Life in Da City! · Pains in my Fifth Point of Contact

Parenting Skills

I was interviewing a soul, who had brought their spawn along with them (because, why WOULDN’T you bring your 5 year old to your urgent care visit?). Said spawn (of course) had no self entertainment skills, likely due to the screen the named patient/parent placed into his hands immediately upon his whining that he wanted the phone, right now! While I was endeavoring to elicit nature of present illness (eg: what are your symptoms, and why did you determine that coming to urgent care was the thing to do?), duration of present illness (and, please Ghawd, please, say something more specific than “a good little while!” Pleasepleaseplease!), and provocative or palliative factors affecting this illness, said sprat was entertaining himself with the phone, and, it developed, felt the burning need to experience the sound track in his very marrow. In order to accomplish this task, he set the volume at eleven. Of course, in the confined space of the examination room, it was deafening.

I stifled my initial impulse to wrest the device from his hands, dash it to the floor, and grind it beneath my heel, all the while shrieking “Kill! Kill! Kill! Kill!…”, and then, settle upon my seat, and, calmly, ask, “Now, where were we?”

Instead, I continued to ply my patient with the appropriate questions, in a normal, soft, tone of voice. Of course, the named patient could not hear a damned thing I was saying. I smiled, and repeated my queries in the same, soft, calm tone of voice.

Still, the cacophony drowned out my every word. I smiled, and paused. The light began to dawn in my patient’s eyes. She turned to Little Jimmy (or whatever this child’s given name was), and directed him to silence the device.

He whined that he could not hear, should that happen. She repeated herself, and he again whined.

Then, in a feat of effective parenting nearly unsurpassed in my clinical experience, she retrieved the phone, silenced it, and pocketed it. Little Jimmy whined and groused, but his mother turned to him, directed him to quiet down, lest they “have a chat” in the vehicle, and turned her gaze, again, in my direction.

Miraculously, Little Jimmy settled down. I completed my examination and interview, and everybody went their separate ways.

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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!

Having A Good Partner Is Very Important! · Life in Da City! · Sometimes You Get to Think That You Have Accomplished Something!

Serendipity

One evening, I was eagerly anticipating the prospect of departing work on time. We had not turned a metaphorical wheel for something like 45 minutes, and the clock on “the clubhouse wall” promised us only 20 more minutes until we recreated a LeMans start, jetting off into the night.

So, of course, somebody wandered in. She got registered, and my MA roomed her, interviewed her, vitaled her, and got some pee to analyze for indicators of a urinary tract infection, as such were her reported symptoms.

I reviewed the vitals, allergies, meds, and past medical history, as the urinalysis machine deliberated, finally printing out it’s findings. Surprisingly, given Miss Lady’s report of frequent, urgent, uncomfortable urination, there were no white blood cells nor nitrate (indicators of bacterial source of her discomfort). What there was, was an abundance of glucose (sugar). Indeed, the machine indicated something like 1,000 mg of glucose per decaliter (100 ml, or 1/10 of a liter). That’s a lot of glucose. I requested a finger stick blood glucose test.

That read “High”, as in, too much glucose in the drop of blood tested, for the machine to measure it. The machine will register blood sugar levels as high as 600 mg/dl.

I entered the room, introduced myself, and asked, what prompted her visit tonight.

She recounted the urgency, frequency, and discomfort with urination. “I feel like I have a bladder infection!”, she declared.

“Well, ma’am, there are no indications of infection in your urine. There is, however, an abundance of sugar in your urine. This is present, as well, in your blood. Are you a diabetic?”

“No.”

“Well, ma’am, you have more sugar per ml of your blood, than is present in a similar volume of sugary soda pop. You are, indeed, a diabetic. You need to go to emergency right now, so that they can get you started on managing your diabetes. Give me a minute, and I will print out your chart so you can show the folks in ER what I have found.”

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

Retail Pharmacy, So To Speak

A long, long time ago, in an ER very far away, I was a night shift ER nurse.

Surprise!

So, TINS, TIWFDASL, well, uh, not so much. I and the other nurses were capitalizing upon a slow moment and gabbing away at the nursing station, when one of our security officers ran in (literally!) and announced that “We got a shooting in the driveway!”

Having heard no loud noises, I was puzzled, but, these officers were not prone to overstatement, so I asked a couple of the other nurses to grab a cart, I grabbed some gloves, and off we went to the ambulance entrance.

Now, by way of background, this was in the early days of the crack cocaine epidemic (although, how one contracted “crack cocaine” from another person without active, willful action on one’s own part is unclear to me). A couple of blocks away was what might be considered to be an open air drug market. Folks (commonly suburbanites) would drive up, engage a soul in conversation and arrange a transaction, another confederate would be summoned and the exchange would take place, money from the buyer, drugs from the vendor.

We were told that in this particular transaction, the named patient, seated in the back seat of this two door vehicle, appeared to believe that he was the designated quality control inspector. Indeed, the tale appeared to paint this fellow as believing that he ought to remonstrate with the vendor regarding the unsatisfactory nature of the product that had been delivered.

As the History Of Present Illness unraveled, the vendor did not seem to have fully committed to a “Zero Product Defect”, nor a “Every Customer Fully Satisfied, Every-time” merchandising philosophy, as, when the shootee indicated that he, the shootee, intended to enforce his product quality complaint by with holding payment, he, the vendor, is reported to have produced a handgun, and shot the shootee.

Bad times ensued. The driver, unsurprisingly, panicked, and sped away. A few blocks later, he, the driver, noticed our bright “Emergency” sign, and pulled in, bellowing an incomprehensible narrative.

So, security cleared the car of the terrorized goslings, and I (and security, and my nursing partners) tried to extricate Mr. Beenshot’s inert form out of the rear seat of a coupe, indeed, a compact coupe.

It only closely resembled a cluster fuck. For a while.

We maneuvered Mr. Beenshot into our code room, and commenced to resuscitating. Before things had progressed very far, our doc had determined that this guy had a “STAT!” transfer in his very near future, and so the nursing supervisor, who had come at a run upon our paging a Code Blue overhead, peeled off to arrange with our transfer ambulance service that they produce a crew and truck RFQ (Right F*%king Quick), and then phoned TBTCIDC to provide them a heads up.

We eventually got him stabilized (kind of, sort of), and the physician had a detailed chat with TBTCIDC senior physician. Off Mr. Beenshot went, and we sought out the entourage, intending to elicit more history, more circumstances leading up to the shooting, more pretty nearly anything, so we could provide that information to TBTCIDC, as well as, well, notify next of kin.

Alas, the posse had unassed our waiting room sometime while we were distracted, trying to save the life of their friend, I mean, co conspirator.

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

Tai Chi: You’re Doing It Wrong!

I recently purchased a new pickup truck. I had been pining for this truck for several years. It took me several years to drop the hammer, because I wanted to thin the herd of my indebtedness, as well as build up my “rainy day” fund again.

Having finally made my purchase, I had several accessories that I desired, and was not about to finance over 6 years. I wanted a “headache rack”, planning to mount antennae for my amateur radio (“HAM radio”), a CB, and other radios that TDW-Mark II and I employ when traveling, or weather spotting, and thereby avoid drilling holes in my shiny, new, truck. (I DID mention, I have a new truck, right?)

So, TINS, there we were, turning off Main Drag in Nearby Bigger City, preparatory to pulling into the lot of The Truck Accessory Place, when we (TDW and I) noticed a disheveled looking adult male approx age of mid twenties, standing in the second driveway of The Truck Accessory Place (hereinafter referred to as TTAP), swinging his arms, and having an animated conversation with person or persons unseen by us.

Nice.

We pulled up to TTAP, entered same (locking my truck in the process), and hailed the counterman. “So, has homeboy here been boxing with dragons very long?”

I received a puzzled look in response. “Huh?”

“See the guy out there, boxing with person or persons unseen by you and me? How long have the dragons in his mind been attacking him?”

He walked around the counter, gazed out of the window, and opined, “He doesn’t look like his mind is quite right.”

I concurred. TDW-Mark II stood nearby, hand concealed in her purse. Her purse wherein she had her sidearm. She stood so as to not obstruct my strong side draw, should that become A Thing.

Mr. Counter returned to his side of the counter, and dialed police dispatch. He described his observations, and asked for an officer to respond. I watched as the boxer bobbed, weaved, punched at unseen adversaries, moving himself toward the neighboring business.

Soon, he crossed the street (startling several drivers on that street, in the process!), and wandered off into the thicket there, not to be seen again.

It has been told that Colonel Jeff Cooper, of Gunsite and Modern Technique of The Pistol fame, was once asked, “Colonel Cooper, if you knew that you were going to a gunfight, what gun would you prefer?”

He is quoted as saying, “If I knew that I was going to a gunfight, I’d stay home!”

I like avoidance. I’m tickled that Mr Dragon Boxing, did not present a lethal force threat.

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.

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

Random Thoughts, Part V

Another day, fighting disease, and saving lives. Another opportunity to consider the fact that everybody brings sunshine into my life. Sometimes, that is when an individual enters my life…….

A long, long time ago, not so very far away, Doug and I had a run on a soul very much like our “O’BEAST!” friend. That reminded me that some folks have so much misery and unhappiness in their lives, that they have enough to share with everyone around them. Or, so they appear to think!

Regarding that: any particular miserable soul provides me the opportunity to be unhappy for a half hour, maybe an hour. On the other hand, they are wallowing in their sourness, unpleasantness, hour after hour, day and night, 24/7/365. Who is worse off?

Among THAT population, are folks who appear to lack an education in The Classics. This is manifested by their diction, their articulation, as well as their vocabulary. From time to time, “Back In The Day”, we in the ED would have one (or more) of these souls gracing us for an extended time, while their livers metabolized them towards freedom. (It takes a while to detox from a high level drunk!) Such a philosopher would feel compelled to share with us all his ruminations about Maternal-child relationships, and conjecture about our particular manifestation of those relationships. (generally running along Oedipal sorts of speculations) Along with thoughts about hygiene and the value to be found in regularity, and legitimacy of parentage (or something like that).

One physician characterized one individual’s declamations as reflecting a certain “Poverty of conversational themes”.

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

O’BEAST

A long, long time ago, in a galaxy not so very far away…Ok, it was something like 40 years ago, and Doug and I were working Medic 19 on nights. We caught a run on a sick person of some sort, and arrived to find a not-so-very-sick person, in an ill humor.

For some reason, this soul appeared to believe that employing us as a lightning rod of sorts for every missed opportunity, failed hope, crushed dream, and malign bit of luck that had befallen them, would in some manner alleviate their misery. I was not seeing it, but, whatever.

Since Doug was of The African Persuasion, whereas I, myself, was very much of the White Bread Persuasion, well, Ms. Misery, herself melanin enhanced, took him under her metaphorical wing, and expected him to commiserate with her in her plight.

Horrible fail.

I was driving, and so stood off to the side whilst Doug negotiated with Ms. Misery. He had worked pretty damned hard to get to where he stood, and was, let us say, unsympathetic to those who did not appear to exert themselves even minimally to better their lot. While he attempted to conceal his views from the folks on the street, we had detailed conversations in the firehouse on this, and other, topics.

Eventually, Ms. Misery concluded that the only succor we were about to offer her involved a trip to the ER, where she anticipated spending her evening, with no benefit to her pity party prospects. Therefore she directed us to depart, bidding us (and our mothers) farewell.

Once back in our truck, as Doug completed the run sheet (and I moved us to a neutral corner, several blocks away), I noted our friend’s considerable girth. “Glad she SNR’d herself. Obese as she is, I’d hate to attempt to carry her large self anywhere.”

Doug chuckled. “Obese? Were you there, as she yelled at us? With that attitude, she was Oh-Beast!”

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

Blazing Saddles and A Philosophy of Life

After another run on a person who was unhappy, yea, verily, unto such depths that he had an abundance of unhappiness to share with everybody in the community, us in particular, Doug was owning his frustration. That might have sounded like bitching and complaining about ungrateful, bitchy, asshole, ignorant layabouts who verbally abused those unfortunate to be trapped into serving them in any capacity whatsoever. But, of course, noble Saviors Of Lives, and Defeaters of Disease, such as Doug and myself, would never, ever, bitch, moan, complain, whine, grouse, pout, sulk, grumble, carp, kvetch, squawk or otherwise gripe about our lot. Oh, no! No, no, no! Not us!

Well, Doug was inspired tonight, and was waxing eloquent about the character deficiencies and general life failures afflicting our service population in general, and Medic 19’s area in particular.

After several minutes of admiring his eloquence, and noting the fact that he did not repeat one swear word, one time, he paused to draw a breath. I jumped in. “Ya know, you sound like you’re frustrated by folks.”

He agreed. “Yep. A more foul hive of scum and villiany, never has a medic unit covered!”

“Doug, I’m not sure you really have the proper perspective on our peeps, here.”

“What do you mean?”

I warmed up, channeling my inner Gene Wilder, as I consoled my metaphorical Cleavon Little partner. “Doug, you have expectations that simply are not going to be met. You have to understand these folks. These are the common sort, with the common touch. They are the folks who chose to move into this district, to drown their lives in drugs, alcohol, and a myriad of other bad life choices. They see themselves victimized by the choices that they make, again and again, every single day. It is as if they awaken each morning, draw in a breath of fresh, morning air, blink in the sunshine of a brand new day, and say, ‘I think I’ll fuck up my life, even more than I did yesterday! I’ll alienate everybody in my family, piss away every opportunity to take a different path, and ever more closely associate myself with other losers, in hopes that they will one day look at me, and sigh, ‘Damn! I wish my life was as fucked up and useless as that guy’s”.” I paused, taking in a breath. “You know, Doug, Morons!”

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.