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

Paying Attention Is Important

So, TINS (c), TIWFDASL (c), and working in Da Corridor. This was Da City’s, well, let us say, in paraphrase of the immortal words of Old Ben Kenobi, “Da Corridor: You will never find a more wretched hive of scum and villainy!” So, not the nice part of Da City.

I was working “The Corridor”, and an academy classmate, let us call him Gordon Lightfoot, was detailed in that day from another house. At this point of time, TBTCIDC was closed, as they were in the midst of moving kit and caboodle to the shiny, new, and in-the-medical-center hospital they had just opened. (Well, it had not been opened, just yet, and that little detail will figure prominently in this tale!) The hospital that was TBTCIDC’s “stand-in” was NOT generally the trauma center, but was in the medical center.

We caught call after call, transported sick (and a lot of not-so-sick) people, and generally saved lives. Our next run was on an asthma patient, and off we went. In fact, this particular address was only a block from the medical center.

We arrived, announced ourselves, and acquainted ourselves with this person’s malady. I brought the stair chair, and we wheeled this soul out to the ambulance, and settled them onto the cot. I had JUST entered the cab, preparatory to a leisurely trip to The Stand In Hospital, when Gordon stuck his head through the window connecting the cab with the patient compartment, and bellowed, “Reltney! He’s arrested!”

I hopped around to the back, and helped Gordon get set up for a spot of in transit CPR. Once he was set, I re entered the cab, and called dispatch: “Medic One, Code One, Stand In Hospital. Cardiac arrest, witnessed. Eta One Minute!”

Dispatch acknowledged. I tuned in the hospital alert frequency, and called: “Stand In Hospital, come in for Priority One traffic!”

They acknowledged, and I started my turn out into traffic, lights flashing, and siren wailing. “Witnessed cardiac arrest! CPR in progress! ETA one minute!”

The nurse on the radio was not clear on the message. “Say your ETA?”

“Open the doors! We’re here!”

Duty · Having A Good Partner Is Very Important!

PROFESSIONALISM, PART II

So, Carmen, my grand daughter, had a couple of additional Magical Mystery Tours of Peds ICU. Brenda, her mom, wound their way through the maze of physicians, and specialists, treating, and attempting to diagnose, what was underlying our recurrent Monday-evening-Grandpa-visits.

Eventually, one of the specialists determined that a surgery would mitigate Carmen’s breathing difficulties, and so a surgical date was set, in a distant Big City Medical Center. Brenda told both of her parents, and her conversation with me went along the lines of “Dad, so Carmen is going to have surgery on (date), at Big City Pediatric Hospital.”

(Dad): “uh huh. I’ll be there.”

(Brenda): “Uh, Dad? So, Mom is gonna be there, too.”

(Dad): “Uh huh. Why would there be any question about that?”

(Brenda):”Well, I know you guys are going through that divorce, and things might be…tense..if you were both in the same room.”:

(Dad):”Well, Honey, your mom is a grown up professional, I flatter myself that I am a grown up professional, and while we are there with you, for that time, what I think about your mother, or what she thinks about me, well, nobody cares. This is about you and Carmen, and nothing else is on my plate for that time. I don’t anticipate any drama coming from either of us. I know I won’t cause any drama, and I am confident that your mother will not, either.”

So, we met at the appointed time, and greeted each other. Carmen received her IV, and was pre medicated, and rested on her mother’s lap, soon falling asleep. I have a photograph, somewhere, of Carmen, relaxedly asleep, on Brenda’s lap, Brenda appearing fatigued herself.

Carmen went for her surgery, and returned, post operatively. Carmen had an uneventful post operative course, and Brenda took her child home. Today, a dozen years later, Carmen is newly adolescent, The Big Sister, and perfectly healthy.

Oh, and my pre and post op interactions with The Plaintiff? Benevolent, professional, and child (and grandchild) focused. No drama.

Gratitude · Having A Good Partner Is Very Important! · Sometimes You Get to Think That You Have Accomplished Something!

“He Didn’t Have To Be”

Well, campers, the sun is shining, it is 40-something outside, and that means that, in The Un-Named Flyover State, it is time to start sunbathing!

Well, almost, but not quite. In any event, it is time to reflect, gratefully, on the looming advent of spring. And, that turns me back to my recent theme, gratitude and thankfulness.

In 2006-2007, The Plaintiff divorced me. It was a dark time. I had taken-for-granted (perhaps, one of our problems, right there?) that she would always be there, and that we would always work through our rough spots. I was, of course, mistaken, and the divorce provided irrefutable evidence of same.

I was immersed in depression, and found myself weeping at traffic lights, for example. (Has anybody else experienced the angst, the melancholy, pouring out of a RED LIGHT?) (uh, no? oh, ok. Maybe it was simply me…..)

It was in the midst of this self pity party, that my step daughter (who I have everywhere else referred to as my daughter, as that is how I view her, notwithstanding the fact that she has none of my chromosomes) made for me, and gave me, a Christmas gift, that I treasure to this very day.

Brad Paisley has a song, on his Who Needs Pictures album, entitled “He Didn’t Have to Be”. The narrative is a step child (in Paisley’s, and his co writer’s case, a son), who gets included early on in his single mother and (to be) step dad’s activities, and how that forms a family. My daughter copied that song, and created a slideshow, set to that song, of photographs of my children, their mother and I, as our own family formed, and grew.

I wept. At the time my daughter created that slideshow, she was, herself, a single mother, working full time, as well as going to school full time. Her child, my oldest grand daughter, had spent more than a little time in pediatric ICU. My daughter had spent who knows how many hours collecting those photos, organizing them, arranging them, including that song, knowing that it would touch my heart, perhaps knowing, even, that I *needed* that memoir.

That was the single nicest, most apt, most engaging Christmas present, that I have ever received. She gave it to me for Christmas 2007, and I played it, again, today.

Over 13 years later, I wept, again. Thank you, honey. You have touched me, again. Still.

For so many reasons, I am grateful for my children.

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

Kharma

This looks like it’s going to be a lengthy spiel. Hope y’all are ready!

Perhaps, in previous ramblings, I have touched on the assertion, I credit it to Ragnar Benson, relating that, if one were to consider the deaths and illnesses attributable to contaminated water supplies, it is not unrealistic to consider that it is entirely likely that plumbers, and assurance of safe water that is their stock-in-trade, have preserved more lives, and done more to alleviate human illness and suffering, than all the physicians ever born.

I remember this thought every time that I am credited with saving lives, or some such stuff. I am as good as I am, in large part due to the folks with whom I work.

And, then there is the lay-of-the-land aspects that can accompany cordial relations with your co-workers.

So, TINS©, TIWFDASL© in a walk in clinic in Da Nawth Country. It had been somewhat tumultuous , negotiating with my locums company, as they had contracted that I start on “Date A”, yet, 4 or 5 days prior to “Date A”, had informed me that things were not organized as needed, and some aspect of my credentialing was awry, and therefore I was not going to start on “Date A”. Therefore, I was not going to be getting paid, starting on “Date A”.

I acknowledged this tidbit. I asked when they anticipated my starting work, and starting receiving pay.

My recruiter could not tell me.

I noted that I had a contract stating that I would be working for The Locums Company, starting on “Date A”, and I anticipated starting to receive pay from The Locums Company, beginning on “Date A”.

The recruiter protested that, since I was not fully credentialed, I could not work, and therefore I would not be getting paid until all these wonderful things came together, and I was, indeed, working.

I set a limit. A hard limit. “Well, simply so that you understand how things will work, *SOMEBODY* is going to be paying me, starting on “Date A”. Your input into this conversation, is will it be The Locums Company, or will it be somebody else. And, just to make everything even plainer, whoever is paying me on “Date A”, will have my loyalty. That means that, if you folks are *NOT* the ones paying me, and you abruptly get your shit together, and invite me to start working at your client’s clinic, well, I am not about to pimp the folks who are providing me with a paycheck, simply because your organization is so grabasstic that you cannot get your credentialing in a group, by the date that *YOU* specified.”

He sputtered, “We have a contract! You have committed to work for us!”

I had read that contract. “Yep. You committed to pay me for my clinical services starting, oh, next Monday. Now come you, to inform me that you are not planning to pay me, starting next Monday. Now, I am not a lawyer, I do not play a lawyer on TV, and I did not stay in a Holiday Inn last night, but it certainly appears that you are proposing to breach one of the foundational elements of your contract, and thereby nullify the entire thing. If you are paying me, then my time is yours. If you have breached that contract by not paying me, then you can go piss up a rope.”

He continued to sputter. “I cannot simply approve paying you for not working.”

“Cool story. Howzabout you speak to somebody who can, indeed, authorize you to abide by the terms of your contract, and let me know how that turns out? As for me, I’m looking for work. If you get your shit together before I find other work, perhaps we can move forward in a mutually profitable way. If not, well, toodle-oo!”

The call terminated. I placed a call to Another Locums Company, with whom I had worked, and who had demonstrated that their stool was, indeed, in a pool. That recruiter and I had a cheery chat, and she promised to see what they had available, and call me back as soon as possible.

The next day, The Locums Company recruiter, who triggered this rant, called me back, breathlessly informing me that they *WOULD* pay me, as if I was working 40 hours, 9-5. In return, I would be on a 24 hour alert to report to the client clinic, upon The Locums Company’s notification that all had been ironed out. His tone was consistent with “…and don’t you try to weasel your way out of it!”

My response was, “Well, if you are paying me, then my time is yours, and I will be available to report for work as soon as is reasonable. 24 hours sounds reasonable.”

So, I hung around, puttering around, and after a couple of days, received The Call, shortly followed by a call from The Client Clinic. These worthies articulated concern. “Uh, you know we are up north, right?”

“Yep. I kind of had figured that out, in the course of the interactions with The Northern State Licensing Authorities. Those conversations led me to assume that this placement would be in The Northern State.”

“So”, they continued, “It’s January, and, well, we get snow here.”

“I had assumed that snow had something to do with your state’s reputation as a skiing destination.”

“So, have you ever driven in snow?”

This was surprising. If somebody had read, oh, the FIRST 6 INCHES of my FREAKING RESUME, it is exceedingly likely that this reader could figure out that I had spent considerable time in A Northern Fly Over State, wherein, every year, there was an abundance of snow on the ground for, oh, heck, 5 or 6 months of the year. My response did not, however, convey this surprise. “Uh, yeah, some.”

“Are you comfortable driving in snow?”

Another aside: it occurred to me that this particular line of inquiry might have been useful, say, during the freaking phone interview. Not the goddamned day before I was to drive my clinical ass up to start work. Again, my response was milder than my thoughts. “Yeah, I’m Ok with driving in snow.”

But, they were not going to let this go. “Are you sure? We really get a lot of snow, you know!”

I was over this line of conversation. “Look, I grew up in A Northern Fly Over State, we get assloads of snow every winter. If you have seen my resume, you will realize that, not only did I learn to drive in that state, I worked my way through Nursing school working for EMS in Da City in that very state. My children were born there, and every one of *them* learned to drive in the winter, in the snow. Since this is not Fairbanks Regional Medical Center, I am pretty sure that I have seen me some snow, and that I can handle it.”

I packed up my stuff, and set out for The Client Clinic.

I got oriented, and was introduced to the EMR. On my first day in clinic, I introduced myself to the registration staff, and the floor staff. Between patients, we swapped stories. This MA was prepping for Nursing school, that one was in undergrad for business. This other one was a survivalist, and prepping for The Zombie Apocalypse. (Kindred spirit, right there!)

A couple of weeks into the contract, things were tranquil. My MA asked me if I knew why my predecessor had quit, abruptly.

I allowed that I did not know all that much about it, simply that this soul had departed with inadequate notice.

Her eyes lit up. “Ahh! You need ‘The Rest Of The Story’!” She informed me that my predecessor had discovered that he, the clinician, had not been accredited with two of the most common third party payors in that area, and, since they were something like 70-80% of the payor mix, not receiving payment for care of those patients would present a cash flow problem of significant proportions.

It seemed that the clinic had elected to have this clinician’s visits billed as if another, credentialed, provider had in fact seen, interviewed, evaluated, diagnosed, and treated those patients. Since this was not exactly accurate, it potentially could get ugly. Very, very ugly.

When it appeared that this clinician would not see that situation remedied, right stat like, that clinician elected to remove himself from that particular pot of stew, immediately. Hence, the opportunity which featured me fighting disease and saving lives.

I spoke with my recruiter at once, and observed that, he either would provide satisfactory evidence that I was, in fact, credentialed with these payors, or I would unass that scene so fast that The Flash would ask, “What the fuck was that, that streaked right past me?” And, he did not have a lot of time to convince me that this was actually so.

An hour later, he not only effusively professed my actual credential-hood, he e mailed me copies of supporting documents, such that my black heart was grudgingly convinced that it was truff! (pronounced “True-ff”)

And that, boys and girls, is one reason that I treat my floor staff, and other co workers, nicely. That, and it is simply good manners.

Gratitude · Having A Good Partner Is Very Important! · Sometimes You Get to Think That You Have Accomplished Something!

Guardian Angel, Working Overtime

So, TINS©, TIWFDASL©, working a weekend gig in a very, very rural corner of The Un-Named Flyover State. I was a mid-level in, completely out of character for me, a very, very rural hospital’s (VVRH) walk in clinic. I was working with an LPN, a woman of sense, alertness, and industry. Sometimes, Blessings are not obvious.

So, mid morning, she gave me report on Our Next Contestant. Late 20’s fellow, had complained of back pain for a week or two, and he attributed this pain to “I pulled my back, working out doors”. So, this was long about February, and in VVRH’s catchment area, it was mighty freaking cold. Snow, long about hip deep, lined the roadways, and the roads, themselves, had been plowed, and, in keeping with Flyover State Rural Road Commission Operating Procedures, had *NOT* been salted. Since everybody got their water from wells, and most of us thought that salting our water was ill advised, the roads had some sand applied, “upstream” of intersections.

I listened to the vitals, and noted her assessment that “this guy doesn’t look right”. I entered the exam room, introducing myself. He told me that he had started to hurt a couple of weeks prior, the pain in his back, described as “Like something tearing”, had increased with time, despite his employing the ever popular intervention of “ignoring it, hoping it would go away”.

Having concluded on this beautiful sunny 8º F day, that is was *NOT* going to get better, he had WALKED three miles into town, by his estimate, seeking help.

He had muscle spasm in his back, true enough, but something about his story sounded several degrees out plumb. I palpated his belly, and felt something therein pulsing away. He also reported that my pushing on his belly, made his back pain worse. I was not certain what it was, but I was pretty sure that this was way, sway above my pay grade.

I phoned the ED physician, spun my tale of oddness, and he accepted my patient. My nurse wheeled him down the hall to Emergency, and we plodded through the rest of our day.

Nearing the end thereof, the ED physician walked in my door, and told me a story, featuring my long walking friend. He, the physician, had also thought that the examination, along with the back pain, was odd, and so he, the physician, had CT’d my patient. That study revealed a honking big, seriously dilated abdominal aortic aneurysm (a dilation of some part of the aorta, in this case in my patient’s abdomen).

For those in the studio audience who are not medically inclined, the aorta is the single largest, highest pressure, artery in your entire body, running about 2 cm in the area just below your diaphragm, about at the level of your renal (kidney) arteries. Those of us who have studied the US Military’s tactical trauma care course, or have had some sort of “care under fire” training”, will have learned that, should the aorta be penetrated, either by projectile or through a rending of it’s wall, the entire blood volume of an adult male (running around 5 quarts) can empty out in something approaching a minute, plus or minus. One thing that places you at risk of experiencing that, besides the projectile-through-your-aorta thing, is having a large aortic aneurysm abruptly rupture.

Of course, in VVRH, there was no abdomino-thoracic surgery service. My friend the ED doc attempted to arrange a transfer for this fellow, only to be SOL (Surenuff Outa Luck). The roads in our corner of the state were being snowed in, and therefore ground transport to pretty nearly anywhere was not going to happen.

Doc cast his net more widely, and more widely. Adjacent State Big Time Medical Center would accept him, but, alas, we would have to figure out how to beam him up transport him there. Middling Outstate Medical Center could not accept him, since they had no vacant ICU beds, which our new friend would certainly require, assuming he survived (a) the trip, (b) the surgery, and (c) the post op period. Any one of which could end him.

Next Up Upstate Medical Center, alas, similarly had no ICU vacancies, and so, finally the physician negotiated a transfer to Downstate Academic Medical Center, who, miraculously, sent a fixed wing aircraft and critical care transport team to our little single runway county airstrip.

A couple of weeks later, I was working a weekend as was the physician in question. He made a point of strolling over , and relating the above to me, both because it was remarkable that the patient had not only survived the trip, as well as the surgery, and the recovery, into the bargain, but was home, and evidently neurologically intact. The doc knew this, because this fellow had come into ED seeking care for a sprain or some such thing, that he had newly acquired, working outdoors!

Duty · Gratitude · Having A Good Partner Is Very Important!

GRATITUDE

My mother died last month. She had passed her 100th birthday, and was living in the house she had occupied for something like 40 years. The immediate trigger to her death was liver failure, occasioned, most likely, by an adverse interaction between anesthetics and a century old liver. She had fallen, a couple of days prior, and fractured her hip. The surgery, fortunately, was for this sort of thing, uncomplicated, and she evidently tolerated the surgery side of the affair pretty well.

That is to set up the following deliberation. Gratitude. My mother was able to spend her last months in her house, because my youngest brother pretty much dropped everything, and moved in with her. The woman who has been his family’s housekeeper for something like a generation (from well before The Plaintiff became The Plaintiff, in fact!), also dropped her comfortable daily routine, and became my mother’s de facto practical nurse. Wordy as I am, I am unable to adequately describe my gratitude to my brother, and (let us call er…) Angelica. I thanked them both, even though my brother sloughed it off, “You would have done the same, if you had been able. Hell, you *did* do the same, for Dad.” Angelica simply smiled, sniffled a bit, and turned away.

Mom was able to live pretty independently in the two years prior to that, due to my middle brother, and his wife, let us call her “Donna”. Due to Donna’s efforts, in particular, Mom was able to live in her own apartment, have her dog with her, and, generally, run her own life. Donna made certain Mom got to her doctor appointments, got and took her medications, had her clothing laundered, had food in her frig, and that the dog got walked. All this on top of running her, Donna’s, own household, and helping her husband, my brother, run his business. Thank you.

Prior to that, well, there are, and were, neighbors who looked in on Mom. Then, there is The Car Service Guy. https://wordpress.com/post/musingsofastretcherape.wordpress.com/431 During one power failure (different from The Car Service Guy story), her neighbors physically took her in, where she stayed at their house, warm due to their generator, eating their hot food, and remained until the power was restored. Without these folks, not a one of whom was any sort of kin to my mother, she could not have lived in the house that she loved, for as long as she did, as nearly independently as she did. Thank you. God Bless you.

Police officers in her town, on a couple of occasions, looked in on her at my, and my brother’s request, and reported back that she had been fine. Thank you.

Several of my youngest brother’s friends, living “only” one state over, would drop in on her a couple of times a year, helping make sure that she was getting on alright, and providing an “eyes on” report to my brother. Thank you, as well.

I have to say, the shriveled vestigial organ where my heart may have once resided, is warmed by the good example of these folks. Not for them the bullshit “You voted for Trump! Demon!, or “You voted for Biden! Traitor!”, pejoratives that seem to pass for political discourse. Simply, good people, watching for their neighbors, and living the admonition, “Whatever you did for one of the least of these brothers and sisters of mine, you did for me.”

Good people, good examples. Thank you.

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

“Show Me Some Teeth!”

One afternoon, I came in to my shift as a nursing supervisor, and the director of nursing had, it appears, JUST finished receiving a phone call asserting that somehow, the hospital staff had lost some patient’s dentures. Of course, I was the High Value Target in that particular free fire zone, and I caught the assignment. “McFee! You find out what happened to this patient’s dentures! Do not rest until you find them!”

I promised my best efforts, and was reprimanded. “I do not want your best efforts! I want you to show me some teeth!”

Uh, Ok. Yes ma’am!

I inspected the patient room, freshly cleaned by housekeeping. No dentures. I went to billing, the keeper of the valuables, and searched for property that had remained unclaimed. No dentures.

I interviewed our laundry folks, and inquired regarding foreign objects in the washer or drier. No dentures.

I inspected the patient intake form, cataloging the patient’s property at arrival. Of course, there was indeed a notation that the patient had brought her dentures with her to the hospital.

I took a break, and visited the security supervisor. We chatted for a bit, until he asked why I had not been wandering around, and had not been in evidence that shift.

I told him the Story Of The Missing Teeth, and my efforts to transition that tale into a dental retelling of The Prodigal Dentures: “Rejoice! My teeth, that have been lost, have been found! Kill the fatted calf, prepare the feast!”

Along with my, thus far, horrible fail in accomplishing it.

He sat back, and a thoughtful look crossed his face. “So, Reltney, do you need to find THE teeth, or just any teeth?”

I observed that the patient in question might feel a little, well, odd, wearing somebody else’s teeth.

My friend the security supervisor opened his safe, and extracted some ancient dentures. He then clarified things for me. “See these green teeth, here? Now suppose they were inadvertently dropped outside the door here, in the driveway, and some inattentive security officer, like, say, me, were to accidentally run them over, like, six or eight times? I doubt that anybody would put the shards into their mouth, you could show your boss teeth, albeit broken teeth, and so she would be happy, the complaining patient would get new dentures, so they would be happy, and your boss would stop breathing down your neck, and so you would be happy. How many opportunities do you think you will get to make that many people happy, all at once?”

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

Phone calls that make you go”WTAF??!!”

So, TINS, TIWFDASL as a nursing supervisor in a small hospital in Da City. I had checked our afternoon staffing, and accounted for all the staff. I had wandered around, meeting and greeting my staff, and made arrangements such that everybody could eat. I checked in with security, and, as usual, there was nothing happening.

I was back in the nursing office, completing some paperwork or other, and received a call from the switchboard. The operator informed me that Channel 69 news was calling, asking about some patient who had fallen out of a window at our facility. I told the operator to send the call to me, and stat call the security supervisor to meet me in my office, RFN.

The call was odd. (Now THAT is a surprise, idn’t it?) The caller identified herself as a reporter for one of the local stations, and that they had received a report that a patient had fallen from a window, and landed on a roof of part of our building. I responded that this was inaccurate. I knew this to be inaccurate because, in the event that such a thing had occurred, the staff would call me immediately, no such call had been placed, therefore no such thing had happened.

We concluded our conversation, and I turned to my friend the security supervisor. I asked him to immediately inspect our roofs, either in person or with one of his officers doing so in person, and ascertain the absence of anybody (or, any body) on any of our roofs. He hopped right to it.

Next I called each of my charge nurses, and ordered them to immediately, with no delay, personally lay their eyes on each and every one of their patients. They were ordered to immediately call the switchboard to report that they had indeed personally laid eyes on every one of their patients, or stat page me overhead in the event that any patient was not physically on their unit.

One charge nurse protested that she was too busy to perform this task. I noted that this was what we termed “a work order” in our employee handbook, and her options were to get to it, right now, or prepare their soliloquy for 0900 the following morning, wherein they would have the opportunity to convince the director of nursing that they should, indeed, continue their employment at our hospital. Because ANY other response other than “Let me go, so I can get to this”, would result in their being clocked out and escorted from the building, right about now.

Surprisingly, that elicited compliance.

The security supervisor paged me, requesting that I meet him in the cafeteria, that being about the center of the hospital. I arrived and he briefed me: his officers had inspected the roofs, and noticed nothing awry. A couple of his officers had shanghaied the maintenance man, and secured a ladder. They were going to climb up and re-inspect the accessible roofs, to verify what their preliminary survey had suggested. And, nobody/no body had been found.

I physically went to each nursing unit, spoke with each charge nurse, and had them show me their census, along with a report of their actions to inspect each patient. No missing persons. Hallelujah!

I phoned my immediate supervisor, and gave her the short form report. Of course, the long report, in five part harmony, with full orchestration, with circles and arrows and illustrations to fully communicate the entirety of the affair, was waiting on her desk for the morning.

Duty · guns · Having A Good Partner Is Very Important! · Pains in my Fifth Point of Contact · Pre Planning Your Scene

Self Defense Cost Benefit Analysis

TINS, TIWFDASL, I had caught the detail, and the happy go lucky soul with whom I was working that particular night on Da City’s EMS, decided it was time to ask me about my ballistic vest. Now, it was not any sort of secret among members of the department that I wore a kevlar vest. After all, in Those Days, Da City was known as “The Murder City”, and not without some justification. We chatted about the threat profile we confronted (although, the chat went along the lines of “What? Do you expect to be shot?” My response was “Nope. I wear this for those scenes on which I do NOT anticipate being shot. On those on which I anticipate being shot, I will simply refuse the run until the police have secured the scene!”)

This guy, no doubt thinking himself clever, pronounced, “Well, if the scene goes to shit, I’ll run out, and you follow me! That way, your vest will protect both of us!”

My rejoinder was, “In that case, you had best be certain that you do not slow down, lest you have my bootprints all up your back, as I run you over!”

Later, my partner and I discussed the vest and EMS. He asked, non-snarkily, how I had come to the conclusion that the vest was the way to go.

I noted that the vest cost me about as much as a Colt Government Model in .45 acp.

It was not a felony to wear the vest concealed, in contrast to the Colt.

It was not a black letter violation of department regulations, in contrast to the Colt (or any other firearm).

The vest would not inadvertently discharge, in contrast to the Colt, where that was a potential problem.

The vest was not going to drop out of my pocket, on the floor of the ED, in front of Ghawd and Everybody, in contrast to a handgun which another of our peers had won the opportunity to explain.

I would not in any circumstance hesitate to use the vest, in contrast to the Colt.

Finally, I was interested in meeting the soul who could relieve me of the vest, and hurt me with it, again, in contrast to the Colt.

So, I wore a vest. Others, or so I was told, elected to wear a firearm.

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

Vehicular Extrication

Long ago and far away, I spent my salad days as a street medic in Da City’s EMS. I know, right? Startlement abounds, amirite? Anyhow, this one time, we caught a run. We arrived to find an intoxicated gentleman seated in the rear seat of a four door sedan. Interestingly enough, he was seated upon the floor thereof, with his legs extended beneath the front seat.

We figured that extricating him from the vehicle would facilitate assessment (eg, WTF was his primary malfunction, and what, if any, would be our role in addressing it?). Therefore we started to attempt to move his legs so that he could return to being seated upon the rear seat, and exit the vehicle from there. No joy.

It tuns out that highly intoxicated folks, like our friend here, were not so very good at listening to and following directions. Our entreaties that he fold one leg, and remove it from beneath the seat, seemed overly complex, as he did not successfully implement step one of our process.

So, we tried to move the seat forward, thinking that this would afford our patient enough maneuvering room so as to fold leg “A”, move it laterally, extend it, and repeat the process with leg “B”, and thereby achieve freedom.

Nope. As the seat moved, he shrieked as if we were removing the leg, likely anticipating reattachment on the sidewalk. So, that avenue of approach was foreclosed.

Doug and I consulted with the vehicle’s owner, who had been pacing about, intent that we not damage his baby. Or the patient, I suppose. Doug and I were fresh out of ideas, and figured that our friends in the firefighting division, with halligan bars, K-12 gasoline powered saws with metal cutting blades, hydraulic extrication tools, and similar toys for fun and games, likely could devise several new plans to remove this gentleman from the floor of the back seat.

I shared this thought with dispatch, noting that our patient appeared in no immediate life threat, and perhaps a “Code Three” (aka “Priority Three”, or no red lights no siren) response might be appropriate.

Dispatch acknowledged our request, told us that a squad would be on the way, and “Firefighters never respond ‘Code Three’, always ‘Code One’”.

Alrighty, then.

The vehicle owner overheard all this, and appeared to become considerably more excited. “You called the mother-f*@$ing firemen! They will f*@$ up my car!”

Doug and I agreed with him, that likely there would be some damage once the firefighters had extricated Mr. Drunk And Boneless from his car.

Mr. Drunk And Boneless thereupon became the recipient of a loud, profane, creative, and enthusiastic exhortation that he remove himself from the vehicle so as to greet the firefighters while sanding upon his own two feet, on the sidewalk, rather than seated upon the floor of the exhortor’s car. (Paraphrased). This was accompanied by pulling, pushing, tugging and bending, as the narrator demonstrated the contortions that he believed would facilitate the exit of the drunk and boneless fellow from the narrator’s vehicle.

And it came to pass that, once the squad had arrived on our scene, Mr. Drunk And Boneless was seated, relatively happily and nearly uninjured, upon somebody’s lawn, rather than enmeshed in the seat of the vehicle that had held him securely within it’s embrace.

The squad looked the scene over, returned to service, and our patient told us to bugger off, as he simply wanted to sleep.

Well, bye!