Fun And Games · guns · Life in Da City!

“Doc, am I gonna die?”

 

So, TINS©, TIWFDASL©, and we caught a run for a shooting. Being full of excitement, because, gosh, THIS was an opportunity to, ya know, SAVE A LIFE!, we coded our happy way to the scene, there to meet the police. They pointed out the named patient, who, to our surprise, was NOT hovering at death’s door. Rather, he had sustained a small caliber gsw to his lower leg, had intact pulses downstream of his injury, and no evident bony injury. We walked him to the rig, buckled everybody in, and set out for TSBTCIDC.

We had dressed and bandaged his wound, and I was busily documenting same, along with the vitals we had obtained, when he asked me a question.

“Doc, am I gonna die?”

I looked at him, and shook my head no.

“Doc, really, am I gonna die?”

Sighing, I tucked my pen away, and addressed him. “No, you are not gonna die from this wound. You may not even be admitted to the hospital overnight.”

Hearing no further inquiry, I turned, again, to my charting. But, it was not to be.

“Doc, really, I can handle it. Am I gonna die?”

Some people, and one track minds. “Sir, you are not gonna die today, and not from that wound. Really, I’ve seen hundreds of shootings, and your injury is in no way life threatening. Okay?”

He nodded, as if in understanding. I (attempted to) return to my charting.

Shortly, he spake again. “Doc, really, I can handle it. Tell it to me straight, Doc. Am I gonna die?”

I was about over the “Doc” idiocy. “Sir, I’m not a physician, I’m a medic. And, do you really think you can handle the truth?”

“Yeah, I can handle it! Give it to me straight?”

“You sure you can handle the hard, icy, no bullshit truth? Because, if you are really, really sure, I’ll tell it to you straight! No punches pulled, no bullshit, no evasions. Is that really what you are looking for?”

“Yeah, Doc! Tell me the real deal!”

(Ah, well, it appeared that ‘listening to and following directions” was not at the very forefront of my friend’s skill set.) I rubbed my forehead, as if confronting some weighty ethical dilemma. I looked skyward, as if seeking Divine Guidance. I gazed at him, and delivered my response.

“Ok, if you’re sure you can handle it, here’s the real deal! You are not going to die! Do you know why, you are not going to die?”

“No, Doc, why?”

“Because you are not going to live that long!”

The rest of the trip was in blessed silence, as he endeavored to make sense of my revelation.

Fun And Games · Life in Da City!

Another Winter Tale

One night at Medic 7, Doug and I were whiling away the hours. For this house, in this city, it was a slow night. On the other hand, it WAS winter, and it WAS snowing it’s ass off. I was finishing my Nursing school studies for the next day’s class, and Doug was reading the book he had brought along for slack times.

We caught a run, and off we went. As we headed east on Warren, we noticed a young woman walking back and forth in front of our fire house. Strikingly enough, she was not dressed for the weather. The heels alone presented a slip-and-fall hazard, and that is not mentioning the short skirt she was wearing.

When we had completed that batch of runs, we returned to quarters. The lap walking woman was still there, and had walked a clear circuit in front of the engine doors.

Hours later, another run, same woman parading in front of the house.

Returned an hour or two later, and there she was, still walking circles on the sidewalk.

She was gone when we caught our next run in the wee hours of pre-dawn. I mentioned her departure to Doug. He, being more wise in the ways of the street than I, opined, “Likely, it took her that long to make her quota, so her pimp would let her back indoors!

Fun And Games · Overdoses · Protect and Serve

Commercial Quantities of Meds

Thanks to Aesop (https://raconteurreport.blogspot.com/) for the inspiration for this post. See his series of posts, July 10 2019 to July 12, 2019. I write this on 12 July 2019. He may have more: it appears that he is just warming up!

So, TINS©, TIWFDASL© as a midlevel in a county lock up. Our sheriff had a policy of no drugs (I.e, no euphoriants narcotics or sleepers) for inmates. I was told that the rationale was that he did not want inmates to “sleep their sentences away”. Cool story, there were very few occasions wherein I would consider prescribing scheduled meds (euphoriants, narcotics) anyhow.

I was working part time. One morning I came in, and an offecer invited me to step into his office. He showed me a dispenser pack of what looked to be 140 or more tablets, labeled “Methadone 10 mg”. The administration instructions read “take 9 tablets daily”. Holy cow! That’s 90 mg of methadone, equal in pain killing (or sedating) effect to around 1 000 mg of morphine every day. ONE THOUSAND MILLIGRAMS of morphine equivalent, every day! The medical history form related that this had been prescribed for debilitating arthritis.

The officer noted the department’s “No Narcotics” policy, and asked me, the medical authority (Hah!) present, for an opinion. I thought that placing this gentleman in the “detox”/observation cell, and obtaining and recording vitals every hour for the first 24 hours sounded prudent. I also provided a checklist of concerning symptoms to watch or. I provided my cell phone number, and directed that, if certain parameters of vitals or observation were exceeded, send him to ED by ambulance immediately. If any grey area, phone me at ny time of day or night.

So, the officers recorded vitals and made “nurse’s notes” on their guest. I came in early the next day, read the noted, and re assessed the gentleman myself. All nominal, no alarming findings. We repeated this process, now every 4 hours, and, again, the next day, I arrived early and re-re-assessed the inmate. Same nominal vitals, same unremarkable exam. This did not seem to all fit together as it had been presented.

Another day, another 24 hours of vitals and “nurse’s notes”, another benign exam.

After several days of this, the jail command suggested that , with nearly a week of normal vitals and normal exams, perhaps our guest could be moved into general population? It seemed alright to do do, and I seconded their initiative.

So, after nearly a week of no methadone, nearly a week of no abstinence symptoms, my attention wandered to other topics. One morning I arrived, and an officer beckoned me into his office. “Hey, I thought you’d want to see this!”, was his opening conversational gambit.

It turns out that there are surveillance camera throughout the jail. (Who knew?). One had captured the methadone-for-debilitating-arthritis fellow getting into an altercation with another inmate, and whupping same. That’s correct: the “debilitating arthritis” inmate, delivered a whupping onto the person of another inmate.

The officer turned to me, and observed, “I am beginning to think that that prescription is rather more of a commercial opportunity, instead of a medical intervention!”

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

Pedicabo non est mecum

So, TINS, after a time, Mallory had succumbed to my animal magnetism, and we had begun to date. Our relationship progressed, and when her apartment lease came up for renewal, she moved in with me.

Now, understand: Mallory was a very nice woman, and had grown up and lived in one of The Suburbs. I, on the other hand, lived in Da City, right off of Elmward, known as State Highway One. In addition, I lived just south of a neighborhood renowned for arson, drug dealing, and assorted mayhem. Kind of a jakey neighborhood. Still, I could afford to buy my two flat, and the rent from the other apartment paid for my house note.

Mallory, for her part, was, to say the least, skittish. This was not helped by my insisting that she phone me as she left work at TSBTCIDC, and subsequently meeting her at the door with a pistol in my hand.

We went to the range, and she became familiar with my assemblage of firearms. She really liked my Colt Government Model in .380 caliber, and purchased one for herself.

From time to time, she’d call, and ask me if I wanted anything from a drive through on her way home. On one of these side trips, she came home, a bit more frazzled than was her baseline.

She related her story as we ate. It turned out that she pulled up and gave her order, and then pulled to the window. As she was gathering her money to pay for the meal, some character knocked upon her (locked) passenger door, and began to panhandle her.

“Go away. I have nothing for you!”, was her response.

He began to tap more insistently upon her car window, and demand a hand out.

“I told you, I got nothing you want! Go away!”

He seemed to be slow on the uptake. Now, pounding upon her window, he demanded that she give him some money.

Mallory was “dressed to impress”, for sure. She produced the little Colt, directed it his way, and admonished him, “I TOLD you that you do not want what I have for you! Now, do you REALLY want me to let you have it, or do you have someplace else to be? Like, right fucking now?”

As she recounted, “People’s eyes really do get THIS big! He never took his eyes off the pistol, as he backed up across the parking lot, stumbled on the curb stone, and, once he regained his feet, ran to wherever he abruptly realized he’d rather be!”

Then, she replaced the pistol in her purse, and turned to the (likewise wide eyed) fast food employee, and asked, “May I have my change, please? And, my sandwiches? Oh, thank so very much! Have a nice night!”

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!”

Uncategorized

Practicing Listening Skills

My father took ill, on the order of 30 years ago. He had a heart attack, and, while recovering from that excitement, was found to have cancer. Given that he was at that point in his seventies, well, it was a rough time for him, and my mother.

Now, shortly prior to these discoveries, they had moved from The Unnamed Midwest State, to The East Coast. They had been born, and met, married, and started our family in The Megalopolis. With my one brother and I living in and about Da City, and our other brother living overseas, well, my brother the contractor was not a strong candidate to help mom take care of dad, and I, the nurse, seemed better suited, occupationally, to show up out there.

So, I did so. The mortgage company did not seem likely to grant me a payment holiday. It appeared that the credit union was on this same page. Therefore, I needed to work as a travel nurse should I spend any time on The East Coast. I did so, pulling 12 hour weekend night shifts.

After I was credentialed, I was assigned to work various East Coast emergency departments, my job back at home. So, this one time, I was sent to St. Elsewhere, in some fishing town on the southern coast of The State.

I arrived early, and announced myself, asking for the charge nurse. She greeted me, and asked me if I had any ER experience.

Now, by this point, I had spent around 8 years on Da City’s EMS, and close to 7 years in ER in Da City. My answer was “Yeah, some.”

She looked me up and down, and gave me her New Kid Spiel. “This is a fishing town. We have a bunch of young guys, working hard fishing, and, when they come into port, they play hard. Now, if you get a 20 something guy, tap dancing away, can’t sit still, anxious, sweating, and complaining that he feels like his heart is about to jump out of his chest, he’s not having a heart attack. Likely, it’s cocaine.”

I nodded. “Sounds right.”

She paused. “You know anything about cocaine? Ever seen any cocaine overdoses?”

“I know some, I’ve seen a couple.”

“Where have you worked?”

“Da City, in ER. 8 years on Da City EMS before that.”

“Why am I telling you about cocaine? You were just gonna let me carry on, weren’t you?”

“Yeah. If I listened, likely I’d learn something.”

She rolled her eyes. “Here are your keys, your module is over there, get Lucy to count narcotics with you.”

Life in Da City!

Medic Six: Medic in Trouble.

So, TINS©, TIWFDASL© in Da City. So, in the course of EMS in, really, any city, you occasionally encounter folks who fail to realize just how wonderful you and your partner truly are. Some of these folks, at a loss for words to articulate their world view, act out. Indeed, from time to time they seek to act out upon members of the uniformed city services, which is why cops have sidearms, firefighters travel in groups of 5 or more, and medics….well, we generally rely on good fortune. And the antipathy police officers most everywhere demonstrate, kinetically, upon those folks who lay hands on medics.

So, having taken note of the above cited occasional dilemma of the tactical variety, The Powers That Be in Da City administration, had established a radio code, to indicate that the crew employing it, was either in trouble, RIGHT NOW!, or anticipated things to get sporty, REALLY FREAKING SOON!. Since we were, by department rule, forbidden arms, we relied upon our friends at TBCPD to extract our bacon from the fire, when the occasion demanded it. In return, we paid very, very close attention to the calls of “officer (insert injury here)”. While nominally all our responses were “Code 1” (red lights and siren), there were varieties of “Code 1”. For instance, there was a “Code 1” response to the call, “man has cough, for two weeks”, and there was the “code 1” response to “Officer shot”. For only one of these, would the ambulance require brake replacement after the call, and other motorists wonder what was that orange streak that had passed them by at “Warp 8”.

Generally, EMS Dispatch was on the ball. They kept track of where you were, how long you had been there, and, if you had not cleared the scene after a suitable interval, they would radio you and check that you were alright. On (thankfully!) rare occasions, they were not. Whether this was to be laid at the feet of dispatch, or the elderly radio system we employed, is not clear.

So, this one time, several crews were hanging out at TBTCIDC, telling tall tales, conversing, and generally waiting for dispatch to decide that it was Our Time To Save Lives. Our handie talkies were on, because dispatch might NOT assume we were still hanging out at TBTCIDC. Our radios, at that time, were open, meaning that any traffic on the frequency was heard on our HT. Therefore, when Medic 6 called “Medic in Trouble”, well, the room went silent. We waited for Dispatch to respond, and heard nothing. One guy phoned dispatch, asking “Did you hear Medic Six call that they were in trouble?”

When answered negatively, he said, “Well, they just did so. What is the address of their scene?” Writing it down, he hung up. “Hey, partner! Wanna take a little drive?”

Sure. Where to?”

Medic Six’s scene.”

Abruptly, four ambulances called on the air from TBTCIDC. We sped over to Six’s scene, and (thankfully) beheld the crew strolling out of the house there. And, no police.

You guys alright?”, one of us asked. 

Yeah, but it go a little tense there, for a minute!”

Everybody drove away, and the rest of that shift passed, without making any more memories.

Thank Ghawd!

guns · Life in Da City!

Still MORE Gun Fun in the ER!

 

So, after everybody heard of my rollicking good times with Mr. GottaGo and his knife, well, they were SOOO jealous. Or, not so much. In any event, subsequently, restrained folks had their clothing removed and placed in a bag, “for safekeeping”, and property inventoried so as to ensure that everything brought in, went home with them.

Soon thereafter, I was working, and our local fire department brought in this soul, who got restrained (for seemingly good reasons, although, at this distance, I could not tell you what that was). The other nurses appeared to have things under control, and so I was busy doing something else. Knowing that I am a “gun guy”, one nurse came to me, TINS©, with a revolver in one hand, and a magazine in the other.

Look what we found in Mr. Man’s pants! Sure glad we got everything!”

I took the revolver from her, and dumped the cylinder into a specimen cup. I checked it again, and again, and, once almost convinced it was unloaded, I asked her, “It that everything you found?”

Yep! We got it all!”

Uh, no you didn’t. That (indicated magazine) does not go with this (indicated revolver).”

What do you mean? Isn’t that how he reloads it?”

Nope. Just for an experiment, why don’t you try to reload this with that?”

She took a couple of minutes poking, turning, and re arranging, but could not get the magazine to mate with the revolver. I retrieved both from her, and placed them into a property envelope, locking both in the narcotics drawer. “Let’s frisk our friend, one more time, just to be certain”.

We found nothing, but when security arrived to secure the firearm, they, too, frisked our guest again, wondering what he had done with the semi-auto the magazine went to.

guns

More gun fun in the Emergency Department

I have to go to my car…because of my stainless steel model 59….

Another time, I was working the floor in our little hospital ER, and a gentleman arrived, and, since it was a Saturday afternoon in July, well, he had a lengthy opportunity to enjoy the hospitality offered by our waiting room. Like, hours and hours.

So, TINS©, when I finally brought this gentleman back, and read the triage note regarding his cough, I handed him one of our gowns, and asked him, “Would you please take off everything above your waist, and put on our gown so it opens in the back?”

I have to talk to my cousin.”

I was kinda busy. “Right now?”

Yes, right now.”

I was puzzled. “What could you possibly have left to say to him, after spending, what, three hours in our waiting room?”

He shrugged, and drew back the left side of his shirt. There, situated crossdraw in a belt holster, was a shiny Smith and Wesson Model 59 semi automatic pistol. Nice.

Is that what you needed to talk to your cousin about?”

Yes.”

Then, I asked what may be the stupidest question of my entire life. (except for the time I asked my wife how she became pregnant. She looked at me and replied, “Really? You were there!”) I asked him, “Sir, do you have a permit for that?”

He said, “Yes.”

Really? What was he going to say, “No, I’m a felon.”, or “No, but I’m gonna carry it around with me anyhow.”? And, what was I going to do with that information? Disarm him? Really?

What I did, was provide the direction I should have started with. “Uh, sir? We really don’t want pistols in our waiting room, just like we don’t really want them in our emergency department.”

He shrugged, again. “Can I go to my car?”

“Certainly! Please come right back!”

He nodded, and I walked with him to our exit door. The security officer at that post asked me what was happening. “See that car, that that gentleman is going to? Please keep a close eye on it, because he’s just now putting a stainless steel 9 mm model 59 away in that car.”

Knives · Pre Planning Your Scene

Why do ER staff frisk patients? This is why!

TINS©. Once I had left Da City’s EMS, I was an Emergency Department nurse in , surprisingly, Da City. Now, this was in the depths of the then current round of the nursing shortage, and so (a) they put me in charge (BIG mistake!), and (b) we had rent a nurses working with us. You might imagine, folks who have spent their careers working in the hospital may not be entirely as cynical as I am, and so might have a different level of urgency regarding, say, frisking a patient, than I do. Remember that thought.

So, one soul, a frequent flyer at our department, was brought in by the local fire department. This municipality was entirely within the border of Da City, but had stand alone police and fire services. These firefighters also provided EMS for the community. This particular wintry evening, they brought us an intoxicated fellow, who wanted to misbehave. Prior to my arrival, the evening staff had placed this gentleman in a vest type restraint, and settled him into a corner with a couple of blankets, and an admonition to take a nap.

So, once things had pretty much cleared out, I figured that a walk through, and placing eyes on my charges might be useful, and so I set out.

As I cleared the curtains surrounding our friend (mistake number one), I noted that he was fiddling with his vest. Closer inspection revealed that he had secured a knife (frisk fail, mistake number two!), and appeared to be attempting to cut his way free, presumably thereafter to make his escape. Acting prior to thinking this all the way thorough (mistake number three!), I grasped the hand with the knife, and extended his arm over the top of the bed, bending it, and securing it, and the knife within, with both hands.

That gave him the opportunity to consider the advantages he might enjoy, by popping me in my face with his off hand. Having considered, he tried to act, and so there we were, me holding onto the knife hand with both of mine, bobbing and weaving to avoid punches directed, drunkenly, my way by our guest, and calling for assistance.

One of the agency nurses walked over to see what the fuss was about. She stood there, motionless, for a long moment, until I suggested, “Ya know, if you could get some security in here, right stat like, that would be wonderful!”

I shit you not: she pivoted in place, and bellowed, “Security Stat To The ER!”

Sheesh! I amended my suggestion. “That was very nice. Now, if you were to open that door over there, and go out in the hallway, where our friends from security actually are, and tried it all over again, it might be just a little more helpful!”

She did earn bonus points for “Listening to and following directions”. Shortly, our friends from security piled into the room, relieved Mr. GottaGo of his knife, replaced his restraint, and frisked him, thoroughly this time. I frisked him, myself, because, well, reasons. I found no surprises. This time.