, and turned to go. I was a bit behind her, and so didn’t really contact the guy, myself, at all. I heard her say that he was dead, and so we wouldn’t be transporting him. While she was standing up to go, he took an agonal breath. Well, the cops freaked out, and started yelling, ‘He’s alive! He’s alive!'”

“She turned back to him, shined her light into the gaping hole in his noggin, showing that there was not hardly any brain left, and said, ‘Oh, just wait a while. He’ll stop that!'”

“Dude! I cannot afford to be suspended for a month and a half! You gotta talk some sense into her!”

Nice. Don’t give me a Herculean task, or something!

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!