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

SPOUSAL ADVICE

A few years ago, I was working a locums gig Up North. TDW-Mark II and I had lived our entire lives in The Un-Named Flyover State, and one recurrent feature of the winter news coverage was the seeming obligatory photograph of the snowy expanse of the northern part of the state. Now, I had grown up in Da City, largest in the state, nestled among the northern tier of states, and figured that I knew me some snow.

Well, it turns out, at least from the photographs of nigh unto 12 foot walls of snow adjacent to the roadways, featured in these photos, I did not know squat. So, when the opportunity arose to work on the shores of Lake Superior, and with this gig an opportunity to see, for reals, these selfsame walls of snow, well, off we went!

When you work 12 hour shifts, you get 4 days off every week. My placement was accommodating, bunching my days into a 3 on/4 off arrangement. That TDW and I plenty of chances to tour the area.

Unfortunately for our intended snow tourism, the winter had been mild, and that snow which had fallen, was paltry. To be honest, we had more snow downstate, than in The Great White North.

Whatever. There was still abundant history and scenery to take in, and we set out to do so. One of our tours took us to the norther edge of the state, to a lakefront town. It was pretty, although, surprisingly, with all the tourists gone, nothing was open.

So, this episode of our curiosity sated, we headed back to our hotel. Cleverly, I suggested that we return along the lakeshore road, which ran along a bluff and overlooked, you guessed it, the lake.

Remember that this was late December, and in Da Nawth, in winter, sunset blasts past you, and night drops upon you like a net. Or, so we experienced.

Simply to make everything nice, it had begun to sleet-mixed-with-snow. Let us review the scene, now: Night? (Check!) Snow/sleet? (Check!) Unplowed Up North roads? (Check!) Slush accumulating on the roads? (Check) And, certainly not least, Anxious Wife overlooking the drop off onto the icy, rocky shore of The Lake?(Why, yes, CHECK!)

So TINS ©, There I Was, Driving Along and Making Time towards our hotel, when I splashed through some accumulation of slush. Our vehicle jogged, just a little, and TDW emitted a shriek.

I suggested that, since it was black outside as a politician’s heart (should such a thing really exist), and I generally had this under control, perhaps declamations of impending doom, absent clear indications of said doom, might distract me from successfully managing to move forward, while maintaining our position on the pavement. Some might consider failure to accomplish this to be A Bad Thing.

She apologized, and I returned to navigating and aviating (so to speak).

A little while later, a county road commission salt truck/plow overtook us (and, yes I WAS driving that slowly!), passed up, and in doing so sent a moderate sized spray of slush and whatnot onto our windshield.

TDW shrieked, again.

I slowed even more, came to a stop on our nearly deserted stretch of icy snowy roadway, and turned to my bride.

“Honey”, I began, “I realize that you have concerns about the wisdom of driving on this road, under these conditions, tonight. However, since we are something like 30 miles from our hotel, and I am unwilling to spend the night sleeping in this car, driving to the hotel is out only reasonable alternative.”

She nodded.

“In addition, you DO recall, that I have driven in snow, for something approaching 50 years, right? And, therefore, know just a little bit about driving in these sorts of conditions, right?”

Again, she nodded.

“While I realize that you want to do your part to help our drive be safe, efficient, and trouble free, I want you to realize that, whatever you may think, it is really not particularly helpful, and nowhere near as helpful as you appear to think it is, when you scream at seemingly random intervals, while I’m driving unfamiliar roads, in pitch black night, in snow and sleet, along a cliff face.

Please, stop!”

Fun And Games Off Duty · Fun With Suits! · School Fun And Games

Hazards of Immobility







So, TINS©, TIWFDASL©, working full time and going to Nursing school full time when not in the firehouse. Oh, and sleeping. When I could.

As you may have surmised from the foregoing, I was acutely-on-chronically sleep deprived pretty much entirely through school. I have previously revealed what the director of the program thought of my first pass resolution of that problem, wherein I skipped lectures and slept in, however briefly. (Review: NOT MUCH!)

Therefore, I showed my happy academic ass up for every lecture, and attempted to take notes and generally avid snoring and/or drooling. In order to assist with my camouflage, I typically sat around 2/3 of the way back in the lecture hall, and about 40 degrees off axis from the lecturer’s line of sight. One particular failure of my strategy still stands out in my mind.

The subject was “Hazards of Immobility”. Unfortunately, one of the hazards of immobility, that the instructor did not enumerate and then explain in PAINFULLY elaborate detail, is somnolence. For those sleep deprived, as I was very much so in those days, sitting still was nearly a death sentence. I was wedged into my seat, and getting more comfortable, and more comfortable, and finally felt my pen slip from my fingers. I woke up at that, and retrieved my pen, again settling myself into my wedged-upright position.

I shook myself kinda sorta more awake, and resumed taking notes. Sleep crept up on me, again, until I heard our instructor asking, “Perhaps Mr. McFee can tell us about calcium and immobility. Mr. McFee? Won’t you join us?”

Without opening my eyes, without moving, I responded, “Well, patients who are immobile long enough, began to mobilize calcium from their bones, and excrete it via their kidneys. This places them at risk of both renal lithiasis, as well as pathological fractures.”

I heard the pause. She sounded surprised. “Mr. McFee, I was convinced that you were completely asleep!”

Still eyes closed, still unmoving, I cleared things up for her. “Ma’am, I understand how you might think so. In contrast, I find myself in an advanced state of relaxed alertness. Ma’am.”

I managed to stay awake enough to take notes for the balance of that hour.


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

“Little Mary Sunshine is NOT a Force Multiplier!”

Once upon a time, long ago and far away, I was nursing in an ER in a medium sized city. For some reason, I was unable to evade being placed in charge.

Lord Knows that I tried! While I have established that I can be reasonably effective in a supervisory role, I really do not like it. For one thing, it places me in overly close proximity to Suits. I do not enjoy proximity to suits. Hell, my Suit Aversion Disorder led me to work midnights, in the first place! (well, that and shift differential, as well as seven-on-and-seven-off scheduling, to be honest.)

For another, I get subjected to all the bullshit from other departments, which, invariably, appears to consist of interacting with slothlike souls who manifest only one burning desire: skate through their shifts, while expending as little effort as is needed to maintain their receipt of a paycheck. Notice, I did not attribute to these chuckleheads the desire to actually do something resembling their jobs. That would be different.

Finally, when in charge, I get to cope with all the malignant and ill considered decisions regarding staffing the aforementioned cursed suits have enacted.

So at this point I was working in a relatively urbanized area, with a sixteen bed ED, in a town with three total Eds of various sizes. We had been short staffed for an extended time. This, of course, made me oh, so very happy. Or, not. I had been bitching, complaining, protesting and generally making known that not only was this sort of staffing insufficient, but, into the bargain, was considerably short of their own goddamned published staffing parameters, written by the goddamned suits themselves, and for which I would be written up should I let someone go home leading to staffing short of these parameters.

Well, as it developed, one of the Junior Suits (our assistant director) was compelled to show her smiling face up to work some of the short midnight shifts. She was, let us say, “entertaining”, to work with. She would “help out” by triaging. Well, when you triage someone, it is helpful if you (1) obtain and record vitals, (2) ascertain, and document allergies, medications, medical history, as well as (3) history of present illness, typically elicited by asking something along the lines of, “So, Mr./Ms/Xr X, what motivated you to come out in the dark of night to join our happy little party?”. You did notice how much fun I seemed to think it was, to, ya know, DOCUMENT, the aforementioned items, right? Sort of like that was, oh, I dunno, a GOOD THING, or something?

So, it develops that Little Mary Sunshine did not document (or even obtain; it was difficult to sort that one out) vitals, allergy/med/history, or present complaint information, at least, not consistently. In addition, it seems that an ED physician with, say, a dozen patients, really, really gets petulant if these items are not there in the chart to be found. Slows him/her down, considerably.

Then, there is the part about both bedding the patient, as well as noting such fact on the greaseboard, as well as reporting off to the the nurse who would, oh, I don’t know, maybe BE CARING FOR THAT PATIENT.

Finally, it was established practice to start the needful IVs, collect the blood, and send it to the lab, along with a requisition for the bloodwork the physician was going to be desiring to see. None of which had penetrated Little Mary Sunshine’s cranial vault.

She was no more helpful as a “floor” nurse, Which is to say, she would half ass do things, not tell anybody at what point she had grown disinterested and wandered of Ghawd alone knew where, let alone document anything that she, by some miracle of random happenstance, completed.

As my partner, Andy, opined, “Ya know, she is not really a very effective force multiplier!”

Much more nicely phrased than the tsunami of profanity that was boiling away, waiting for me to spew forth as my OWN opinion of her “efforts”!

So, visiting as she was from the warm climate of Daytime “Suitworld”, Little Mary Sunshine was chilly most of the time. (she might have been warmer, had she been moving about as briskly as the rest of us, but, then….) Andy, once again demonstrating the situational awareness that made him a fine nurse and great partner, noted this fact, and brought it to my attention one long, long night during a missing Mary moment.

He implemented a plan based upon this observation, and turned the department thermostat down to around 60, from the typically balmy 70 where it normally rested.

Well, time passed, Mary Sunshine wandered around, fucking things up, and soon the HVAC system equibrillated at the new set point. Mary zipped up her sweatshirt, and began to complain that it was cold.

Nice of her to notice.

Shortly thereafter, she loudly opined that “You guys seem to have things under control. I’m gonna go back into my office and do some paperwork. Call me if you need me!”

Once she was safely away down the hall towards her (independently heated) office, we returned the thermostat to the baseline setting.

The rest of the night passed as the typical clusterfuck of shortstaffed jackassery, fortunately not exacerbated by halfwit half assed managerial fumble fingering.

Fun And Games

“The Price is Right!”

Once I had departed the employ of Da City, I worked as a RN in one of the little ERs dotting Da City. At that point in time, there were perhaps 18, maybe 20 hospitals big or small serving Da City. I worked at one of the middling sized ones, at that time around 300 beds.

Working midnights in ER, well, you commonly find yourself spending time with folks who make poor life choices. Those of you who have worked nights, or do presently, bear with me. Alcohol is a commonly abused drug. Shocker, right? Moreover, those who use alcohol to excess, commonly also do other, similarly, stupid shit. Said stupid shit, typified by the admonition, “Hold my beer, and watch this!”, places the stupid shit performer at significantly higher risk of ER visitation eliciting injury.

In retrospect, that all makes sense. Well, those of our neighbors who fail to contemplate consequences, readily foreseeable consequences at that, PROSPECTIVELY, well, those folks are why my children slept indoors, ate every day, and got suitable shoes regularly. Thanks for the business, my friend!

Later in the night/early in the morning, the flow of sick/injured tends to slack off. When all the stuff that needed doing, had been done, we got to thinking. From those deliberations arose the night shift game of The Ethanol Is Right!

The goal is to appraise a given patient, without any lab work reported as of the time of the prediction, and then write down your vote for the patient’s blood alcohol level. The vote closest to the lab reported value, but not over, “won”.

Fun With Suits! · Pains in my Fifth Point of Contact · Sometimes You Get to Think That You Have Accomplished Something!

Hospice Nurse Midnight Shift Call Off

A long, long time ago, in a galaxy not so far from here….

No, wait, that is not quite right. Well, anyway, after I had departed Da City’s EMS, and started working as an RN, my father took ill. Years previously, he and my mother had moved back to The Megalopolis, and resided in The Maternal State, nearly half way across the country from me. My brother the contractor did not seem well suited to the demands of helping care for a sick elderly man, so I volunteered.

As it happened, while I was helping Mom take care of my Dad, I was working 12 hour night shifts in various EDs around The Maternal State, receiving my assignments from this or that temporary staffing agency. The money was OK, and I was able to keep up with my house payment, my car payments, and all that stuff.

Things progressed. My father was dying, and there was no stopping it. I was glad that I could take some of the burden off of my mother, who was nearly overwhelmed in any event by the looming demise of her husband of decades. You do that which you can do, correct? Around this point in the process, my father had been admitted to hospice, and his care needs had escalated to the point where Hospice supplied a nurse to care for my dad around the clock.

So one morning around 0900, I arrived home from work, and went to bed. I was awakened for a phone call around 11 am, to find that the agency was informing me that my shift that night had been canceled. I mumbled affirmation, and stumbled back to bed.

Around 1400, I was again awakened to learn from the Hospice case manager that they were unable to find a nurse to care for my dad overnight that night. “I don’t know what we are going to do!” she apologized.

I wasn’t all that wound up over it. “So, it looks as if you have a nurse, then.”

No, I don’t. I have called, and called, and I cannot find a nurse to care for your father tonight!”

Yeah, you did. Me.”

You cannot care for your father overnight!”

How come? You need a nurse. I’m a nurse. You need somebody who will be reliable. I flatter myself, that I am reliable. You need somebody here. I’m gonna be here, nurse or no nurse. Looks like I know what I’m gonna be doing, instead of watching late night TV!”

Are you going to be able to do this? Can you handle that responsibility?”

Do you have a better idea?”

She admitted that no, she did not.

Well, then, it certainly looks as if I have to do it, and have no alternative to handling it, doesn’t it?”

We agreed, and I returned to bed.

This time, around 1500, I was awakened for another phone call (this appeared to be developing into A Thing!, and I was not liking it!). My agency was calling, and the staffing coordinator perkily informed me that she had found me an assignment for that very night! “Gosh, thanks, but, after you called me to cancel me, I made other plans.”

She was aghast. “What? Are you refusing an assignment?”

Nope. I had an assignment as of 0730 this morning, when I left duty. I was sleeping, in preparation for reporting for that assignment, when you called me, to cancel it. Once you had canceled me, I had no obligations to anyone, and I have made other arrangements since then. Now, you are calling me and asking, at the eleventh hour, may I remind you, if I can take a last minute assignment. No, I cannot. I am busy tonight, with obligations that I cannot ignore. I’m not refusing an assignment, I am simply not able to accommodate your last minute brainstorms.”

We ended the call at that point, and I resigned myself to my (sleep deprived) fate.

Mom and I had supper, I made some calls, and wrote checks for some of my bills. Once 2300 arrived, the afternoon nurse gave me report, and oriented me to the overnight routine.

We changed my father’s bedding, and bathed him. As we turned him to his left, I held him for her part of the cleaning and linen change, and he sighed once, long and loud. I looked into his eyes, and watched them dilate. I felt for a carotid pulse, and found none. “I think he’s gone”, I told the nurse. She and I tidied up the bed, tucked him in, and she went for my mother.

The next couple of hours were not etched in my memory. Eventually, Mom and I were alone in the house. We cried, we hugged, and we went to our beds.

Monday I had an assignment. I showed up, happy, in a sort of left handed way, to be doing SOMETHING that did not involve constant reminders of my dad’s death. The charge nurse for St. Elsewhere greeted me with, “We heard about your dad. We’re sorry to hear it. How are you doing?”

I was surprised. She was a lovely soul, cute, smart, professional, and capable (all things that I admire in a woman). She was friendly, and I was very open to that. However, I hadn’t told anyone about my dad’s demise. I was touched that she would make the effort to offer consolation to me, a relative stranger. I had been hoping that I could immerse myself in ED nursing, and not think about my dad for a while.

I offered my response, thanked her for her concern, and asked what pod was mine for the night.

Fast forward a couple of weeks. I received another call from the agency, and another assignment offer. I had made plans to take my mother out for dinner, and therefore I declined the assignment. (Yeah, THIS one I straight up declined.). The coordinator took me to task. “I’m getting really tired of covering for you all the time!”

What the fuck? My query was edited before being spoken. “Huh?”

I said I’m getting tired of covering for you!”

Uh, what are you talking about? Covering for me? When?”

Remember two weeks ago? That Friday night, when you had made other plans? That’s what I’m talking about!”

I was almost speechless. Fortunately, this was a telephone conversation, not one taken across a desk. That fact alone kept me from big trouble. I put as much ice into my voice as I could, and clarified: “Oh, wait! Do you mean the night my father died? Do you mean to tell me that you are irritated that I could not work on the night my father died, in my arms, and you are really, no shit, taking me to task for not working that night? Did you really, actually, just say that to me, not two weeks after he died? It sure sounds as if you did, and I cannot think, off hand, of any other way to take that. What did your supervisor say when you told her you were inconvenienced by my not working that night? Say, how about I call her, right fucking now, and ask her? Gimme her goddamned phone number, please. I feel the need for a heartfelt chat!”

For some reason, she was, well, “reluctant” probably does not fully capture her lack of enthusiasm for me chatting with the manager of the office on a Saturday night.

I continue to be surprised. By humanity in general. And, in particular, that she was such a jackwagon, and that she did not provide me that number.

Although, not giving me the number might have been a good thing.

Fun And Games

The Metric Calendar

So, TINS©, TIWFDASL© as a midlevel in an urgent care, when one of the medical assistants in my office announced that she was going to hit the coffee shop on her lunch break, and canvassed everybody to see if they wanted her to pick anything up.

I told her that the coffeeshop was closed, it was a federal holiday, St. Swithin’s Day.

She looked at me, and turned to her computer, tapping furiously. Minutes later, she emerged from her search, triumphant, announcing, “St. Swithin’s Day is July 15th, this is October, and you are wrong!”

I smiled. “Well, St. Swithin’s day is a European holiday, and in Europe they use the metric calendar. On the metric calendar, it is July, and today is St. Swithin’s Day! You could look it up!”

She did. At length. Repeatedly. The NP who was my partner pulled me aside, grinning large, and whispered, “You rat! You know she is gullible, and you fed her that line of manure! What, you gonna carry on until she is spinning around, biting at her own tail?”

I assumed a faux-hurt look, and lied through my teeth. “Who, Me? I would never do such a thing! How can you accuse me of such a thing?”

She settled back on her heels, crossed her arms over her chest, and replied, “Oh, could it be because I have seen you in action? Multiple times? Just like this? Yeah, that would be it!”

Two weeks later, one of the other assistants teased her about the “metric calendar”, and my friend turned to me, “I blame you! You started all this idiocy about a metric calendar that does not exist!”

Fun With Suits! · Life in Da City! · Pre Planning Your Scene

Alimony

Some back story. When TDWM1 (The Darling Wife Mark 1) and I had met up, she was a single mother of two children, working full time and going to nursing school. And, yes, she was successfully pulling that off. Once it was plain that our relationship was going places, well, I invited her to give up her apartment, move in with me, and let me support everybody. I made as much money in one OT shift, as she made as a nursing aid over an entire week. Or two. I told her, “You can always make a buck. You will not get a second chance to make that grade.”

She accepted my offer, completed Nursing school, got licensed, and we lived happily ever after. Or, at least, several years, happily (or so I thought).

So, fast forward to The Divorce. Let me admit, early in my tale, that she could have been way, way WAY more wretched than she elected to be. For example, had she alleged (falsely, but nonetheless she could have alleged…) that I had threatened her, well, a personal protective order was routine in such events, and until I successfully proved to the judge’s satisfaction that I had NOT threatened anyone, well, all my firearms would have to find new, happy homes. That is one example of wretchedness that she passed by.

On the other hand, getting back to my story, TINS ©, TIWFDASL ©…well, OK. There I was in a courthouse conference room with The Plaintiff (en route to transitioning from TDWM1 to The Wretched EX), her attorney, my attorney and me. Her attorney had just finished describing one of their demands, that I pay The Plaintiff alimony, and I quote, “So that Ms. Stretcher Ape can complete her Bachelor Degree in Nursing, so she can support her children better.”

I looked at my attorney, and he shrugged. With that signal, I dove in.

“Uh, Ma’am? why does your client require alimony in order to complete her BSN?”

“Mr. Stretcher Ape, it seems only fair. After all, she worked to put you through PA school, didn’t she?”

I contemplated this gambit. “You know, you have a point. I think we all agree that we all want fairness. You *do* realize that, while she was earning her associate nursing degree, I paid all of the household expenses for her, the children, and myself, right?”

Everyone at the table nodded, some more warily than others.

“So, since I contributed $1000 every month from my student loans to the family budget, while I was in graduate school, full time, isn’t it reasonable to expect your client to make a similar contribution toward her own education?”

Again nods, some wary.

“And, since I worked night shifts, 12 hours each, every night that I could, during our month long semester breaks, and every holiday shift that I could sneak in, as well isn’t it fair to expect Ms. Stretcher Ape to do likewise?”

The attorney nodded. I continued. “So, if we review my W2 forms, which I am sure our friends at the Friend of the Court have supplied you with, you can see that I contributed around $30,000 every year from my night shift earnings, as well as another $12,000 from my student loans. Isn’t it fair to expect a similar contribution from your client?”

The Plaintiff’s attorney started to bluster, but I held up a hand. “I’m not done yet. Now, you are suggesting all this effort should be directed toward earning her BSN, so that, as you term it, she could provide better for our children, right? This will add up to thousands of hours when your client could be mothering our children, and thousands of dollars in tuition, books, fees, and associated expenses, money that could be spent to the benefit of our children, right? All so that your client can earn a BSN, and earn more money, correct?”

The opposing attorney nodded. “Well, I, myself have a BSN. I am presently employed as an RN, and I can tell you, for a fact, that your client will earn twenty five cents an hour premium, as the holder of a degree in Nursing at the 4 year level! That means that, conservatively, her education investment will have paid for itself in (mumble, mumble, scribble, scribble) somewhere between ten to forty years, depending upon where she takes her classes.”

Opposing counsel leapt to her feet. “I do not believe that the earnings increase that comes with a BSN is so paltry!”

I leaned back, and smiled. “Madam, you have my pay stubs. They reflect that my employer, the largest hospital system in this part of the state, pays twenty five cents an hour. Most hospitals do not pay any sort of premium for that degree.”

Across the table, they leaned into each other, and held a hurried, whispered, conference.

I interjected. “May I make a counter offer? One that you likely will see again, like in court?”

Warily, I received nods of assent.

“Well, since I am a MAN, and a MAN wants what is best for his children I propose that, rather than spend thousands of hours in academics, hours when she could be mothering our children, and rather than spending tens of thousands of dollars, money that could be spent to the advantage of our children, that your client instead spend that time, spend that money, for the betterment of our children. And, since I am a MAN, and, being a MAN, I want to do what is best for our children, for my part, I will offer to pay her, annually, in one lump sum, in addition to whatever other money I am directed to pay, the five hundred dollars annually that she will forgo should she defer her education.”

I sat back.

THAT was the last I heard of alimony!

Fun And Games Off Duty · Fun With Suits! · Pre Planning Your Scene · School Fun And Games

Not Fitting The Mold

So, TINS. I decided after several years as a nursing assistant, that I wanted to be an RN when I grew up. By the time that things lined up, I had already started working for EMS in Da City. So, I set to knocking off the pre-requisite classes I had not already collected, and waited for my Nursing school application to be processed.

Now, at this time, there were very, very, very few men in Nursing. The school I applied to, a community college, had a decidedly  problematic academic tendency among the population from which they drew their students.  So, since I had attended Tremendous State University for a couple of years, it seemed that I was a good candidate to handle collegiate level studies. For these reasons, it developed that I was accepted to this school.

In the course of the intake, I had to interview with an admissions officer. We talked about coursework, and finances. She asked me about what financial aid I had lined up. I admitted that I had none, and planned to pay for school through Da City’s tuition reimbursement program, as well as my earnings.

She did not think much of that idea, for some reason. “Mr. McFee, we do not allow our students to work.”

I was surprised. This was, after all, nearly 1980, and I had thought that liberated women, and various movements to remove barriers had changed things. Simply to be certain that I had heard her correctly, I asked her, “Er, ma’am? you do not ‘allow’ your students to work?”

“That’s right, Mr McFee. We do not allow our students to work.”

“Uh, ma’am, you do realize that I am working full time, have a house, and am my own only source of support, right?”

“Mr. McFee, you need to plan for that. We do not allow our students to work while they are in school.”

“Uh, OK. Uh, ma’am, so, where do you live?”

“Why do you ask me that?”

“Well, I support myself and you are telling me that I cannot work. I suppose that means that I’m moving in with you.”

THAT got her attention! “Mr. McFee! You are NOT moving in with me!”

“Hmm. So, how about you document that you have told me that your experience is that students who work while in school do not perform as well as those who do not. You could note that I have acknowledged that warning, and the school’s extensive experience behind that warning. You could write down that I will elect to work while in school, and therefore, any failure on my part will be in spite of your vehement admonitions. Do you think that will work for you? It is a chance that I am willing to take.”

“Uh, Mr. McFee, please sign here, next to my notes to that effect. Thank you. Welcome to Un-Named Community College School of Nursing. You have selected a challenging course of action, both academically as well as because you have chosen to work. Good luck!”

guns · Having A Good Partner Is Very Important! · Life in Da City! · Pre Planning Your Scene

Medic 5 Heart Attack

 

So, this one time, at band camp…..no, wait. That’s not quite right.

So TINS©. There I was FDASL©, detailed out to Medic Five from my home house. It appeared that I had offended the Patron Saint Of EMS and Street Medics, grievously, because I arrived to find Cletus, grinning widely, awaiting me. Shit.

I asserted The Prerogative of Seniority, and drove, leaving Cletus to medic. (Remember that. File under “Things That Come Back To Bite Me in The Ass”) The day passed pretty uneventfully, runs came in, patients got transported, and we, of course, fought disease and saved lives.

Now, at that time, nearly 40 years ago, Medic 5 was out toward the western margins of Da City. The firehouse called home was on Bliss Road, close by to the Western Expressway. Western suburbs included Gardenia and Westworld. Our hospital choices included a couple of small hospitals of the plethora that (at that time) dotted the city, or a couple of respectably sized facilities in those selfsame suburbs.

So, somewhat later in the afternoon dispatch invited us to respond to a “heart attack”. This took us nearly to the city limits. As we pulled up, there was a figure hopping around on the porch, arms a-waving, feet a-tapping, directing us to that dwelling. (Uh, you mean to tell me that every other house, lacking front porch frenetic interpretive dance performances, are NOT the scenes to which we were called? This is my shocked face!)

So, of course, Cletus bought into the pandemonium, whole hog. He leapt from the rig, just about as soon as I brought it to a stop, and beat feet into the house, leaving me, the handheld radio, and every other thing (except the medic bag) behind. I placed the ambulance in park, shut off the beacons, and radioed in to dispatch that we were on the scene.

I turned on the handheld radio, and followed him into the house. As the occupants opened the door, I was struck (nearly literally) by the pall of gunsmoke that wafted out into my face. Asking about my partner, I was directed into the rear of the house.

I reached the end of the hall, and, in the bedroom to my right noted my partner bending over a supine soul. I announced myself, and CLETUS TURNED ON ME, SNUB BARRELLED REVOLVER IN HAND. Of course, he was pointing the barrel at my belt buckle. I swept his hand over my head, removed the handgun from his hand, and asked him what the…er, fenomenon he thought he was doing.

“She had it in her hand, as I entered the room.”

“Uh huh. What else is up?”

“I dunno.”

“Howzabout you find out?”

As he turned to assess this lady, I figured that having a loaded gun, on my scene, and not in my control, was A BAD THING. I wasn’t about to remove it from the scene: that seemed to me to be very like tampering with evidence, so, instead, I opened the dresser next to me, opened the cylinder and dumped the bullets into one drawer, slammed that drawer shut, and tossed the revolver into another drawer, which I also shut.

I turned back to Cletus, and saw him reaching for the BVM (bag-valve-mask), as he evidently had determined that this soul was arrested. Hmmm. Trauma code. Kinda expecting a malign outcome.

I handed him the prep (handheld radio), asked what else he thought he would need, and ran to the truck for the cot. We wrestled the patient onto the cot, trotted from the house, and set Cletus up for a restful episode of solo CPR in the back of a moving ambulance. Yeah, totally.

I called to dispatch, asking the location of and directions to the nearest trauma center (it wasn’t my house, wasn’t my district.) I reported , “Medic Five, Code One, Westworld Hospital. GSW Chest, cardiac arrest. Notify police, no scout at scene.”

Sometimes, you can hear the double take over the radio. “Medic 5, did you say GSW?”

“Affirmative. GSW chest, cardiac arrest.”

“Medic 5, are you sure?”

“Yeah, dispatch, kinda sure. My partner retrieved the pistol from the victim’s hands, I tossed it into the dresser drawer next to her.”

“Very good, Medic 5. We’re calling the hospital now.”

So, I navigated the Tie Fighter that is an ambulance running code, through the suburban traffic. I was (pleasantly) surprised to see traffic moving aside, as if I were Moses at the Red Sea, as the siren and beacons made known our intent.

We arrived at Westworld Hospital, and turned our patient over to the ED crew who, unsurprisingly, called the code after a brief attempt at resuscitation. Cletus and I cleaned up the truck, and completed the trip sheet.

We were just about to head out, when dispatch called us, directing us to phone them.

Once I had done so, I was directed to phone another number, because the detective wanted to talk to me. Once I had identified myself, he launched into his inquiry.

“You the medic on the scene?”

“Yeah, me and Cletus.”

“So, this was a shooting, right?”

“Yep, gunsmoke and all.”

“So, where is the pistol?”

“I dumped the cartridges into the dresser drawer, and tossed the gun itself into the top drawer.”

There was a pause. “You know, you have messed up my scene, and tainted my chain of custody.”

I contemplated this for a moment. “Well, sir, there was no officer on the scene I could turn the gun over to, and I was reluctant to leave a loaded, unsecured, firearm floating about on my scene. I did not think it would be clever to (a) remove a gun from a likely crime scene, (b) have in my possession a firearm that had been implicated in a likely crime scene, or (c) carry said firearm into a hospital with me. So, I did not identify any better option, at that time and on that scene.”

Life Lesson Number One: Sometimes, you have to extemporize.

Life Lesson Number Two: to quote John Farnam: “You may be killed when you take decisive action. You may likewise be killed when you do nothing. Either way, dithering is toxic. Indecision and delay will prove fatal. So, size-up the situation quickly. Hit the “go” button. Don’t look back.”

http://defense-training.com/2018/who-dare/ (datelined 14 May 2018)

guns · Life in Da City!

Why am I a suspicious soul?

 

Why am I a suspicious soul?

 

Because of runs like the following.

 

TINS ©, TIWFDASL © , and Medic 13 (our unit) caught a shooting. (Yeah, I know. Shocking! Shocking! Folks getting shot in Da Big City!) So as per the usual plan, we Weedle-Deedled our way to the scene, and pulled up after the police had retired the combatants to neutral corners. (Remember that assumption. It figures prominently in the rest of this story.)

So, our friends at DBCPD (Da Big City police Department) pointed out the shoot-ee, who did not appear to have a care in the world. Well, not THIS world. In fact, he appeared disturbingly unaware of the excitement unfolding around him, and so we assessed him quickly. Awake? Nope. Breathing? Nope. Carotid pulse? Nope. Trifecta of cardiac arrest. The Bonus Points of chest wounds meant that our friend was a trauma code, and trauma codes are widely renowned for having malign outcomes. In short, pretty much Dude be Daid. (for our non-street speaking readers, “daid”=DEAD.)

 

Around this time in Da City, another crew had left a dead fellow on the scene. They had figured that the GSW that had pretty thoroughly emptied his cranium had removed him from the living column of life’s census. However, once they had gone in service, one remaining neuron in this person’s hind brain had met up with another lonely neuron therein, and, in saying “Hello!”, had elicited one, last, agonal breath. The cops on the scene had freaked out (“He’s alive!”), called for another unit, and this medic crew, reading the writing on the wall which said, “This way to departmental charges and unemployment”, took another path, which included transporting this patient so the hospital could pronounce him. The first crew was suspended without pay for something like 6 weeks.

 

For this, and other reasons, there was no way we were going to leave this soul on the scene. Onto the cot, into the truck, and prep for liftoff! As I was connecting the oxygen to the BVM, and generally settling in for a lengthy episode of solo CPR in a moving vehicle (nearly as much fun as it sounds like it is, you ought to know), the rear door opened, and a female face appeared therein. She asked, “Can I ride with you?”

“Who are you?” I inquired.

“Oh, that’s my fiance!”

Let’s pause a moment. After several years on Da Streets of Da City, I concluded that there was not a solitary female older than 17 in the corporate limits of the City of Da City, who was not betrothed. This particular run was NOT after those several years, and so the following may be unsurprising, in retrospect.

Well, I invited said Fiance to enter the vehicle, and secure her safety belt. Doug set off to the The Best Trauma Center In Da City (TBTCIDC). He gave radio report, and I CPR’d my little heart out. Ms. Fiance inquired after my patient’s condition and prospects: “Is he gonna be alright?”

I gave her the long answer. “Well, ya know, when we do CPR-this is CPR- on somebody, they are very, very sick. In fact they are critically ill. Critically ill means that there is a very real chance that they will not survive. Now, I’m doing everything I can to help him, but people who are this sick, well, a lot of ’em die. We’ll just have to see how he turns out.”

She digested this for a moment. “I’m sorry I shot him.”

Huh? I mean, What The Fuck? Huh? Gotta admit, I was so startled, I stopped CPR, looking at her for a minute. After several breaths (mine, not his), I collected myself again and resumed CPR. Ya know, CPR, by yourself, in the back of a moving ambulance, coding to TBTCIDC, is kind of challenging. It becomes particularly so if you are trying to keep your eyes on the just-self-admitted-shooter of your trauma code. Yeah, him. Right there, under your hands. And, well, she is all of 24 inches away. Yeah, that sort of distracting.

I had just about deluded myself into thinking that I was getting back into my resuscitative groove, and had turned my gaze from Ms. Shooter/Fiance, when she decided it was time to expand her fund of knowledge. “Is this gun big enough to kill him with?”

Holy Fenestrated Fertilizer! What the absolute fuck could possibly happen to make this run any worse?

I froze, keeping my eyes on my shootee. “Er, Ma’am? Would you please put that back wherever you got it from?”

A moment later, “Ok, I put it away.”

“Thank you! Please keep your hands on your lap!” NOW, I kept my gaze upon the shooter/Fiance. Of course, THAT meant I wasn’t doing compressions, or ventilating my patient, but, in truth, I was kinda paralyzed. So, when we pulled to a stop, and Doug launched from the driver’s seat, to extract the smoothly running resuscitation that was his smooth, professional, skilled partner, well, that is NOT what he beheld. Rather, it looked like a sort of diorama, perhaps entitled, “Medic Gets A revelation In The Back of the Ambulance”. In any event, it was a still life, not a moving picture. He tried to form his question, along the lines of “Why aren’t you doing CPR?”, but I propelled myself past him, and dragged him away, stuttering profusely. My part of the dialogue sounded like “G…G…G..G…GUH…GUH…GUH…GUN!”, and it took him a moment to process it. Meanwhile the ER crew had extracted our patient, and were running him into resuscitation.

Doug and I grabbed one of the BTCIDC cops, and Doug, by now obviously the brains of the operation, told said cop our tale. “She’s got a gun, she shot our patient, and here she is!”

We found somewhere else to be.