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“These are a few of my favorite things!”

Exhibit 1: Cleti seeking work noted excusing them for their call off yesterday. When I did NOT see them, And there is no record of any visit anywhere. And, of course, no symptoms today. (Hangover, anybody?)

Exhibit 2: Jane Doe arrives, reports (complaint). My MA elicits a chief complaint, obtains vital signs, verifies medications, allergies, medical history. Generally, as the MAs with whom I work are smart and on the game, they try to identify what, if anything, Jane Doe has attempted to manage her symptoms with, as well as how long this has afflicted Jane.

Since not uncommonly the interrogatory the MA initiates will get those ol’ neurons a’firing, and other, potentially relevant, information will bubble to the forefront of Jane’s consciousness, I will myself reiterate the allergy-medication-history-symptoms-duration-efforts to remedy these symptoms line of inquiry.

So, when you have twice assured health care professionals that you have NOT employed anything to address your sniffles, for the love of Crom, do NOT interject into my instructions, right after I instruct you to employ any of a dozen over-the-counter nasal steroid sprays, that “I have already tried Flonase!” (or whatever).

It wastes my (indeed, as well as your) time, provides you with the appearance of stupidity, and raises my blood pressure.

Item 3: (Heads Up! This is NOT a ‘sick person’ story!) If any of you have shopped for a vehicle recently, you may have noticed that nearly every vehicle in America that has four wheels and an engine, has a back up camera. My new truck, indeed, does have one.

So, TINS©, there I was at the gas station, looking for a vacant pump. This one fellow pulled away, and I noticed, as I approached the spot that he had vacated, that the woman parked at the next pump behind him had, well, let us say that she had decided to determine how far she could stretch the dispensing hose forward, and still reach her gas inlet.

I pulled in, and backed my full sized truck up, attempting to avoid replicating her hose stretching experiment. Of course, that required that I approach her front bumper closely, a fact that I observed in my (Surprise!) back up camera display. I halted, something like 6-12 inches from her bumper. I exited, and approached the pump to begin my transaction, and she looked me over, and observed, “You got kind of close to my bumper, ya know!”

I smiled, indeed, with a smile that likely even reached my eyes. “Yep. That’s why I have a back up camera, to make sure that I did not get too, too close!”

She looked surprised at that. “You have a back up camera?”

Again, as I started to pump my own gas, “Yep, sure do!”

Uneventfully, she drove away.

(TDW-Mark II observed two things: First, “When she spoke up, I pulled down my visor mirror, so I could keep an armed eye on things”. Secondly, as she and I discussed it later, she observed, “You were nicer than I would have been. I might have observed, ‘Ya know, sweetie, it’s kind of sad that the Rover brought you back here!'”)

Item 4: I have whimsical voices in my head. In this, The Age Of Da Rona, folks seeking entry to our clinic are interviewed. Those who answer affirmatively to any of several inquiries get “drive through” health care. The registrar noted the vehicle, as well as the complaint.

That leads to several whimsical moments. For instance, there is the “GMC sinus” entry. That would be an altogether new variety of sinus affliction.

Then there is the notation of the “Tan Dodge Congestion”. (Hmm. THAT’S a new model name for me!)

Or the “Silver Ram”, leading to the chorus in my head serenading me with

“City sidewalks,

Busy sidewalks,

Dressed in Holiday style,

In the air there’s a feeling of Christmas.

Children laughing, people passing
Meeting smile after smile
And on every street corner you’ll hear
Silver RAM
Silver RAM, It’s Christmas time in the city….”

Finally, Item 5: a comment in response to post at Gun Free Zone blog (https://gunfreezone.net/journalists-are-dumbasses-who-think-that-tv-shows-are-reality/)

Christopher Schwehr

APRIL 23, 2021 AT 2:04 PM

It’s known as FOCUS: Fuck Off ‘Cuz U Stupid.

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Memorial Day

May you all have a contemplative Memorial Day, full of gratitude for those who gave their last breath, to protect, preserve, and defend this experiment in self government.

Please consider this, a story of one such sacrifice.

https://www.google.com/url?sa=t&source=web&rct=j&url=https://tulsaworld.com/archive/mission-saving-mariam/article_caeece59-65cc-56a2-8558-867ee99161ce.amp.html&ved=2ahUKEwiVwujTz-3wAhVAKVkFHReVDngQFjAFegQICBAC&usg=AOvVaw1wJBISE5G8uolzvme0pfGP&ampcf=1&cshid=1622247821492

“Saving Miriam”, regarding Corpsman Chris Walsh.

I read it, and my damned allergies overcame me.

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Self Own (or) EMR follies

It occurred to me that I have been venting, recently, on a tear about my encounters with third parties that, well, are not dazzling me with their brilliance. Perhaps, in the spirit of full disclosure and honesty, I ought to own up to a couple of episodes that tell one and all why my pencils no longer have erasers. Here’s one recent experience.

When I first encountered electronic medical records (EMR), many, many years ago, one of my precepting physicians walked me through his office’s EMR. In the course of his narrative, he observed that, “One of the follies of the EMR is that it will allow you to thoughtlessly chart very stupid stuff, easily and repeatedly. You have to be careful of that, or you will look like an idiot.”

I was reminded of that physician’s wisdom the other day. I had a gentleman in my clinic, seeking care for a sexually transmitted disease (STD). He reported that he had been notified by his paramour that she, the paramour, had been diagnosed with some STD or another, and therefore he would require treatment before another round of Happy Fun Times could be arranged.

Cool. I performed my exam, obtained the specimens required to verify the particular sort of affliction that had been visited upon him, and ordered the appropriate medications. Then I sat down to chart.

In order to save charting time, I have a pre populated template, citing various common or normal findings. I reviewed my template, preparatory to signing off on this chart and moving along to the next patient, and noted my common finding of “post nasal drip”, “runny nose’, and “sore throat”.

I corrected these entries, thinking at the time, “If you have a runny nose, sore throat, and post nasal drip because of your venereal disease, you are likely way, way too sick to be seen by my midlevel self!”

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Prayers: Answered!

My brother, the “Massachusetts Brother”, with whom The Momette is presently residing, encountered an affirmative ANGEL, professional, engaged, conscious *AND* conscientious, who, per his report, has arranged a Rad Onc appointment, freaking TOMORROW!

That appears to resolve THAT dilemma.

Hearty thanks for any and all prayers, presented on Mom’s behalf.

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AN APPEAL TO HEAVEN

My mother HAD an appointment to see a clinician at the office she had gone to for 40 or so years, and that appointment was booked for 1030 this morning 10 September.

Circa 60 minutes prior to that appointment my brother, in Massachusetts with her, received a phone call relating, as he reports it, that the insurance she has from out here, was not accepted, notwithstanding the fact (according to the insurance company out here), that “any office that accepts original Medicare will accept our insurance”.

In addition, they would not, for reasons I do not understand, accept payment by check/cash/other negotiable specie, which my brother explicitly promised.

All of which they had two ….er, weeks… to figure out.

So, my appeal. My mother needs a radiation oncologist in Massachusetts. Typically, she will require a family doctor to refer her to one. Based upon present evidence, she does not have one. To our surprise.

Do any of you know of a radiation oncologist in Massachusetts, or can one of you finagle a referral to one?

Please?

Contact me at “reltney_mcfeeatyahoo.com”

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Tangents.

A long, long time ago, in a Blue Hive not so very far from here, I was Fighting Disease, and Saving Lives. In addition, I was pursuing my BSN, as in my imaginings, that which I desired to do required a graduate degree, and THAT required that I earn a baccalaureate degree.

As it developed, this week’s version of BSN program entry prerequisites included physics, and so I registered for, and took, a physics class. Of course, I worked 1900 to 0700, and, equally of course, class was from 1900 to 2000. So, I played “Let’s Make A Deal!” with one of the guys from day shift. In exchange for Day Dude staying over to 2030 hours, I would stick around until 0830 the following morning, allowing Day Dude to sleep in a bit. Sleeping was an activity generally highly thought of in my circles.

I am a bit of a science dilettante, and enjoyed the academic aspects of the course. This one time, I had a question regarding the material. Once class had taken a break, I approached the instructor. Since I had to immediately scurry off to the firehouse post class (see above), I was in uniform. In those days, EMS uniform was tan shirts (think sheriff office), and forest green pants. On each shoulder was a large (think, Seventh Cavalry sized) patch proclaiming the bearer to be a part of “Da City Fire Department, EMS Division”, rockered around a large, forest green, “Star of Life” which occupied the very center of the patch. Not particularly subtle, amirite?

So, I approached the instructor. As my turn to have his attention arrived, I started to speak my question, only to be interrupted by him. “Are you some sort of forest ranger? “

Wow, talk about flight of ideas! I ignored him, and asked my question. He asked his, again. I answered him. “Nope, I’m EMS, See?”, and turned so the large patch was almost in his face. “Now, about the class….”