Fun With Suits! · School Fun And Games

“School Daze, School Daze, Dear Auld Golden Rule Daze!”

My parents had moved from one of the suburbs of Da City, to Some Unnamed Eastern state. Once there, they met the neighbors. One of whom was married to a meteorologist on Da TeeWee.

He (the meteorologist) found himself, from time to time, changing jobs, and this generally involved moving to an altogether new city. Of course, once they had moved, the children would have to be registered in the new school system.

I have, previously, suggested that not every functionary associated with our public schools is, shall we say, the best and/or the brightest. Indeed, from time to time I have wondered if some of these folks are alumni of The Short Bus.

Mrs. Meteorologist told a tale that supported this theory.

It seems that, after one move, she was undergoing the interrogation customarily associated with registering one’s children at the public school. The clerk was presenting questions, and my mother’s friend was answering them.

“Name?” asked the clerk.

My mother’s friend responded with “Name (whatever)”

“Address?”

The response, “(Address)!”

“Telephone number?”

“(Telephone number)!”

“Mother’s occupation?”

“Home maker.”

“Father’s occupation?”

“Meteorologist!”

(Clerk, without missing a beat, steadily typing away:)“What hospital is he on staff at?”

“(Huh?)”

Fun And Games Off Duty · Having A Good Partner Is Very Important!

My Cardiac Cath Story

I once heard the aphorism that “a man who is his own attorney has a fool for a client”. It turns out that legal matters is not the only arena in which that insight is applicable. Let me tell you a story about that.

So, several years ago, The Darling Wife and I were vacationing in Georgia. There are multiple sites, preserving locations where significant battles of The War Between The States/The War of Northern Aggression (depending upon when and where you learned of such things) occurred. I wanted to walk one of the battlefields (Chickamauga), both to stretch my legs as well as to get a feel for the closeness of the opposing forces.

I was winded by the time I finished my rambling over one section of battlefield, considerably more so than I had expected. I chalked it up to “bronchitis”. (remember that thought!) This persisted as I wandered from site to site, and paused to read the explanatory tablets set here and there.

We finished our vacation, and returned home. There, my “bronchitis” persisted, until, eventually, my Long Suffering Wife asked me about my illness. I admitted that it had not improved, which was curious since I had been having this “bronchitis” for about a month by then.

“How’s your fever?”, she asked.

I did not have a fever.

“Is that common when you see a patient who has had bronchitis for several weeks?”

No, I admitted, it was not.

“So, get your shoes.”

“Why?”

“Because, if you do not, your feet will become muddy”

“Why would they get muddy?”

“When you walk to the car.”

“Why would I be walking to the car?”

“Because I’m not going to carry you there.”

“Why do I need to go to the car anyhow?”

“Because it is too far to walk.”

“Where is too far to walk?”

“Your doctor appointment.”

“I don’t have a doctor appointment!”

“Oh, yes you do! Your wife made one for you!”

“Why did you do that?”

“Because she (my PCP) is not going to come here to see you, that is why.”

“Why do I need to see her?”

“A couple of reasons. First, to get you to stop asking dumb questions. Secondly, because you are sick some kind of way, and your plan is not working. You are going to talk to your doctor, and listen to her plan. And, then, act on it.”

I went to my doctor (actually a Nurse Practitioner, with whom I had ER nursed), who did an EKG, “because you are old and all.” “Well”, she told me, “This looks pretty OK, but, your story is concerning. I’m gonna schedule you for a stress test.”

Cool story. So, I arrived the next day in my running shoes and running shorts, and proceeded to tank the stress test. I mean, I did not even finish the first stage before the physician administering the test stopped me, repeatedly took my vitals, and called cardiology.

Next week, I’m sitting in the cardiology office, and the cardiologist is admiring my EKG, and enjoying my Tale Of The Failed Stress Test. He told me, “My partner will be waiting for you, to do a cardiac cath, at 3:30 (it was now about noon).”

Okey-dokey! So, I went in to my cath, with The Darling Wife and her BFF waving me farewell.

When I awakened, it was like a family re-union. Darling Wife, her BFF, her niece, my second son, my third son, my daughter, and something like 4 or 5 other folks, family in one way or another, who I cannot recall off the top of my head. Once I had sobered up enough for The Darling Wife to brief me on the doctor’s report, her precis was sobering: “You had 95% of your main artery in your heart blocked, but they were able to open it with a balloon and a stent. The doctor said had you waited a few more days, you would have had a big, bad heart attack, and, where that blockage was located, you heart would have stopped. Missed it by That Much!”

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

Again, with not fitting the mold!

Remember my fun filled interview for Nursing school? So, nearly 30 years later I applied for PA school. Among the requirements was 500 hours of patient contact experience. So, I had worked as an RN for (shockingly enough) 30 years at that point, and had accrued, with overtime, something on the order of 63,000 hours of patient care.

So, I went to interview for the incoming class, and they asked me if I had 500 hours of patient care experience. I had included my resume detailing my schooling and work experience as part of my application, so I assumed that my work history was not a surprise.

I asked, “Do you mean, in the past 3 months? or overall?”

“How about, overall?”

“Well, something like 60,000 plus hours, I guess.”

The reply? “Well, alright then! Let’s move along!”

I succeeded, and so got to deal with the financial aid office.

I filled out the form, complete with the birthdate revealing that I had been born some 50 + years previously. I ignored the part where they sought my parent’s tax forms.

When I turned in my application, the gosling behind the counter reviewed my papers,  and looked my elderly ass right in the eye, saying, “You don’t have your father’s tax form in here!”

She sure was quick! “No, ma’am, I do not.”

She was, albeit, persistent. “You have to include your father’s tax forms.”

“Ma’am, I am not going to submit my father’s tax forms. For one thing, he has not filed in 13 years. ”

“He hasn’t filed in 13 years? He has to!”

“Ma’am, perhaps you could call him up, and let him know that. But, it’s going to be kind of a long distance call. And, when you reach him, please tell him that I love him, and miss him every day.”

Perhaps, she was not so quick. “Huh?”

“Ma’am, my father died over a dozen years ago. You will not be receiving his tax forms.”

Undeterred, she demanded, “Well, we will need your mother’s tax forms!”

I was over this. “Ma’am, you are not going to receive my mother’s tax forms, either. She is pushing 80 years old, I have lived on my own for 30 years, and the only tax forms you will receive are those belonging to my wife and me. Perhaps I should talk to your supervisor?”

After several minutes, an adult appeared. I reviewed my position. “Ma’am, this young lady insists on my providing my parents’ tax forms. That is not going to happen. I have supported my own family for nearly a dozen years. I am not about to provide my parents’ forms, nor have they supported me for longer than this nice young lady has been alive.”

The adult looked at me for a moment. “And, you are Mr. McFee, correct? And, you are the student? Not one of your children?”

“Ma’am, if you look at the applicant’s birthday on the application, you will see that it matches my apparent age.”

This soul indeed perused the applicant’s birthday, and regarded me. “Uh, sir? I think we have everything we need here. You will not be asked again to provide your mother’s tax forms. Thank you, and have a nice day!”

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

“But, what do I do?”

So, TINS, TIWFDASL as a nursing supervisor at The Little Un-Named Hospital In Da City (TLUNHIDC). One night, I received a call from our ICU. The nurse on the other endtold me that she had an order to transfer a patient, from our hospital to The House Of God. She asked me what I wanted her to do.

(Again), I thought, “This! This is why I get the Big Bucks!”. I told her, “In that case, I think you ought to transfer your patient to The House Of God!”

She responded, “But, I don’t know if they have a receiving physician at The House Of God.”

My rejoinder, “Well, then, call the House Of God, talk to the nurse in their ICU, and verify that there is a receiving physician.”

(Henceforth, I’ll dispense with the “He said, She said” business. From now on, any dialog beginning with “But…”, is her. Any other dialog, is me.)

“But, what if their physician hasn’t received report from our physician?”

“Note that fact in your nursing notes of that conversation, call our doctor, and invite him/her to call House Of God’s receiving physician, and remedy that oversight.”

“But, I don’t know if report has been called!”

“You might elect to look in the chart, for a note documenting that report has been called. Or, when you talk to their ICU, ASK!”

“But, what if report has not been called?”

“Well, while you have them on the phone, give them report. And chart that fact.”

“But, I don’t know what ambulance service to call, to transport that patient!”

“Ask the switchboard who is next on the rotation, and call that service.”

“But, I don’t know if the family has been notified.”

“So, the required phone number is in the chart, correct? Once all the other pieces are in place, phone the contact person, bring them up to speed, and document same in your notes.”

“But, what do I do about his property?”

“I suppose that bagging it up, and sending it with him, might be reasonable.”

“But, what about the chart? How am I going to send the chart with him?”

“Most nurses photocopy it, and send the photocopy with the patient. I recommend you do likewise.”

“But, how am I going to get it photocopied?”

“Most charge nurses, have the ward clerk servicing their floor do the photocopying.”

“But, we cannot spare her for that long!”

“You have an eight bed unit, have three vacant beds, haven’t had an admission in 6 hours. If you cannot spare her, right now would be a good time to fill your supervisor in on what catastrophe is unfolding in your unit!”

(her: “stutter…stutter…er…um…uh…”)

(Me) “I’m waiting?”

(Her) “But…But…What do you want me to do?”

“Get a pen and paper.”

(her) “What?”

“Get a pen and paper.”

(her) “Why do you want me to get a pen and paper?”

“Simply do it. Now.”

(her) “I have a pen and paper.”

“Good. Write this down. Call The House Of God, verify that our doctor has reported to their doctor.

If not, call our doctor, and invite him to do so. You give report, and chart same. Call the ambulance service that the switchboard tells you is next up on the call list. Call his family, bag his property. Have your clerk copy the chart, and send that copy with him. Have you written all that down?”

(Her) “Uh, yeah.”

“Do you understand all that?”

(Her) “Uh, yeah.”

“Ok, now Do IT!”

End of call.

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.”

Life in Da City!

Dead man on the roof

We typically ran a three medic house, at Medic Seven, just so one of us could take a road trip in the event that somebody or other called in sick, was injured, or other wise was absent for one reason or another. I got the detail, and wound up working Medic One with (let’s call him) Roger Whitaker.

It was his house, and I therefore was the medic that day. It was mid summer in Da City, one of those days with blue skies, sunshine, and temps running high 70’s to low 80’s. Simply a great day to be alive, in your twenties, and working outdoors. We cruised along, between runs, windows open, talking about inconsequential things, and listening for our next run. And, it happened.

We were sent out on a “unconscious man”, at an address down the street from the engine company where we commonly gassed up. At one point, like 30 or more years ago, this had been a prosperous, upper middle class neighborhood. Just off Main Street, the buses (I suppose, at that time, it was trolleys, but the same effect obtains) ran to downtown and back, and north to, let us call it, Middleville, where another of the industrial empires had several of their factories. The managers and suchlike, living in this neighborhood at that time, could take public transport to and from their jobs, and the families, with domestic help, could keep the home fires burning.

Once Da City changed, and the prosperous moved to Da Burbs, well, all those 4, 5 and 6 bedroom homes became multiple apartment buildings. One of them was our destination.

We pulled up in front, called on the scene, and walked to the door. One of the residents met us there, and led us up the staircase, into one of the apartments, around a corner into the kitchen, out of the kitchen window, and onto the tarred roof of the grand porch the building boasted.

This had evolved into some sort of patio for the residents, and there were three men there, two of whom were drinking something from a brown paper bag in the sunny July afternoon, and the other lay, as if asleep, semi prone. Alumni of the old-school Red cross Advanced First Aid And Emergency Care course (yes, I AM THAT old!) might recognize this posture as “the coma position”, as it facilitated drainage of oral secretions from someone who could not manage them on their own. Like, someone in a coma, fer instance.

Roger approached the upright, actively drinking folks, in order to elicit some information regarding our presumably somnolent subject. I approached him, and, kneeling, channeled my inner “CPR Manikin”. I did not quite bellow, “Annie! Annie! Are you all right?”, but I did attempt to shake our friend, to rouse him for conversation.

It quickly became evident that no amount of shaking, nor shouting, nor any other sort of human intervention would cause this gentleman to join in our conversation, without a Ouija board. When I lifted his off arm, as a lever to roll him preparatory to sitting him up, well, he rolled as a unit, as if he was a man shaped board. Students of emergency care might recognize this as “rigor mortis”, and it occurs variably, on the order of 6-14 hours after death.

Our patient had been laying on that hot roof for a long time.

Roger asked one of the bystanders, “When was the last time any of you all talked to him?”

One looked at the other, squinted up into the sky, and answered, “I guess it was before noon when he sort of moaned, laid down, and sort of rolled over. He hasn’t moved since.” Since this was late afternoon, well, this was not going to be a successful resuscitation.

I looked at Roger, he looked at me, and we shook our heads. He retrieved the handie talkie, and called dispatch for TBCPD, and a medical examiner’s crew, and holstered the radio. The second fellow, agitated now, asked, “Is he….? Is he….? Is he….?”

Roger interrupted, “Man, he daid!”

This gentleman walked to the parapet of the porch, threw one leg over same, and made as if to leap. Roger peered over said parapet, admiring all the broken concrete piled against the foundation, and said, “Friend, if you don’t mind, kinda jump a ways out there, into the yard, why doncha? My knees are aching, and I just know I’ll wrench something if I have to pull your broken body off all those rocks!”

The guy stopped, frozen, and stared at Roger for a moment. He lifted his leg back over the parapet, re entered the building through the kitchen window, and was last seen walking down the middle of the street, gesticulating and cursing, heading westbound.

Life in Da City!

Baby Huey And The Guy in the Gutter

 

Welcome back. Now TINS©, TIWFDASL ©, and we came across a figure in the gutter. Ok, we weren’t FDASL*, really. In fact, we were cruising. Now, “cruising” was verboten. It reeked of spending Da City’s hard earned fuel to lollygag about, on da streets of Da City. No, Da City, in it’s wisdom, would much rather we lollygag in quarters. But, THAT is a tale for another time.

So, this one time, we were “Touring Our District”. (There, doesn’t that sound so much better?) Indeed, our sole mission was to improve our understanding of the streets of our primary response district, in order to hasten responses, and avoid potential delays in lifesaving care!

Yeah, That’s it! That’s the ticket! We were “touring the district”! Absolutely!

So, in the course of familiarizing ourselves with the streets of Medic 8’s district (conveniently enough, we were working at Medic 8, myself, Baby Huey, and Cletus, Da Genius), we happened across a figure in, TINS ©, da gutter of Turnbuckle Avenue. Curious as to how this might have happened, we stopped, and advised dispatch of this interruption to our night.

So the night in question was raining, and therefore, unsurprisingly, our new friend was wet, muddy, and, simply to make everything just nice, intoxicated as hell. We bundled him up, in our nice, warm, and dry truck, and proceeded to The Little hospital That Thought It Could (TLHTTIC). En route, I attempted to elicit any sort of helpful information, such as allergies, medications, medical history, name, address, phone number we could call for somebody to pick his soggy self up from TLHTTIC, but he wasn’t in much of a mood for conversation. (remember THAT thought.)

I tried chafing his wrists, I tried tapping his cheeks, I tried the tried and tested “Annie! Annie! Are you all right?”, but he was not having any of it. I contented myself with vitals, and idly admiring our ceiling, en route to TLHTTIC.

Once we arrived, the ED staff informed us that they had no vacant stretchers, and we would have to wait. Cletus Da Genius set off in search of a vacant stretcher. So, there I was, Baby Huey, Mr Soggy Intoxicated, and me, with Mr. Intoxicated on an ambulance cart fully elevated.

Now, potential energy is a funny thing. Different heights allow for different durations within which gravity (“It’s not just a good idea! It’s the LAW!”) can act upon a body in flight. Given the formula v=AT, well, a falling body from, let’s say, 3 ½ feet in the air, can achieve enough velocity that, suddenly stopping on a concrete floor covered with tile,  fracture something will fracture. Hips are popular in the falling populace, and among orthopedic surgeons who have children in expensive colleges, as well. So our new friend was at “The Orthopedic Height”.

With this in mind, our new friend decides to awaken. Whatever my other failings, I am not a fan of added injuries to folks who are, however briefly, my patients. So, I attempted to stop Mr. Intoxicated from launching himself over the side of the cart, and into a consult with orthopedic surgery.

At this point in my life, I was a union steward in our union. I was also an RN, having finished school and passed the boards a couple of years before. I’m not the smartest SOB, but I generally can recognize really, really dumb stuff, and avoid it.

So, OF COURSE, NOW Baby Huey bestirs himself from his coma, to provide me with an extemporaneous lecture on the medico-legal niceties and particulars of patient restraint. I had some familiarity with said niceties, and, as I tried to explain to my newly legal-beagle partner, if my choices were to “illegally”restrain this guy, or watch him fracture his hip, I wanted to be explaining my actions taken to protect the patient from harm. Baby Huey was unmoved, repeating, “Da man wants to go, you got to let him go!”

Several things passed through my mind. Foremost, I hated-truly LOATHED-rolling around in close contact with unwashed, smelly, halitosis ridden children of God. Secondly, I wondered where TLHTTIC got all those nurse-statues, because they sure as hell weren’t moving. Thirdly, where was Cletus Da Genius?

A couple of minutes of wrestling later Cletus arrived with a stretcher. Cletus, in contrast to Huey (in his newfound persona of Legal Authority on All Matters Relating to False Imprisonment and Illegal Restraint), did take direction, serenaded by Huey’s Moot Court exposition. Cletus and I managed to pivot our new friend, writhing as he now was, onto TLHTTIC’s cart, lower it to the laceration height, and secure all siderails up. As I turned to escape this clown show, I noticed said friend start to inch-worm himself to the head end of the cart, and there, I predicted, tumble headfirst onto the cement floor. Didn’t seem all that good of a plan to me, so I watched him. The nurse-statues remained immobile, and so, once I figured his center of gravity was approaching the tipping point, I slid next to him, reached beneath his arms, and controlled his descent to the floor. I then turned and moved smartly to the door. I figured that, by the time he found someplace to fall to, from the floor, I would be happily somewhere else.

Huey had apparently concluded his summation, and decided that he needed to follow me out to the truck. I was really over him and his stupid, pretentious, pompous nonsensical bullshit, but, since he was about 4 inches taller than me, and 80 pounds more obese, I didn’t figure that any conversation he and I would have, would end well for me. I tossed the cart into the back of the truck, and hit the bathroom, figuring he’d leave me in peace to do my business.

I figured wrong.

Huey had, it seemed, figured out, all by himself, that I was irritated. With this insight, he decided that this was a good time to become confrontational. Well, I did not really have to go to the bathroom all that badly, and, besides, I wanted witnesses if I had to knife him in self defense. I exited the bathroom, and went to the counter of the nurse’s station, to finish the run sheet. With how wonderful this run had been, I was gonna be writing the Great American Novel, with footnotes, illustrations, bibliography, and annotated commentary by both Johnny Gage as well as Roy DeSoto. (Foreword by Dr. Eugene Nagel).

Huey, not the smartest representative of Australopithecus, decided that he needed to know if I wanted a supervisor. Indeed, ignoring him was unhelpful, and he got louder, and closer to my personal space (and approaching the “Let’s find out what you have hiding in your peritoneum” range), bellowing, “Do you want a supervisor, Mr. StretcherApe? Well, do you?”

I paused, putting the pen on the counter, and reflected. I asked the nurse-statue posed behind the counter if I could please, borrow her phone for a moment? She said yes. I placed it upon the counter, smiled my best “The voices told me I really don’t need to take my medication every single day” smile, and sweetly invited him, “Great idea! Would you please call dispatch, and ask that they invite the shift captain to meet the on duty union steward, right stat like**, at TLHTTIC? Right about now would work just fine for me! Oh, thank you so very, very much!”

I turned back to my documentation, only to have a nurse-statue develop the powers of speech, finally.

You know, I need your name and unit number for my incident report!”

I responded, “Of course you do. And, I’ll need the names of every staff member on duty, now, for my incident report.”

She did a double take. “What are you going to be writing an incident report about?”

Well, besides the obvious, there is the matter of your personnel admiring my patient’s efforts to fracture his hip, without moving to stop him. That’s pretty remarkable, right there!”

You cannot write us up in an incident report!”

I’ll be sure to mention that. In my incident report.”

I had thought that the demons of pre hospital care could not possibly bedevil me any more. It was a nightmare shift, with nightmare “partners”, and my life truly sucked stool. Doug was off at another house, working start of the week days, and therefore soaking up sunshine and living the good life, while I was on nights, in EMS hell with Cletus and Baby Huey. Once again, I thought wrong.

So, a couple of weeks later I went up to headquarters to pick up my paycheck. Captain Raconteur was the administrative captain this schedule, and when I signed for my check, he asked, as if it was just another casual conversation, “So, you beaten up any patients lately?”

What the fuck? “Uh, pardon me, Captain?”

I asked if you had beaten up any patients lately?”

Uh, well, you know, I haven’t beaten anybody up at all, any time, anywhere. So, what prompts this question?”

Well, your partner wrote a letter reporting that you had beaten a patient, and that he was so distraught that he could not keep what he had seen to himself.”

Doug? Doug wrote a letter?”

Oh, hell no! It was Baby Huey. He wrote a letter about you beating some poor schmuck.”

Are you kidding? Were you gonna give me a chance to respond?”

Do you want to respond?”

Hell, Yes!”

Ok, let me dig it out of the file I placed it in.” So saying, Captain Raconteur poured his trash can onto the floor, and started to pick through the papers therein.

Did you really shitcan a letter reporting that I had struck a patient?”

Hell, yeah! Everybody knows Baby Huey is an idiot. You, well, you’re an RN, the union steward, and never had a single charge against you. Hell, I know you, and how you operate. If, in fact, you had smacked some fool, you would submit a lengthy letter, with names, addresses, phone numbers, and shoe sizes of a dozen honest citizens who will all testify that not only did this fool need smacking, if they had been the ones doing the smacking, they would have smacked him harder, and longer than you did. You did not submit any such letter, so therefore, Baby Huey is full of shit.” Captain Raconteur looked into the distance. “If I could buy Baby Huey for what he is in fact worth, and find somebody to buy him for what he thinks he is worth, I could retire tomorrow!”

I later crossed paths with Doug, and told him the tale. He stopped me. “Baby Huey has been running his mouth, about how he got you in trouble. Nobody, yet, has asked him how it’s clever to monumentally piss off your shift steward. We have a pool going, on when he’ll go up on charges, and see your smiling face, sitting there to represent him!”

*FDASL: Fighting Disease and Saving Lives

** “Right stat like” = “stat”, which means immediately. In medicalese, this means that there is nothing else you really need to be doing, other than this thing, and you must NOT be distracted from doing it until it is fully done.

And, to review: TINS=This is no Shit

TIWFDASL=There I was, Fighting Disease and Saving Lives