cats · Duty · Pains in my Fifth Point of Contact

Two more snippets

FICKLE CATS::

When I am in bed, they snuggle up against me: likely due to the warmth from my electric blanket. I can pet them, and they do not beat feet, alarmed, at my approach. They purr, and roll into my petting. On the table in the cat room, similarly, I can pet them, and they purr like miniature motorcycles.

Elsewhere in the house, I approach them, and they elope as if I were the Cat Attacking Golem, or something. Of course, when they are on the counter, or the dining room table while we are eating, I do chastise them: “Are you on MY counter? Bad Cat!” accompanied with a sort of interpretive dance, which most closely resembles an effort to shoo away angry, invisible, hornets.

ANOTHE STORY FROM THE STREET

So, TINS, TIWFDASL….well, no. I was at home, long ago and far away, when The Plaintiff (aka TDW-Mark 1) and I were still in wedded bliss. In the very rural county in which we lived, EMS was provided by a sort of tiered response: in the event of an emergency, dispatch would alert the sheriff’s deputies on patrol, and tone out the nearest fire department to send their rescue. The ambulance would depart from the hospital in The County Seat, and the crew would make their way to the scene. There, the three agencies would address the problem, and then, response complete, resume whatever they had been previously been doing.

I volunteered for the local rescue, since, I figured, I would want SOMEONE to respond when/if we had our own emergency, therefore it seemed reasonable to carry a pager and respond when some neighbor had THEIR emergency.

Let me interject that I had a scanner at home, and so I (and TDW-Mark 1) could monitor the goings on in the Fire/Police/EMS world. Or, our corner thereof.

So, one evening I was home. The pager went off, and I responded to the fire hall. Another firefighter arrived, and we were off.

We arrived to find a sedan crumpled amongst the trees lining the side of County Road Whatever. The deputies had already triaged the scene, and pointed out one soul who was not making much sense. As I approached, my differential diagnosis expanded from head injury, to head injury, or intoxicated, or combinations of the above. This was elicited by the prominent odors of ethanol emanating from my subject.

Well, when you have a soul who was involved in a collision, as this guy had been, who is not able to navigate or articulate, as this fellow was not, one must wonder if the collision had cracked his coconut (not, strictly speaking, a medical term, you know…), and that was why he had his articulation and locomotion difficulties, or was he intoxicated into dystaxia/dyarthria, or (perhaps worst of all potential scenarios) was the intoxication obscuring his intracranial bleed, or something similarly dire?

I, paramedic and RN that I was at the time, was elected to ride in the back as Mr. Ethanol Odor was transported to hospital assessment and management. Of course, he was spine boarded. Of course, he disapproved. Of course, he protested, loudly and profanely, about our handling of him, as well as the fact that he desired to depart our company and be on about his business (not an exact quote).

I recall providing report by radio, his soliloquy in the background. He was describing my character flaws, and errors in my upbringing, at volume. As an exact quote, he suggested the my shortcomings included, “Assholes! M@74erf&25ers! Dickheads!” (I suppose he included my partners in this assessment, come to think about it.)

I unkeyed for a moment, prior to concluding my report, and, rekeying the radio, observed, as he renewed his Short Course On Character Disorders, “As you can tell, patient in no evident respiratory distress!”

I arrived home to find TDW-Mark 1, chuckling. “No distress, huh? Have you told your mother hello for him?”

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

Snippets VI

The following is a collection of tangents. Please, be tolerant.

I was talking with the midlevel student taking a rotation with me, and, it being her first rotation (…unfortunate soul, to be stuck with The Stretcher Ape as your first clinical!), and was waxing poetic about gestalt, quickie patient assessment, and binary EMS assessment.

I observed that a writer for JEMS magazine, decades ago, observed that there were stages to EMS patient assessment: initially, is the named patient “Big Sick”, or “Little Sick”?

If “Big Sick, particularly in the setting of basic life support services, probably you desired to load that patient, and go.

If “Little Sick”, you likely had time to assess the patient in greater detail, and either rethink your initial assessment that this soul was “Little Sick”, or reinforce that assessment, and then transport in a leisurely and deliberate manner as appropriate.

The application to our walk in clinic, is that should your, or your MA’s snap assessment be along the lines of “That dude don’t look right!” (immortalized as “DDLR”), perhaps you ought to look into expediting that soul’s transport to ED, perhaps via EMS. I told her that “DDLR” is probably The Primary Vital Sign.

Another Story

One night, we had cleaned out the ED, and done all our housework. This was long, long ago, and far, far away, back in my halcyon days in Da City. I was a staff nurse in our ED, and we had “story hour”, many a night when there were no patients, and nothing to clean or restock.

Somehow, the conversation turned to threatening patients. One nurse volunteered, “You know, I have something in my purse that might be a conversation starter with such a soul, with the conversation trending towards, “How do I get my ass out of here, before this crazy nurse kills my ass?”

Another offered, “Hmm. Such a sad sack might, or might not, find himself in a cross fire, not that I would know anything about that sort of thing, myself!”

Another thought out loud, “I wonder why it is that I always place my bookbag in the med room? Could it be that there might be something there that would trigger a reconsideration of life choices, in some bad actor?”

One of my buddies, still on the road, laughed when I told him that story. “Really? Don’t you realize we all on the street know your ED is the most heavily armed ED in Da City?”

A Thought Experiment

If you were married to Nancy Pelosi, and was faced with the choice of having sex with her, or finding a homeless psychotic gay guy, what would You do?

Recounted conversation:

Patient: “I don’t believe in covid!”

Me, responding to my partner who had just quoted said patient (faux-Russian accent) “Da, tovarisch, but, covid believe in YOU! (stifle your cough, and wear your damned mask!)

Bob Marley Tribute Band

Cletus and Jane-Bob came in the other day, accompanied by their spawn. The nominal adults smelled as if they had just sat in with a Bob Marley Tribute band. The children were clean and inquisitive, and engaged readily with me as I inquired about their symptoms.

The childrens’ ear infections were readily identified, instructions provided, and they were off and on their merry way.

With these poor life choices as their life exemplars, I wonder how long the children will remain clean, or inquisitive, or engaged with the world?

Another opportunity to bask in the wonderfulness of legalized, recreational, marijuana.

Fun And Games Off Duty · Life in Da City! · Pre Planning Your Scene

Lessons Learned From Other’s Experiences

Another blogger posted a recounting of his experience, recently, at a public range (I believe he is in Canada). He cited Elisjsha Dicken, the armed civilian who stopped the Greenwood Indiana mall shooter, hereafter referred to as Some Asshole In Greenwood, within 2 minutes of the crime beginning, and, according to Dicken’s attorney, from a distance of 40 yards.

Speaking only for myself, and throwing no shade one way or the other, I attempted to recreate Mr. Dicken’s accomplishment, with my EDC sidearm, and no time/life threat pressure. I failed, miserably. My personal take home, is “Moar! Range! Time!” If you get advice to practice, practice, and practice some more, that is sound advice, and we all should do so.

Other reports that I recall seeing, assert that Dicken’s girlfriend, a student nurse, responded to care for casualties, once the shooting had stopped.

THAT reminds me of everyday carry. As is often asserted on the blog, Gun Free Zone, if you carry a sidearm in order to put holes in bad people, should the need to stop such arise, then you ought to anticipate that these selfsame bad people may put holes in you, yours, or other innocents. Therefore you (and I) ought to be ready to address that problem.

There are many ways to address that need. I carry a CAT tourniquet in an ankle holster, as well as a SWAT-T elastic tourniquet in my pocket, all the time. There are two exceptions: when I carry TWO CAT tourniquets, or when I am swimming.

While it is worthwhile to carry a medic bag, suitable to your own training, getting that training is JOB NUMBER ONE! I betcha that I can finagle trauma dressings from at hand materials, faster than I can learn, in the first place, what sort of thing is immediately needful to care for a trauma patient.

Of course, I have something approaching 50 years (not a typo) of experience in this business, so, there is that going for me, I suppose.

If you wonder what you ought to pack for bad times, look over my blog post, here. Or, you could see what Aesop has to say. He is controversial, but, regarding medical matters that I have the experience to have an opinion about, he is spot on. No crap, straight up. He recently posted a set of links to his “greatest hits”. I direct you to peruse same: there’s GOLD in them thar hills!

So, I will attempt to let my preachin’ end, here, for a while. Thank you for riding along.

Life in Da City! · Protect and Serve · Sometimes You Get to Think That You Have Accomplished Something!

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!

Duty · Fun With Suits! · Pains in my Fifth Point of Contact · Pre Planning Your Scene

FPC: Phenomenal Phone Company

A long, long time ago, in a state capitol city not so very far from here, I was seated in the basement of The Enormous Hospital System Mothership, where She Who Would Become TDW-Mark II was undergoing surgery of some sort. I was seated next to, well, let’s simply call him my father in law.

At this point in the celebrations, the divorce from The Plaintiff had concluded, and she and I had a week-on-and-week-off child custody arrangement. My adolescent children had cell phones, and had both me and their mother on speed dial.

So, Number Three Son had occasion to call me, but I could not make out what he had to say, and my attempts to re connect with him were for naught.

I did not know if this was generic adolescent ‘gotta call dad’, or something emergent. That latter was very unlikely, but, after all, I have kinda spent my life in the “this is sort of an emergency” business, and therefore considering that possibility is an occupational hazard. Therefore, since I was NOT at home, and, should my children need me, their ability to communicate that to me in a timely manner was mission critical, well, The Phone Company, and their inability to connect a freaking call something like 12 blocks from the freaking state freaking capitol, well, to understate the thing, I found it unsatisfactory.

Father In Law offered the use of his phone, on Another Carrier. I entered the number of my son, hit “connect”, and, par miracle’!, just like that, I was speaking to my son!

We concluded our conversation, since it was a generic “ought to call dad” call, and I asked Father In Law if I could make one more call. He assented.

I then called “customer service” (spit!) of The Phone Company. I explained my problem, and how this was not acceptable. Phone Company Minion asked my location, and I described myself as being one floor down from street level, in waiting lounge of Enormous Hospital System Mothership. Minion then regaled me with a bit of RF theory, to wit: “You cannot reasonably expect a cell phone to have a reliable signal when you are underground!”

I asked Minion, do you have caller id?

Affirmative.

Could you tell me the originating telephone number for this call we are having, right now?

He read back Father In Law’s phone number.

Is that a Phone Company number? If not, what carrier services that number.

Why do you ask?, responded the Minion.

“Because, that is the carrier who is henceforth going to be receiving checks from me approximating $200/month, because my phone, my childrens’ phones, and the phone of every mo$%#r f@!%&er who will stand still long enough to hear this story, will be giving their business to this carrier, whose phone I presently hold in my hand, in this basement, as you and I converse!”

Having said that, I realized that there is no satisfying way to slam down a cell phone. I miss plain old wired phones.

Fun And Games · Fun And Games Off Duty · Life in Da City! · Pains in my Fifth Point of Contact

Gotta Scratch That Itch!

A week or two ago, my MA returned from her lunch, and showed me her parking lot find: a couple of dirty syringes, with bent needles. “I found them on the ground behind my tire”, she related.

My thoughts were, ‘what sort of fool, even among the universe of fools who inject drugs, leaves a freaking needle on the ground in a parking lot, where children come and go on their way to their own physician appointments?’

@

So, just the other day, TDW-Mark II needed to recharge her cash card. Off to her bank we went. The gentleman attending to her transaction appeared to be somewhere in his twenties, whereas I, myself, am approaching 70 (and so closely approaching 70, that 70 has started to tap his brakes, and slow down, in hopes that I would not admire his bumper so closely anymore!).

TDW was making conversation with this gentleman, and he was owning that this sort of transaction was unfamiliar to him. TDW then up and chirps, “It must be hard on poor elderly people, who don’t have computers, or know how to use them! That whole smart phone, and computer banking thing can be rough on the elderly!”

I looked at her for a moment, and spoke up. “Am I not standing right here? You CAN see me, right? Really? I. Am. Right. Here!”

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

9-1-1 Follies

So, TINS, TIWFDASL…. er, well, OK: I was NOT FDASL, rather, this was long, long ago, and far, far away, and Doug, my partner, had his car in the shop, and so I picked him up, and we went to headquarters in order to pick up our paychecks.

I was driving him home, and we were chatting about inconsequentials, when I had stopped at a traffic light. Coming from our right, a soul had stopped in order to make a right turn, and once he attempted to make his turn, another idiot (wait for it!) had stepped out in front of the vehicle.

The driver slammed on his brakes, and chastised the pedestrian-idiot (who had not been paying attention), whereupon the pedestrian rejoined with some unwelcome insights about the driver’s mother, and her lifestyle choices.

The driver exited his vehicle, displaying a knife (that was clearly visible from across the street!), and chasing the pedestrian. He (the driver) was bellowing, “You sunovabitch! I could have killed you!”, as the pedestrian retreated around the parked vehicle, retreating for his life.

Just past this dance, was a pair of pay telephones (remember them? Another artifact from my youth!). Doug went to one, and dialed 9-1-1, and I took the other, deposited some change, and called our dispatch Bell line.

My call got answered first. Ronnie the dispatcher answered my call, took my information, and passed it to another dispatcher. Then, he chastized me.

“Mcfee, you DO get, that you are off duty. Right? Why don’t you let the other guys get some excitement, for a change?”

I laughed, said my goodbyes, and hung up.

Doug was still awaiting 9-1-1 to answer his call.

We got back in my car, and drove on.

Fun And Games Off Duty · guns · Having A Good Partner Is Very Important! · Life in Da City! · Pre Planning Your Scene · Sometimes You Get to Think That You Have Accomplished Something!

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.

cats · Fun And Games Off Duty · Life in Da City!

SNIPPETS PART IV

I hope that nobody is surprised to learn that, since The Un-Named Fly-Over State is in the northern tier of states, it snows here in the winter (And the fall. And the spring.) That has been the case for certainly the past nearly 70 years that I have been here. Therefore I would hope that my neighbors would have figured that shit out, by now.

On the other hand, there is abundant evidence that my hope in this matter is misplaced.

So, TINS, TIWFDASL…well, OK, I was driving in to work one snowy winter day in order to begin my day of FDASL. I was listening to the amateur radio in my vehicle, and monitoring the county’s fire department dispatch. No ill tidings from that front.

I did notice a car off the road, into the ditch, but I figured that the county deputy already on the scene had things well in hand.

So, there I was, listening to the FM radio, and waiting for any alarming traffic on the HAM radio, when I saw this guy, no shit, skate his compact pickup truck completely across the 3 lanes of expressway traffic, having apparently originated from the on ramp. My guess was that he had entered the ramp at speed that was excessive for the conditions. (did I mention that it had snowed the preceding night? Well, it had. Likely had something to do with the other guy in the ditch.)

Anyhow, once he reached the median shoulder, he started to wifferdill his way along that shoulder, inching his way into the median’s ditch. He did manage to stay upright, so, that was nice…..

The thought crossed my mind, “coefficient of friction: words to live by!”

@@@Snippet The Second@@@

You may recall my tales of cat-herding (Farming? Wrangling?). In any event, one of the cats had a recurring conjunctivitis, such that our local vet voiced concern regarding the potential of a ruptured globe (eyeball breach, with vision-destroying loss of the fluid-vitreous and aqueous humor that is within the eyeball), versus a vision damaging occurrence of scars on the (supposed to be) clear portion of the eyeball.

So, we arranged an appointment with a veterinary ophthalmologist.

Of course, this doctor practiced in an office something like three counties over from our home. Of course, on the appointed day, it was a balmy 33 degrees (f), and could not decide to snow, rain, sleet, or what.

Fun times.

I learned on this trip, that driving Trixie T. Cat anywhere, was very much akin to driving your small, furry, outspoken, elderly, mother-in-law somewhere. I was the recipient of a running series of corrections, spoken (of course) in Cat, that likely would have sounded like “You’re driving too fast!”, “You’re driving too slow!”, “Why can’t you stay in one lane?” (this as I signaled, eased over into the -clear-adjacent lane, and in the course of doing so, ran over the ridge of slush built up between the lanes. So the truck jerked.), “Why aren’t we there yet?”, and the ever popular, “Where the hell are you taking me? I don’t want to go there! Let me out of this damned cat carrier!”

That is, would have sounded like that, if I spoke Cat.

As you might imagine, first off, back seat driving is oh, so very welcome at any time at all. Secondly, such corrections are even more welcome when the driving is, oh, gosh, I dunno, HAZARDOUS! Thirdly, let me take a moment to congratulate TDW-Mark II. She successfully suppressed her baseline impulses to shriek, gasp, or otherwise demonstrate her appreciation of her/our impending DOOM! Probably figured that the cat had that well covered.

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

Your View, Is *NOT* The Entirety of The World

So, TINS©, TIWFDASL©, alone as my midlevel walk in clinic shift started. We were supposed to have two of us from opening, but, well, some of us are renowned for strolling in something on the order of 30 minutes late. In addition, there was a third provider slated to come in around 2 hours after opening, and work til close.

To start off with, I had a 5 pack of kids. Well behaved kids (Thanks be to Crom!), but, five at a time nonetheless. All in one room, so, of course, it appeared to whoever else had decided to start their day with a visit to the walk in clinic that I was taking something over an hour with one patient.

One such soul opened her exam room door, around 40 minutes after we had opened our doors for the day, and while I was on Number 3 of 5 in the 5 pack, and asked “how much longer?”

I was charting, and replied, “20-30 minutes”.

She asked, “How come?”, and the MA explained “there are 5 in front of you.”

The questioning patient was surprised. “How can that be? There was nobody here when I arrived!”

The MA answered “I had already roomed them when you had arrived”.

“That’s crazy!” observed the impatient patient.

I was kind of busy. My response was “Yep.”