And Now For Something Completely Different

Well, THOSE were some dark stories! And, now for something completely different.

TDW got a kitten from a friend, whom we named Max.

It developed that Max would laze away the afternoon, gazing out the window. After a while, he started to do this sort of “click-click-click” noise, and move from one window to the next, as if following something. Investigation revealed that this something was another cat, who eventually demonstrated that she had had kittens in our window wells. TDW eventually noted that the kittens were eating the dry cat food that she had been putting our for the new cat, who we dubbed Momma Kitty, and we soon retrieved the kittens: Momma Kitty escaped our clutches.

When we got the kittens inside, we locked them in the second bathroom, providing a crate where they could hide, water and food, and litter boxes. We would enter a couple of times a day to clean up the mess, refresh the water, refresh the food, and attempt to play with them, trying to socialize them into their new lives as house cats.

Took some doing. The one kitten would sit in a corner and snarl at us with all the gravitas a 6 ounce kitten could muster. She was named Henrietta, after the chickenhawk character in the Foghorn Leghorn cartoons.

Another kitten would gnaw at our fingers, then rush to lick and pat the same finger, reminiscent of the big blue “Sullie” character in the “Monsters Inc.” cartoon. A third kitten would lay, tranquilly, in our arms, allowing us to pet her and provide neck scritches, purring all the while. She was named Olivia (as in olive branch, the historic symbol of peace).

The final sister was named Dynamite, since she would nearly explode into a fury of claws and fangs upon any approach. She has since calmed down, although she is not altogether sure about the whole “hold still while Ipet you” thing, and would rather get going after a brief interval of tolerating our petting.

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Serendipitous Connections.

Among the maladies that motivates folks to come visit me in the clinic, is that their infant has diaper rash, also known as diaper dermatitis. Should this persist past, say, 3-5 days, there is an increased likelihood of Candida (you may recognize it as yeast) joining in to add to the discomfort. Yeast (Candida) is commonly found in stool, and, well, with infants, stool in the diaper is a common occurrence. If there is diaper rash, susceptibility to candida climbs.

So, microorganisms really, really like a particular set of conditions in order to grow and proliferate. Generally, that includes warmth (like you might find beneath a diaper, for example), moisture (which just MIGHT be found, beneath a well fitted, and perhaps, oh, gosh, let’s spitball here: wet! diaper) as well as darkness, so that those pesky UV rays do not disturb the microorganism’s DNA, as well as that nasty old sunlight not drying out the area of operations.

This being The Un-Named Fly Over State, and deer hunting being nigh unto the State Religion, once you get into the outer ring of Big City Suburbs, most folks recognize the existence of a program known as Quality Deer Management (QDM). The premise is that, should the landowner provide for high quality food (acorns, or suchlike), access to water (ponds do nicely for this), shelter (like deer tend to find in a woodlot), AND you avoid hunting young bucks, then you tend to hunt, and harvest, larger, healthier bucks in later years simply because you provided an environment conducive to such bucks reaching maturity, in an environment providing them with their needs.

Therefore, when I suggest that parents who attempt to provide an environment that DOES NOT provide these elements to the germs in their child’s diaper, the child is likely to have fewer episodes of diaper rash, of shorter duration, and less likely to require my attention. That means, naked babies (generally in the kitchen, on the linoleum), kept meticulously clean using bland soaps and tepid water, with their (the babies) bottoms protected from the irritant effects of urine and stool by such means as petroleum jelly. That means, to those steeped in such things (like your Mark 1, Mod Ø deer hunter), that concerned parents do THE OPPOSITE of what QDM practitioners do for deer. Take you kid’s germs, and dry ’em out, blast them with sunlight, cool them out, and let Nature, and your child’s immune system, take care of business.

Serendipitous connections.

“Warn-A-Brutha”, in action.

So, TINS©, TIWFDASL©, and my MA, let us call her Maryann, exited the room that she had entered, shortly before, to assess and obtain vitals on a child.

“Reltney, this child here is working kind of hard to breathe, and he is coughing a lot: it seems to interfere with his taking a breath!”

I entered the room, and noted a child coughing approx every 10 seconds (and I mean a full throated cough, not some modest little “harrumph!” kind of thing), and, as I observed his breathing, noted a rate of around 60 breaths a minute.

Not so good.

We administered a breathing treatment, and he had kind of, sort of, maybe improved just a little bit.

I finished my assessment, and went to chart, intending to return and re assess him once my (generally 4-7 minute) charting was completed.

I did so, and noted that his breathing had dis-improved (is that really a word?). I invited the physician with whom I was working to lay eyes upon him, briefing her upon my observations and actions thus far.

Once she had assessed him, she was not favorably impressed. She, also, thought he was working kind of hard to breath. She, also, wondered if this was fixing to run him out beyond the end of his reserves, whereupon he would crash, likely biggly, and become a no shit emergency. She wondered if sending him to emergency, prior to that happening, might not be more wise than waiting until he did, indeed, crash.

I agreed.

I wrapped up my charting, once the child was safely on the way, and hunted up Maryann. I congratulated her. “You did good. Your prompt assessment that this child was not breathing right, set in motion events necessary to get him to the appropriate level of care, in a timely manner. Well done!”

Revelations, and Pride In My Child

A couple of months ago, I was chatting with my daughter, Brenda. She somehow revealed that, years ago, when she was a single mother, working part time and going to school, money was tight.

I had kinda known that.

Just HOW tight, I evidently had not appreciated. She revealed that several times, she had gone to bed without supper, in order that her child could eat.

Let’s consider that, for a moment. It certainly elicits mixed feelings in me.

Foremost, pride. My daughter is professional, committed, and decisive. Her revelation reveals outstanding triage skills, as well as monumental commitment to her child.

Secondly, frustration. It is not as if I could not/would not remedy her pantry problems. Hell, I have been an overtime working fool nearly all my life, and another day of OT, in order to feed my child and grandchild, well, I suspect “BFD!” communicates my feelings adequately. (that is “big freaking deal”, although the second word generally refers to certain ancient and generally highly regarded fertility rites…).

Thirdly, frustration. (again). It is not as if I do not buy groceries, to this day, just as if I were still feeding four hungry adolescents. That both provides me with plentiful left-overs for my meals at work, as well as abundant food-in-waiting. The only thing stopping me from a pantry filling visit to my child, is her failing to tell me such might be useful.

Finally, it reinforces my appraisal of my child, that she is A WOMAN, and, like her mother, knows not of this “back down”, you might speak of, with regard to her children. Formidable, competent, decisive.

Family Business

My daughter, let us call her Brenda, got married a couple of weeks ago. She has found a man who is made of righteous stuff, who complements her, and fathers (dad-s?) her children.

Since I am a step father, I respect men who step whole heartedly into the role of fatherhood, even if ready-made fatherhood. This man is such a man.

So, several insights occurred to me over the past couple of weeks.

First off, without The Plaintiff, I would not have this wonderful woman, who calls me “Dad”, in my life. For all The Plaintiff’s (and my, to be honest) imperfections and shortcomings, if she had not married me, there would be a Brenda sized hole in my life.

So, as the Father of the Bride, when asked, “Who gives this woman?”, I replied, “Her mother and I”.

Secondly, this amazing woman put herself through college, as well as grad school, working full time, and mothering what would turn out to be 4 children. Proud Poppa moment, right there.

I took the chance to tell her how proud I am of her, and in so many ways that she has earned that pride.

When she responded, “Thank you, Daddy”, well I nearly melted. I had told her how meaningful that Christmas powerpoint was to me, how, even now, it moves me to tears.

So, of course, the Father-Bride dance was to, “He Didn’t Have to Be”, by Brad Paisley.

Thirdly, The Darling Wife-Mark II is an unequivocal blessing to me, in my life. TDW labored to make the decorations, to make everything at this wedding Just Nice. Brenda nearly gushed over the wedding decorations, multiple guests made a point of approaching TDW, and complimenting her over how well her efforts had turned out.

Proud Poppa Moment

Thank you, ERJ, for the inspiration for another blog post. One of your commenters to your post about the fiscal consequences of “kicking the (payroll and benefits) can down the road”, and the implications of same for actually MAINTAINING a given level of government/police/fire/EMS services, presented the following:

“I suspect another reason for services eroding is lack of employees.
I know that many police departments have openings for lack of qualified candidates, as do many county agencies. Whether their qualification requirements are reasonable is another question. I know that some places intentionally understaff so that existing staff can easily justify overtime, occasionally to a ridiculous degree.”

This ties in, very neatly, to a conversation I had with The Darling Daughter the other weekend. She was talking to somebody with whom she works, this somebody being involved in some manner with providing EMS services. This Somebody (hereinafter referred to as “TS”) was sharing with her the difficulty of obtaining personnel to staff ambulances, in the numbers required to provide ambulances, 24/7/365/surge capacity in the event if BFD emergency.

The Darling Daughter (to be referenced as “TDD”) pointed out that she spent her childhood in the household of a medic, and noted to her correspondent that “You DO know, that McDonalds is paying more than you are, right?”

That elicited an observation about insurance company reimbursement for ambulance transport (TL:DR: meager), and the difficulties that provides in paying personnel more.

TDD noted that for mothers who might contemplate a career Fighting Disease, And Saving Lives, child care, and in particular child care after 5 pm, is AN ISSUE.

Her correspondent, TS, was reported to have metaphorically waved his hands, responding “I KNEW you were going to bring up child care!”

I agreed with TDD, noting that should a crew pick up a transfer to, say Ann Arbor at something like 3 pm, (the drive alone is on the order of 90 minutes, one way, from, oh, let’s pick a town at random: Eaton Rapids, and Sparrow Eaton Hospital. Not mentioned is unload time, as well as the drive back, restocking the rig, and tootling home.), then Our Heroine is looking at being, maybe, in the parking lot of University of Michigan Medical Center, heading home if she is fortunate, just about the time that her day care provider is beginning to blow up her phone with warnings of five-dollar-a-MINUTE late charges for EACH of her children, now that she is late.

At a pay that compares, sort of, with minimum wage.

So, hell YEAH, child care is an issue.

She (TDD) then noted to TS, that there does not appear to be any sort of career ladder for EMS. So far as she knew, it went something like

Basic EMT–>Paramedic–>Do Something Else.

She relates that this sort of issue might adversely affect retention. Which will, as a readily foreseeable follow on effect, “thin the herd” of individuals entering that pipeline. Leading to just this conversation.

Another Proud Poppa Moment!

Smoking is Bad, M’kay?

Several times a week I get the opportunity to “cheerlead” one soul or another along the path that ends with not smoking. Some folks are receptive, and they get the full orchestration. Others, not so much, and they get the admonition, “So, smoking is not health promoting behavior, is it? There, I’m done yelling at you about smoking!”

Those who appear receptive get told, among other things, that The Plaintiff smokes, She is a nurse, so it cannot be that she does not know the effects of smoking. And, if you ignore the fact that she married ME, and divorced me, well, ignoring those two errors of judgment, she is pretty smart. Finally, she has never been any sort of shrinking violet. As a mother, I enthusiastically applaud that sort of strength of character.

As The Plaintiff, well, not so much.

I move on to observe that this set of facts (see previous paragraph) tells me that stopping smoking is a monumental task, complex and demanding much of those who would make that journey.

Then, I observe that I worked, full time, in my Nursing school years. Spent two years on around 2 hours sleep a day, in my AD program.

Pretty worthwhile. Mighty difficult.

I conclude by observing that worthwhile things are seldom easy (cf. Raising children), and that easy things are seldom worthwhile (see: video games).

Occasionally, I will see some soul who was on the receiving end of that spiel, several months later, and some of those folks will tell me”I have really cut down, and am trying to finally quit, because of what you told me!”

Sometimes, you get to think that you have, indeed, made a difference!

SNIPPETS V

STORY THE FIRST

So, TINS, TIWFDASL, just a couple of weeks ago, and, as I entered the room, I was greeted by the younger of the two women seated in the exam room. “There he is! You saved my mother’s life!”

While that certainly was a welcome greeting, I admitted that I was confused. The younger woman, evidently the daughter, filled in the missing pieces. Several weeks previously, she (the narrator) had accompanied her mother (the other soul in the room while we conversed) to a visit to our clinic. She (the mother) had been having a cough of some sort, and I had felt that something in the experience did not sound right. After some assessment in clinic, I had sent the mother to ED, and those worthies had identified a 100% occlusion of one of mom’s coronary arteries (the arteries feeding the heart). Mother had received a stent, and been sent home, and was still among us. Indeed, she was here, today, due to another cough.

Thankfully, today’s cough appeared uncomplicated, and I recommended my usual measures to ameliorate the post nasal drip that seemed to be the source of the cough.

Sometimes I get to think that I really do, from time to time, positively impact people’s lives. That’s nice to think.

STORY, THE SECOND.

Just the other day, I was shopping. Such is the life of a life saving, disease fighting, internet blogging champion (of sorts). As it develops, I am middling tall: 5-7 or so. It turns out that the pasta I was hunting for was on the top shelf, and several other people had purchased some, before me. THAT meant that I could just barely not reach the boxes. I had just realized that I, a tool using animal, could open my knife and extend my reach, tipping over the needed number of boxes, and add same to my cart. That is, I had just realized it, when a gentleman, taller than I, reached up, grabbed a box, and handed it to me, asking me if I needed more.

I requested two more, and thanked him, moving forward with my shopping.

A few aisles over I observed a woman attempting to retrieve an item from a shelf beyond her reach. Before I could respond, another (taller) gentleman stepped up, retrieved the sought item, and handed it to her.

Everyday, plain folks, acts of civility and kindness.

STORY, THE THIRD

We visited my wife’s sister, and her husband, recently. They live in rural Kentucky, and it is rather a change from their previous neighborhood in Metropolis. Indeed, it is a considerable change from my table-flat neighborhood of Un-Named Flyover State.

We arrived, following the directions provided, and noted that the terrain was, well, “hilly” does not really do it justice. As a consequence of that terrain, roadways tend to meander, circling around this hill, or weaving their way up to, over, and down that ridge.

We had spent something like 45 minutes meandering , as the road took us up in elevation, when I noted a sign ahead, announcing “Curves Ahead!”.

I turned to TDW-Mark II, and exclaimed, “Wait, what? THAT was the STRAIGHT part?”

STORY, THE FOURTH: OOPS!

So, TINS, TIWFDASL, and, well, things had come to a slow down. I was working with a physician, on this day at this clinic, and she had never handled an adrenalin autoinjector. We had one handy, and I handed it to her so she could examine it.

I was not quite quick enough, to admonish her to not remove the guard, nor to handle the trigger, on the one end of the device. Therefore, she did, successfully, remove the cap, and then trigger it, sending the needle into one of her fingers, along with some of the adrenalin therein.

The Good News was that, since she was youthful, she promptly withdrew her hand, and therefore only received a fractional dose. The bad news is that adrenalin is a very, very powerful vasoconstrictor, and therefore her affected finger became very, very white, and also burned. Oh, yes, it burned. I cast about, wondering if we had any phentolamine. (an alpha blocker: used to reverse the effects of, among others, adrenalin, when injected into an end capillary bed, Like you would find in your fingers.) Since ours was not an ICU, nor an ED, we did not have phentolamine, nor anything that would serve.

The good news, such as it was, is that due to her youthful age, good health habits (spelled n-o-t s-m-o-k-i-n-g) and the fractional dose of adrenalin she had received, well, after around 20 minutes, her finger regained it’s color, the burning pain faded, and she returned to normal, simply just a bit more shaky than previously.

Subsequently, I obtained, and CONSPICUOUSLY labeled a trainer, specifically intended to harmlessly teach folks how to handle and operate an adrenalin autoinjector. This one has no needle, and no drug.

STORY, THE FIFTH

So, TINS, TIWFDASL….well, okay. I was NOT FDASL, rather, I was off, and, having accomplished all my chores (or, such fraction of “all my chores” as I was going to accomplish that day), my step son (son of TDW-Mark II) called. I had spoken to him about a range day, and he was off work that day, I was off work that day, and it was off to the range we went.

I took my Garand, my .380 pistol, and my 9 mm pistol. Of course, I grabbed the ammo can labeled 30-06 (for the Garand), .380 (surprisingly enough, for the pistol in caliber .380), and the ammo can labeled “9 mm” for, no doubt surprising, the 9 mm pistol.

Now, recall that I have been an RN for, lo, these many yeas. That I have passed uncounted thousands upon thousands of doses of medications, and double checked myself each time, so as to accomplish the “5 rights” of med pass: right patient, right drug, right dose, right route, and at the proper time. This was effected by reading the order, the med container, comparing each with the other, and then, DOING SO AGAIN.

So, we arrived at the range, uncased the Garand, and set up targets. Several dozen rounds later, we placed the rifle in the case, put the ammunition away, and took out the .380 pistol. Fun times.

When it came time to take out, and shoot, the 9 mm pistol, well, I went to the “9 mm” ammo can, opened it, and beheld something like 200 rounds of RIFLE AMMUNITION.

For those in the studio audience who are unfamiliar with Things Firearm, well, 9 mm is a pistol round, and rifle rounds are (a) the wrong size overall, (b) with the wrong projectile (bullet), propelled by (c) an entirely wrong charge of powder, leading to (d) entirely way, way more pressure once the cartridge is set off, for any common pistol to contain, meaning (e) should, somehow, a rifle cartridge be forced into the pistol that I had before me, anyone firing it, should they survive the resulting explosion, would forever after be known as “Lefty”.

Not mentioning the emotional distress I would experience should this pistol, one of my favorites, be reduced to shrapnel.

Sigh. It appears that I had horribly failed the ammunition labeling process, leading to jovial kidding from my step son. Other than that, a good day at the range.

And, the ammunition got re-(and correctly)-labeled.

PARENTING STRIPES

Another blog had an entry that reminded me of one of my own parenting moments. As I recollect, Number One Son was misbehaving, and so The Darling Wife-Mark I and I imposed some limits: grounding or some such thing. We observed that a repeat performance would elicit a spanking.

He responded, “Well, I’ll just call the police!”

I smiled. Told him to get his shoes, and get in the car. Now.

We had a leisurely drive to our local small town police department. I asked if I could speak to an officer. The nice desk lady asked, why?

I responded, “This child just informed me that should he require a spanking, and I administer it, he will call the police. I simply do not want to wait. May I speak to an officer, please?”

She bade us sit, and soon an officer arrived. I introduced myself and Number One Son. The officer asked, had I spanked the lad yet?

I replied, no, not yet.

He asked, in what manner would I spank the child?

I responded, with my bare hand, since the point was not pain, nor injury, but, rather, recalibration of his behavior. Once my hand started to hurt, likely my purpose had been accomplished.

So, the officer asked, you intend to spank this child, if other measures do not change his behavior, in order to discipline him?

Yep, was my answer.

“Isn’t that kind of your duty as a parent, to correct misbehaving children? I do not see anything you are describing as actionable by me. You’re simply doing your job as a dad.”

I turned to my son, and asked, “Do you have any other questions for the nice officer?”

Jes’ Folks. Plain, Everyday Folks

Glenn Reynolds, proprietor of Instapundit, wrote an article for USA Today, nearly three years ago. Read it, please. And, reflect on who benefits when we are set at each other’s throats.

https://www.usatoday.com/story/opinion/2019/07/22/fatal-car-accident-reveals-fundamental-american-decency-column/1790753001/

I have had similar experiences, among them one chronicled here. It was as if we had our own “Insert Name Here County First Responders Association” meeting, there on that highway.

Again, this tale recalls a similar event. In this case, folks trudged their happy asses out of their warm, dry, non-windy homes, to help push a nearly (lessee: nought goes into nought… divide by zero…. carry the eight… three guzintas…) 10,000 pound ambulance out of a snow drift, at night, while it was snowing it’s freaking ass off.

So, tell me again who benefits when we are set against each other? If we are demonizing each other, how likely is it that we can ever (a) agree on a list of priority problems, (b) discuss rational maneuvers to address these problems, and (c) agree on any sort of effort to implement these interventions?

Por ejemplo, howzabout covid? Could we have discussed risk vs benefit of lockdowns, of “two years to flatten the curve” (had our governor been honest), or, even, “two weeks to flatten the curve”? Could we have had a real, ya know, two way, conversation about vaccination, efficacy, adverse drug reactions, liberty, personal autonomy (remember “my body, my choice”? Seems so long ago. Good times, eh?), risk vs benefit? Instead, anybody who speaks about any sort of disincentive to accepting vaccination, like, say, severely truncated testing protocols, or, say, known (even if small in magnitude) incidence of cardiac adverse reactions, or any of a dozen (that I can think of off the top of my head) risks genuinely presented by the extant vaccines, gets shouted down, deplatformed, or, worse, fired and hounded. So, I ask, who benefits when that happens?

In stark contrast to the Chattering Class, above cited are first person narratives of genuine Americans who, in a crisis, come together and identify what needs doing, and then, quietly, FREAKING DO IT. These folks identified one of their neighbors, identified that this neighbor was in need, and set to work. No command, no haggling, no bullshit. Simply, “How can I help?”

Tell you what: I resolve to be inspired by good examples. I will try to NOT buy into name calling, and, rather, own disagreements with others, and seek to see those disagreements as honest differences of opinion, where I am able to do so.

I resolve to try to be inspired by volunteer firefighters who interrupt Christmas with their families, in order to respond to a neighbors catastrophe.

If we open our eyes, there are uncounted examples of folks living up to their ideals, even as there are examples everywhere of those who fail. Sometimes fail horribly.

Mr. Reynolds, thank you for reminding me that most of the time, most folks simply try to get through their day, and, maybe, help their neighbor. To paraphrase his thought, I will try to let myself be reminded that, given the opportunity, most folks will reveal their fundamental decency.