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

Sleeping With a Chainsaw

A long, long time, in a galaxy not so very far away, I was working for Da City’s EMS. Since I was in school during the daytime, I worked nights.

So, TINS©, TIWFDASL©, and it was my turn to take the detail. In those days, several of the medic houses on each shift had three medics assigned. In the event that another unit had a sick call, or somebody off injured, well, “Tag! You’re IT!”, and somebody got to pack their crap up, drive across town, and work an unfamiliar house with a (occasionally) unfamiliar partner. The night of this tale, it was my turn.

EMS, in those days, was sort of a small town. There were around 160-170 personnel on the rolls, and what with shift rotations, details, and commonly running into a couple of the dozen or so hospitals in Da City, well, nobody was an unknown quantity. For example, during several of the years I was on the road, I was dating one of my nursing school classmates. She was, let us say, “of the African persuasion”, whereas I am purely white bread. One fellow, who I was acquainted with only in passing, had occasion to work with one of my former partners, and was quoted, by that partner, as inquiring as to the status of my relationship with my classmate. The exact quote was relayed to me as “Is McFee still seeing that (‘N-word’) bitch?”

(clears throat) Uh, well, ya see, (a) the pejorative referenced nowadays by the circumlocution “The N-Word”, was not acceptable among persons of education or pretense of good upbringing, even in those benighted times. (b) My girlfriend was in no way, shape, manner or form “a bitch”. Indeed, the time we shared lifted my own life in ways that, now, nearly 40 years later, I am still discovering. And, of course, (c) My partner stood up for me, inquiring of Mr. “More Mouth Than Sense”, if his mother was still employing her skills as a practitioner of The Oldest Profession. For some reason, in my partner’s report, further conversation ended right about that point.

So, nearly everybody on the job in those days either knew everybody else, or knew of everybody else. So, it came to pass that I was detailed out to work with Lonnie Evans, let us call him. He was renowned as working two, perhaps three, full time jobs. This led to his reputation as the soundest sleeper in the department. In addition, since it seemed that he was acutely-on-chronically something like 2500 hours in arrears on his sleep allotment, well, when you add obstructive sleep apnea to that recipe, stir lightly, and allow to rise overnight, you get to observe what 40-60 seconds between breaths sounds like. And, due to the fact that he snored with a sound like a tractor trailer starting up on a very, very cold morning, well, if your 8th cranial nerve was functioning, you were not going to miss it.

I had a sleepless night, with only a few runs. (talk about mixed blessings!). The next night I reported to Medic Four, and regaled my partners, Doug and Andy, with a review of my night across town. Andy had had a similar experience, a few weeks previously.

He reported, “Yeah, Lonnie snored like a chainsaw starting up, alright. That wasn’t the bad part! Every time he stopped breathing, I snapped awake, wondering if I would have to start coding him! After considering this possibility for several minutes, I decided that I was NOT going to do mouth-to-mouth on him, so I got the bag-valve-mask, an oral airway, some tongue blades, and positioned the handie talkie where I could reach it in a hurry. While I did not sleep any better, at least I knew I wouldn’t have to wind up kissing his wrinkly ass!”

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

“Social distancing”, before it was KEWL!

So, TINS ©, TIWFDASL ©, working midnights in a little ED in a little hospital, Up North. One fine day, I awakened at the crack of noon, only to find that TDW-Mark I had my afternoon planned out for me. Our little town had a poverty of grocery options, so every so often, TDW-Mark I would venture over to the next county (or two), shopping in the Mega Mart found there.

This was a sort of yin/yang experience. Yin: inconvenient drive, dragging young children along, considerable time devoted to the expedition. Yang: better selection, better prices, and Family! Bonding! Time!.

So, off we went. TDW had a list, of course, and she was mission focused. That left me to corral the kids, and prevent them from adding unauthorized items to the cart. (“No, Adam! You cannot get marshmallow cocoa sugar treats for breakfast! No, I do not care what all the other kids eat, you are not all those other kids, and your parents are ogres, who insist that you eat something in the same phylum as wholesome, when you eat!”)

As I hovered, redirecting my children, I noticed that this particular store seemed infested with bovine obliviots. I reached this conclusion after several near collisions wherein Obliviot A would nearly run one or the other child over, and then look at me irately when I intervened, and noted that striking my child with a cart would result in severe injury. To the obliviot.

Whatever. I figured it ranked up there with a “beware of dog” sign. Likely, my jury would think that I had an obligation to warn the lowing masses that there was a ravening dad about, and they might want to take suitable precautions. Before I did.

So, after several near misses, I decided that I had had enough. Most of the traffic went this way up this aisle, and that way down that aisle, a fact that I capitalized upon. I settled myself, straddle gaited, in the very middle of the aisle, upstream from my wife and children. Yes, I effectively blocked the entire aisle. That, was, in fact, my “plan a”. My intent was that, succeeding in “plan a”, I would not have to implement “plan b”, which would be accompanied by shrieking and blood, both emanating from the inattentive obliviot who succeeded in striking, and hurting, one of my children.

So, there I stood, colossus like, and, of course, one of the bovine meandered down the aisle. Finding me in her way, she spoke. (surprise!) “You are blocking the aisle!”

I smiled, a smile that in no way reached my eyes. Indeed, most of my teeth showed. “That is correct.”

She advanced, as if to strike me with the cart. I smiled wider. “You have to move! I cannot get past you!”

“Yep! That’s sort of my plan!”

She was not taking in the entire picture. “But, you have to move!”

More teeth on my part. “Well, ma’am, why don’t you just move me? If, that is, you think you will survive that encounter, uninjured?”

Unwilling to take that bet, she continued her protests. I glanced over my shoulder, noted that my charges were rounding the corner, and clearing this aisle. I waved, cheerily, and made my way to the next aisle, which I then blocked.

Soon, TDW-Mark I asked me what I was doing. I replied, “Have you noticed the folks who nearly struck the kids with their carts?”

“Yes! That is so rude!”

I agreed. “Yep. Do you know what is successful in preventing that?”

“No, what?”

“My convincing them that, yes, I am crazy enough to put a beat down on them, should they successfully strike my children! It turns out, if I look crazy enough, they shop in some other corner of the store, and my children are not gonna get struck by an idiot with a shopping cart!”

Fun And Games Off Duty · Pains in my Fifth Point of Contact

Customer “service”, and Why I Grind My Teeth.

Conversation with XM customer service:

“I want to cancel my service with you people.”

“You can’t. You have a contract that lasts a year”

“Well, I’m not going to pay you. We agreed you’d bill me at the ‘new customer’ rate for each of the next 12 months, yet this bill is nearly twice that. I will not pay it.”

“If you do not pay us in the next 5 days, we’ll cancel your service.”

“Why don’t you think about what you just said. Can you explain the difference between what you just said, and what I want to happen?”

Pains in my Fifth Point of Contact · Pre Planning Your Scene · Protect and Serve

WuFlu, Kung Flu, Chinese Flu, or Coronavirus: It IS a big deal, but not for the reasons you likely have been told!

The number of projected deaths, when all is done, is not THE PROBLEM. At north of a million people (that’s one million, or more fathers, mothers, brothers, sisters, sons, daughters, grandfathers and grandmothers. And aunts, uncles and husbands and wives.), that is certainly bad enough. Particularly if someone you love is enumerated in that group. Life changing. Reality altering. Leaves a hole in your heart, your life, that you cannot imagine, unless you have lived through it.

BUT! THAT is not THE PROBLEM. THE PROBLEM, is the follow on effects, as a tsunami of ill inundates our already (on a good day) marginal health “system”, that it is in no way prepared for.

“Just in time” inventory systems will not bite us in the ass. Nope, not at all. Rather, the shortfalls and absent supplies will make us yearn for simply being bitten in the ass. Indeed, the “bite us in the ass” problem will more closely resemble the “bite in the ass” one might receive from a hungry great white shark, or, maybe, a ravenous tiger.

Ragarding the magnitude of THE PROBLEM, you need honest numbers, and then you NEED TO UNDERSTAND THOSE NUMBERS! See Lawdog’s blog, here , for an explanation of testing error (false positives/negatives, and the implications thereof).

See Aesop’s articles, here, for his description of the second order effects, and how it will make a clusterf…er, HUG! look like a picnic with your Bible study group. I do not know about timing, but, based on 30 + years as an ER nurse, and a dozen as a PA, and several as a medic, well, his assessment of effects is certainly defensible. I pray he is wrong, but I do NOT believe that he is wrong. (While you are there, read his other posts, about the follow on effects, about how this has been mishandled since, oh, 20 or more years ago, and about missed opportunities).

(and, READ HIS COUNSEL [in other posts] ABOUT PREPAREDNESS, BOTH LOGISTIC AND TRAINING! AND TAKE IT TO HEART!)

Good fortune to you all, and WASH YOUR DAMNED HANDS! NOW, DO IT AGAIN! AND AGAIN!

Fun And Games · Pains in my Fifth Point of Contact · Pre Planning Your Scene · School Fun And Games

Paramedic School Stories, Part Two:

Which brings us to STORY NUMBER TWO: (remember the grading scheme outlined last week) In the fullness of time, the second semester ended. I calculated the point total for each student, compared said total to the pre established thresholds for each grade, and, based upon this calculation, assigned grades.

I posted these grades, after turning them in to the program director, who was my immediate superior.

Shortly thereafter, I received a phone call from one student, let us call her Little Mary Sunshine. She was upset at her grade.

“Mr. McFee, you gave me an A minus, and I think that I deserved an A”

“Oh?”

“Yes. I think that you should have given me an A.”

“I agree with you.”

“Oh? You are going to give me an A?”

“Nope. I agree that you think that you should be given an A. On the other hand, you earned an A minus.”

“But, I checked my scores! I only missed an A by a single point!”

I checked my grade book. Yep, needed 920 points, earned 919 points.

“I agree with your calculations. You missed it by a single point.”

“I think that you should simply give me that point!”

“How interesting. I however, do not.”

“But…but…it’s not FAIR!”

“In what way?”

“I think you should just give me that point, and then I’d have an A!”

“If I were to give you that point, you would, indeed have an A. On the other hand, you, indeed, EARNED an A minus.”

“But..but..It’s Not Fair!”

“May I ask you a few questions?”

“Uh, OK.”

“You were present in class the first day of class, correct?

“Uh-huh.”

“As well, for the midterm, and the final that first semester, correct?”

“Uh-huh.”

“Likewise, the first class of the second semester, and the mid term of that second semester, correct?”

“Uh, yeah.”

“Did you hear me talk about extra credit, on each of those 5 occasions?”

“I suppose so.”

“And, did you speak to me one solitary time about any sort of extra credit of any sort?”

“But…but…I never imagined that I’d need any extra credit!”

“Yet, here we are. Had you turned one solitary extra drug card, and the only things on that drug card that were correct were your name, the brand name of the drug, and the generic name, you would have earned that extra point. You did not do so. If you do not care about your grade that much, why should I care any more than you demonstrably do?”

Sometime later I received a call from the director of the program, who asked me about Little Mary Sunshine’s concern. I related the conversation, as related above, and summed up: “Bob, it’s your program. You run it, you are responsible for it. If YOU want to give her that A, go ahead. Simply understand that I will not be signing any other grade form for her. You want to do it, be my guest.”

I heard nothing further on that topic.

Fun And Games · Pains in my Fifth Point of Contact · Pre Planning Your Scene · School Fun And Games · Sometimes You Get to Think That You Have Accomplished Something!

More Paramedic School Stories: The First:

Years and years ago, before I left Da City’s employ as a medic, I had completed nursing school, written my boards, received my license and was living large. For certain values of “large”, that is.

I had been offered, and accepted , a position teaching pharmacology, part time, for the program that I had graduated from. The textbook we used (Nancy Caroline MD: “Emergency Care In The Streets”) was outstanding, and provided a clear template around which to build my lesson plans.

One of the innovations that I introduced, from my own nursing school days, was a particular format for drug cards. The point thereof was to have, on a 3 x 5 or 4 x 6 card, the names of the drug in question (trade and generic), the common dosing and route of administration of the subject drug, indications for using the drug, contra indications for using the drug, the mechanism of action of the drug, and the class (often, these last two overlap: a drug classified as a “Beta Blocker” worked by blocking beta agonism on the sympathetic nervous system. If you had mastered that point, you knew that the drug would serve to slow heart rate, mildly constrict arterial muscles (net effect of lowering blood pressure due to slower heart rate and decreased strength of contraction leading to diminished cardiac output), CONSTRICT bronchial muscles, and reduce intra ocular pressure. Or, you could write all that stuff out. For every beta blocker you encountered. Fun times. I simply earned what beta agonism tickled, and knew that blockade thereof reversed those effects.)

In addition, the cards noted nursing considerations (things the nurse, or paramedic, ought to have in his/her mind when employing this medication. Like, Beta blockers: check and recheck heart rate, blood pressure, and monitor the EKG, looking for slowing conduction of the elelctricity that controlled things).

Now, some of my students were first timers. They were folks who, as you might imagine, were taking paramedic classes for the first time.


In The Un-Named Flyover State, the licensing drill went something like this. You successfully completed the course, and took the exam. Pass it in one, bingo, license in hand, go out and fight disease and save lives.

If you failed the exam, then you got one chance to re take the test portion that you had failed.

If you failed the retest, you had to successfully complete a refresher course, whereupon you could re-test, again.

If you failed THIS test, you had to take the entire generic paramedic program, from step one, all over again.

As it happened, a couple of students had, indeed, found themselves taking the paramedic class, in order to qualify for a FOURTH retest.

So, TINS©, I laid out my expectations, had conjured up a 1,000 point, tow semester grading scheme, wherein around ½ of the grade (250 points each semester) would come from the midterm and final, combined. Another 25 points came from each quiz, administered each week in class. 16 weeks in a semester, no quiz on mid term or final weeks, and two other weeks off for review for the mid term and finals, 20 quizzes.

I announced at the beginning of each semester that I would consider extra credit in the event that any student came to me in advance, suggested something that would reflect additional pharmacologic study, and be pertinent to paramedic practice.

So, STORY NUMBER ONE: Somewhere around mid terms, one of the students rose in class, and delivered a pronouncement: Reltney, paramedics don’t need to know all this stuff. Nurses, yeah, I get that nurses need to know this stuff, but paramedics don’t!”

I invited him to hold that thought, and we could speak, in detail, after class. After the end of class, this fellow, along with a couple fo his work mates, all met with me, eager to set me straight.

As it happened, all of these folks were of the looking-at-a-fourth-retest group.

I invited my correspondent to state his case. He did so, as outlined above, with no new explicative material, no new rationale for his position.

I deliberated a moment, and fact checked myself. “So, you have taken the paramedic exam, correct?”

“Yep!”

“And, you failed it, is that correct?”

“Uh, yeah…”

“Then, you took it again, did you not? And, failed it, again, am I correct?”

“yeah…”

“And, again, after a refresher course, you took the paramedic exam, and, again, you failed it, is that also correct?”

(much more quietly) “yes…”

“So, I’m confused: you are not an RN, are you?”

“Uh, no…”

“So, let me see if I am understanding you: you are telling me, who has taken, and passed, the paramedic exam, and who is, also, an RN, that you are in a position to have an opinion that I ought to find persuasive, regarding what it takes to successfully take and pass the paramedic exam, based upon your experience in taking the exam, and failing it, what, three separate times?, did I hear you correctly?”

He mumbled something indistinct, and found somewhere else that he felt the need to be.

And, I did not hear THAT particular argument again.

Fun And Games · Pains in my Fifth Point of Contact · Uncategorized

Random Thoughts III

Story “A”

You may recall my delight at marijuana legalization, correct? Because, “medical marijuana” wasn’t ENOUGH of a cluster f*&k, right? Of course, there is my recurrent delight at the discretion, great judgment, and common courtesy displayed by the genuii who stroll (nay, stumble) about, reefer fumes pouring from every fold of their clothing, if not every pore, in a nigh overpowering display of Poor Life Choices On Parade.

So, TINS©, TIWFDASL© when this braniac arrived, spawn in tow. My poor clerk registered the Named Patient (actually, plural, as in both kids), and then let me know that the chart was ready for me to lay some healing upon them. As if.

So, my first clue that Things Were Not Right, was when the nominally 3 year old child, named Adam, was sitting upright reading some (non picture) book. My second clue was that the nominally 12 year old child, was around 36 inches tall, and appeared to be around 40 pounds. And, did NOT appear critically malnourished.

I asked the reading child, “Please, tell me how old you are?”

The reply was “I’m 12!”

“How old is your brother?”

“Oh, he’s 3!”

I excused myself, and asked my clerk, “Did you know that Adam is 12, and Brady is 3?”

She looked at me, and informed me, “I asked the mother, and asked her twice, which child was which, and who had what birthday. It did not look right to me, but she repeated herself, same birthday both times, for each child. That is what I put down.”

“Well, it is wrong. Please, fix it, and double check it, all over again. Please try to sort out what else she fucked up in registering the kids, please.”

Once the clerk asked the 12 year old for his school id, the mystery was resolved.

My new Life Rule! If you are so stoned that you cannot remember your own gorramned childrens’ birthdays, and you successfully mix the TWO of them up, either stay the Fenomenon home, or WRITE IT DOWN!

Story “B”

Have you heard about Homeopathic Medicine?

What Is Homeopathy?

“Homeopathy, also known as homeopathic medicine, is a medical system that was developed in Germany more than 200 years ago. It’s based on two unconventional theories:

*“Like cures like”—the notion that a disease can be cured by a substance that produces similar symptoms in healthy people
*“Law of minimum dose”—the notion that the lower the dose of the medication, the greater its effectiveness. Many homeopathic products are so diluted that no molecules of the original substance remain.

(from: https://nccih.nih.gov/health/homeopathy )

Let’s keep “The Law Of Minimum Dose” in mind for a moment. So, I work in an urgent care clinic in The Un-Named Flyover State. It’s….quirky. Yeah, let’s go with that. So, our cleaners are some folks who are NOT from some national housekeeping chain. I do not know where the owners hired these folks from, but, well, they are, in keeping with the theme of the organization, quirky themselves.

Over the past several weeks, I have been noticing that the hand soap dispensed from pump bottles, has been appearing clearer, and clearer. Similarly, it has seemed less viscous, and less viscous, from week to week.

In keeping with these observations, it has started to require more and more pumps to elicit enough soap to, ya know, WASH MY HANDS!

One of the MA s clued me in to what is happening.

“The cleaners never pour more soap into the dispensers, they just add water. It’s free, unlike the soap that costs.”

I wondered, out loud, “What happens when it is simply only water in the “soap” dispenser?”

She told me, “I dunno, maybe, finally, they’ll buy more soap?”

I corrected her. “NOPE! We will be told, that this is the latest public health innovation! Homeopathic soap!”

Story C

A long time ago, in a county far, far away, I was working as an ER nurse. I overheard one of the clerks engaged in a telephone call.

Now in this agency, at that time, Administration did not want us providing “medical advice” over the phone. I was on board. My stock spiel, when I was trapped into answering some such call, was along the lines of “If you think you have an emergency, you ought to come to the emergency department. If you do not think that you have an emergency, perhaps your problem could wait until (the morning)(Monday), at which time you could arrange for your family doctor to address it. If you do not think that your problem can wait until (the morning)(Monday), well, at this time of night, your only option is to come in to emergency.”

I, myself, often would be the recipient of some query at that point, along the lines of “Well, how do I know if it is an emergency/can wait until Monday?”

My answer would be “You are there, you have sense (Yeah, I was lying through my teeth!), and only you can make that determination. I am not there, and I cannot see what you can see, since you are on the scene, and I am not.”

So, I heard the clerk speaking to some Brain Truster. Attempting to explain, repeatedly, how and why she could not tell him whether his laceration needed stitching. Mr. Telephone was persistent, and I could tell, from my clerk’s responses to him, that he was saying stuff like “Well it’s (insert length here) long, and about (insert depth here) deep, and it’s (insert some indicator of severity, like bleeding or suchlike here), so why can’t you tell me if it needs to be stitched?”

She finally had had her fill of his idiocy. “Sir, what color blouse am I wearing?”

“How the hell would I know what color blouse you are wearing?”

“So, how am I supposed to have any opinion worth anything about your cut?”

Fun With Suits! · guns · Pains in my Fifth Point of Contact

“The Gun Show Loophole!”

One year, my (very successful) brother rented a house in Some Blue Hive State, so his family could summer there. I received an invitation, that should I wrangle the time off of work, and my own transportation, I’d have a spot to stay and join in the merriment.

TDW was interested, and so I arranged vacation, and purchased plane tickets. One car rental later, and we were off!

My brother is an alumnus of an Eastern Sophisticated University, and, therefore, all of his college buddies are, as well. That trends towards them also being of the Blue Hive Borg, where, evidently, “assimilation is Mandatory!”

All these fellows are attorneys, and, generally, pretty smart. No surprise there, right? So, one evening, after consumption of Tax Stamped Beverages, well, one guy (let’s call him Bob, “not-his-real-name”) overheard The Darling Wife regaling me with her recent visit to an Unnamed Flyover State Gun Show, wherein she had purchased an AR pattern rifle, in 6.8 Rem Special. Good News: She was very excited at her selection, describing her new rifle as “Pretty!”. Bad news: Have you PRICED 6.8 Rem Spl ammo lately? Holy Stool, that is expensive ammunition. Not as pricey as H & H .375, or .416 Rigby, I’ll grant you, but pretty spendy against sixty-cent-a-round .223 ammo.

So, Bob told us what his thoughts about that were. That is, if you could characterize him as “thinking” on that subject. “Man, they ought outlaw gun shows! That gun show loophole is awful!”

I know a thing or two about guns, as does The Darling Wife. She had, after all, just the preceding month gone to a gun show, and purchased a rifle. Indeed, in terms of contemporaneous experience based knowledge, she might qualify, within the confines of that house, as a subject matter expert.

Therefore, I asked Bob, “Oh, really? What is the ‘gun show loophole’, and what is the most objectionable part of it, in your view?”

He apparently was not one to let ignorance of the subject get in the way of a good opportunity to let his “woke” flag fly. “Why, it shouldn’t be allowed that simply anyone can just walk right in to a gun show, and just buy any sort of gun that they want, and then just walk right out!”

“Say what?”

He was gonna repeat himself. “Any sort of drunken lout, or mental defective, or terrorist, or mass shooter, can just walk into any gun show, buy any sort of mass murder machine that they want, and waltz out! No background check, no permit, no nothing!”

I turned to My Darling Bride, and said, “Honey, didn’t you just buy a rifle at a gun show a couple of weeks ago? Why don’t you tell Bob, here, how that worked?”

She smiled sweetly at me, and turned to Bob. “Well, I paid my admission, I walked the aisles until I found that rifle. It looked so pretty, I thought that it ought to be my first AR. I negotiated a rice with the seller. He then needed my picture ID, as well as my concealed carry license. He called the National Instant Check System with my information, and got an approval. He recorded the approval serial number, and then I had to complete a form 4473 before we could complete the sale.”

I invited her to be more detailed in her tutorial for Bob. “So, Honey, what’s a ‘Form 4473’?”

“Well, it is a sworn statement, under penalties of both perjury as well as violation of the federal Gun Control Act, that I’m not a felon, fugitive from justice, mentally ill, an illegal alien, have never been convicted of a crime of domestic violence. There’s a couple of other reasons that I could be disqualified, but they are all listed right there on the form. No sale can move forward without that form.”

Bob could not contain his superior expertise any longer. “That’s just wrong! None of that is required!”

I turned to him. “Really? Why don’t you tell us how it went, the last time YOU purchased a gun at a gun show?”

He looked at me, surprised. “I have never bought any sort of gun, ever! I do not own a gun!”

I feigned surprise. “Really? So, just how did you come by your expertise regarding how things really happen in a gun show, such as to contradict my wife’s recent, personal experience in a gun show? Buying a gun, no less?”

“I read it in the New York Times! They said that’s how it works!”

I looked at my wife, and she at me. I continued. “So, let me see if I heard you correctly. You have never bought any gun, ever, anywhere. You read some bullshit in the New York Times, and that is canonical, for some reason. Based on some perhaps third, maybe fourth hand story, that you think you remember reading, in that noted journal of all things firearms, The New York Times, you are in a solid position to tell my adult wife, sitting right here, that things that she, in fact, and in her own direct testimony actually, really, and recently experienced, did not actually experience. Now, that means that you are either telling me my wife will lie, smiling all the while, to your face, or she is so stupid or mentally defective that she cannot tell what she actually did, at a gun show, buying a gun. Now, mind you, she successfully passed the training to qualify for, and the background check to be issued, a license to carry a concealed handgun from The Un-Named Flyover State. So, pray tell, on what basis does your superior intellect and greater knowledge in All Things Gun, lead you to accuse my wife of imbecility, or lying to your face? Please, go slowly, and show your work!”

At this point, Bob had the wit to stammer, and not answer my questions. My brother, wisely, diverted my attention with some query of firearms law esoterica.

So, therefore, I did not break a stein over Bob’s head.

Although, I still wonder if it might have improved either his manners, or his intellect. Or, perhaps, both.

Fun And Games · Fun With Suits! · Pains in my Fifth Point of Contact

RANDOM THOUGHTS

RANDOM THOUGHT THE FIRST:

I had seen a soul for some malady or another, and had prescribed an antibiotic. In keeping with our usual practice, I had e-prescribed this medication, sending it off to the pharmacy the patient had identified as his preference.

An hour or so later, the receptionist received a phone call FROM THE PATIENT, asserting that the medication was not covered by his insurance.

I receive these calls frequently. Simply so that you know, the mere fact that any particular medication had been covered by one or another of the hundreds and hundreds of different health insurance plans that are out there, by no means establishes that this medication will be subsidized, today. In addition, each individual health insurance plan has it’s own “formulary”, or list of what medications it will subsidize, and to what extent. These formularies differ from Medicare (and among different medicare plans, as well), to Medicaid (and, again, among various flavors of Medicaid), to assorted flavors of private health insurance. Again, formularies vary from one private insurance plan (say, one particular form of Humana insurance), to another (like, one of the insurance products from Blue Cross).

Therefore, it is not uncommon for these calls to come in. Generally, they are from the pharmacist. Then, the pharmacist, who has access to the insurance company’s formulary, can suggest another similar medication that will be subsidized. I will request it, and we all go on about out lives.

When they originate from the patient, it becomes somewhat of a time sink. What, am I gonna tell the patient what the new medication will be, and the dosing regimen, how many doses to dispense, and so forth, so that the patient can communicate this to the pharmacist? (anybody ever hear about, ya know, PRESCRIPTIONS?)

Occasionally, when I have some sort of wild hair up my ass, I am tempted, briefly, to do just that. “Why, thank you for the call, Mr. X! Please tell the pharmacist that I am changing your prescription from Amoxicillin, and instead I will prescribe Mofeen, one pound, and you are to take ad lib and prn until the heat death of the universe! And, you have a nice day!”

My filter has,thus far, worked without fail. I have never told anybody that…out loud.

Instead, what I do, indeed, say, out loud, is “Please invite the pharmacist to phone me, and he and I can discuss it.”

The Second:

I had occasion to phone another physician’s office, in order to have my patient seen that very day. I generally make this sort of call myself, when I need a same day appointment for my patient, because I can either explain all the particulars of the scenario to my MA, who can then repeat it to the other office’s MA, and then have her seek me out when, inevitably, there is some question that I have failed to explain in sufficient detail, or I can do it myself, explaining things once.

I vote for “Once!”

So, TINS©, TIWFDASL©, and on hold/ignore. Eventually, the other office’s scheduler came on the line, and we had our lovely little conversation about my patient’s malady, and why I felt the burning need that this soul be seen TODAY!

Everything proceeded swimmingly, and I noted the time and address of the particular office my patient was to report to. The scheduler asked my name.

“Reltney McFee, PA.”

“How do you spell that?”

“R-E-L-T-N-E-Y, M-C-F-E-E.”

She read back her note: “R-I-A-L-D-M-A-I, M-A-K-A-S-E-E?”

I had not really slept all that well the previous night, and had several people in the waiting room, eagerly awaiting (DYSWIDT?) my attention, so that they could get on with their own days. I quickly calculated that I could get this chucklehead to properly spell my name on the scrap of paper that she would soon discard, or get this patient the hell out of my department, and on to Higher Level Of Care, sooner.

I (unsurprisingly, I wager) went with option “B”.

“Nailed it!”

The Third Random Thought:

My home state, The UnNamed Flyover State, legalized marijuana last year, for recreational purposes. I have spoken, previously, about my rapture at this development. While I have not, completely, cataloged every single way in which I think that this is a fail of epic proportions, perhaps I have revealed just a little bit of my lack of enthusiasm for this development.

A couple of times.

I have noticed in recent months the phenomenon of idiots (er, I MEAN, children of God) evidently wandering through the world stoned. I reached this conclusion because of the numerous folks who stop by my clinic reeking of reefer fumes.

I do not mean, “Hey! If I pay attention, I can detect a waft of a smell, as if of marijuana, somewhere about this person!” Nay, I mean “Dude! Are Cheech and Chong shooting another movie hereabouts?”, or, perhaps, “Is there some sort of Rastafarian festival in town?”

Indeed, occasionally the smoke is eye wateringly intense, yet the purveyors of the fumes appear unaware of the air quality hazard that they present.

I have wondered about that. I suspect one of two things is in operation here. Either they are so stupid, either at baseline, or due to the deleterious effects of marijuana upon their mentation, (maybe, I should embrace the power of “and!”?) that they simply cannot realize what they are spreading in their wake, or else it is some sort of pheromone, at least in their minds, that attracts The Opposite Sex.

Although, to be honest, anybody who would be attracted by the olfactory cues these folks present, I would not romance with your johnston!