Thoughts, observations, sea stories and ideas from a former sailor and lifelong rancher
Thursday, December 29, 2016
Corpsman Chronicles XIV: Mo
As Sarge points out over at the Chant, there are a lot of silly bastards blaming the year 2016 for killing all their BFF's. It's a conspiracy that many seem to genuinely believe. It also seems that the true believers are the ones who live in the SJW realm, that mind-rotting cesspool that the gubmint and media would have you believe is the core of reality.
SMH, Facepalm.
An old shipmate of mine died on December 11. Moise Willis was only 57.
I first met Mo at Oceana in about 1985. We were both squadron corpsmen, both E-5's. We worked a lot together and stood a lot of watches together. When you do that, you get to know one another in a way that's perhaps unique to the military. Mo was a hell of a good guy. A hell of a solid shipmate.
He went on to be commissioned in the Navy Nurse corps and retired as a Captain. I had no idea, but I'm not surprised. I'm proud of his accomplishments.
When we mourn the passing of our friends, and even of our idols, our first flush of emotion is selfish. It's about our loss. That's okay, it's the way we're wired. At some point, though, we must find a way to remember a sense of gratitude for the time we shared with our departed friend.
And here's the Mo I remember best, wearing a bright-eyed happy smile with just a touch of lurking sailor-mischievousness. I'll miss you, Mo, and I was blessed to know you as a shipmate. Thanks. Fair winds and following seas.
Sunday, December 25, 2016
The physics of not hitting the ground on Christmas (or any other day)
Merry Christmas to all!
My 5:30 a.m. Christmas Day wakeup call was a thunderstorm.
That's right, lightning, thunder and heavy rain. The temperature wasn't very far north of freezing and the ground was still frozen so the rain turned instantly to slush, then ice. As I write this the temperature is 33 and falling, it's very foggy, and a brisk north wind is driving a fresh batch of stinging sleet from the heavens. The weather guesses say it's supposed to start snowing and blowing in an hour or so. On the upside, we're looking only at an inch of snow in the prediction. On the downside, that's enough to make a blizzard. So not a great travelling day.
And now, on with the show.
The other day Sarge had a post about the phynal phlights of the Phantom in U.S. service. Posted a couple of interesting videos he did. Extremely cool to see those lovely QF-4E's motoring around the Wisconsin sky.
One video was taken from the ground and the other was a helmet cam video from inside the cockpit. As I said, they were fun to watch, but parts of each video made me cringe. I did not feel good about the low speed dirty pass.
That pass was made at about 500' AGL with gear, flaps and hook down, very slow, and with a pretty hefty angle of attack. I think they were demonstrating both the carrier landing configuration and slow speed flight.
Now I'm not a pilot, and I've never played one on tee-vee. Nor have I stayed at a holiday inn express. I did in my younger days spend a bit of time around naval air patches, ashore and afloat, and I've seen more than one low and slow come out on the wrong side of the ledger.
In the comments of sarge's post Juvat explained what being behind the power curve means in aviation. Basically, you can get into a part of the flight envelope where you no longer have enough power available to 1) avoid the stall and/or 2) overcome the inertia of your descent vector. With enough altitude you can recover before hitting the ground, but without enough altitude you will hit the ground most crunchingly.
One of the first mishaps I investigated was the one that took the life of the first female Naval Aviator, Barbara Allen Rainey and her student Naval Aviator. They got low and slow and hit the ground.
One of the last mishaps I worked was for an F/A-18, the pilot of which entered a loop at too low altitude at an airshow in California.
In between those two I saw a number of slow, dirty, nose-high aircraft come to grief. And that's why the passes in those videos made me nervous.
Here are a couple of interesting videos. One is old-old school, one merely old school. A video can be worth a zillion words.
Thursday, December 22, 2016
By popular demand
The post-surgical checkup went well. Surgeon was very pleased with the way the wound is healing and the way the infection is clearing up. Since the surgeon is pleased, I also is pleased.
The sutures came out today, so one of my pre-visit wishes came true. The other wish, to have my picc line removed and switch to oral antibiotics, well... That one did not come true. The guidelines for this kind of infection call for six weeks of post-surgical IV antibiotics, and that's just the way it is. So another month of that. I can't and won't complain because it's such a very small price to pay. Especially when you consider that it wasn't so very long ago when this kind of infection guaranteed amputation and was more often than not a death sentence.
Before today's visit I'd been pretty sure that I'd be allowed to start bearing weight and rehabbing -- at least a little bit. I was wrong on that though. No weight bearing until at least four weeks post-surgery, so January 5. That's the date of my next follow up appointment.
So, all in all, a good visit and a good report. Seems there's a light at the end of the tunnel!
Now for the gore, although I'm afraid it's getting to be pretty tame gore. In fact it's nearly fake gore at this point. :)
Moments before the sutures came out. |
Sutures gone, steri-strips in place. |
Corpsman Chronicles XIII: Christmas at sea
I spent well over half of my military Christmases underway on the big grey bird boat. Well, not always underway, because the boat was occasionally in port on the blessed day. Regardless, Christmas on the boat was very little different than any other day on the boat. If you were in port and were in the duty section, you had a pretty normal work day. If you were not in the duty section you could go ashore, provided, of course, that you had not run afoul of some rule or regulation and had your liberty "modified." In my early navy days it was not unusual for my liberty to have been modified in some fashion.
I do remember going ashore in Naples on Christmas Day. Pretty sure that was in '83. It was nice to get off the boat and walk around but there wasn't anything Christmasy to do other than get drunk in a sailor bar. There was a lot of that going on, as I recall, but I really wasn't in the mood. I returned to the boat early and a bit dejected and missed the big Christmas meal. Now that was a real bummer.
It was a bummer because on every ship I deployed on the cooks went out of their minds insane to produce a remarkable meal. Now in general navy chow, at least in my experience, was very, very good. The food was well and correctly prepared and served. It was tasty and nourishing. There was plenty of variety. Some of it was a bit strange, like the extruded "french fries," but only rarely did I see a really bad meal, and those were limited to midrat leftovers. And box lunches, of course. But that's a different post.
The only downside to navy chow, especially on the boat, was the chow line. I really didn't like standing in those lines. To this day, if there's a line at a fast food place -- or any other place come to think of it -- I take my business elsewhere.
So anyway, chow was always pretty good on the boat, at least in my experience. But on Thanksgiving and Christmas it was astonishingly good. Perhaps the festive decorations helped, and perhaps the crew's knowledge that it was a special day and special meal eased deployment grumpiness and lifted spirits. In fact I'm sure that was part of it. But believe it or not, the quality, flavor and satisfaction of holiday meals on the boats I served on absolutely rivaled the best holiday meals I ever had at home.
Most of those deployed holiday meals have long since run together in my mind. The abiding memory is one of very good food and a certain kind of holiday cheer that you'll only ever find on a deployed warship. It's holiday cheer spiked with a strong sense of giving. I don't remember anyone ever talking about it, but I think we all felt that serving at the pointy end on Christmas was a gift to our fellow Americans. The following menus are from well before my time, but they ring true to the spirit and the food I experienced underway at Christmas.
Foot update: Today is the 14th day post-surgery. The infection seems to be coming under control, though it also seems to have a ways to go. In general the foot feels "better." I did have a fall on the ice yesterday, and during that fall I whacked my heel pretty good, so I'm having a bit more pain than I had pre-fall. I don't think it's any big deal, just one of those things. I'm still getting IV antibiotics. I'll be seeing the surgeon today and see what he has to say about where I am and where I'm headed. I'd like to get the sutures out, and I'd like to lose the picc line and perhaps go on a course of oral antibiotics to finish this off, but what I'd like and what makes sense medically may be at odds. We'll see.
Wednesday, December 21, 2016
Corpsman Chronicles XII: Tree farmin'
There are a lot of trees in Virginia and, consequently, timber is a rather large industry. Of course there are a lot of trees all up and down the east coast, and a lot of trees extending westward from the coastal states as well, until they fade away and the land becomes the grassland of the Great Plains.
Having been born and raised on the shortgrass prairie of the High Plains, my experience with trees, forestry and the timber was sharply limited. In my neck of the woods, there was no woods. I understood the concept of "forest," had seen pictures of the things, and had even spent a month in the heart of the northwest forest at Prospect, Oregon when the family visited my maternal grandparents. I enjoyed that visit immensely.
But I didn't know from trees.
My first few months of naval life were spent in San Diego, which is not exactly a forested area.
From there I made my way to Florida,
then Virginia,
and found myself in the heart of lotta-tree country.
In lotta-tree country trees grow in exactly the opposite fashion as they do on the plains. On the plains trees are largely (some exceptions, of course) limited to the places where people live, having been planted by said people. In lotta-tree country the only place trees are absent is where people live, the people having cut the trees down to make space for their humble abodes and businesses.
The largest treeless plots in lotta-tree country seemed to be military air bases. Fourteen thousand-foot runways will do that. I always felt a little more at ease on the wide open spaces of the jet bases. Gave me a bit more air to breathe, it seemed, and I could expect a few more precious seconds to plan and react should hordes of hostiles erupt from the woodlands.
On the plains of my youth I always had a clear horizon all around and was thus able to effortlessly orient myself. In lotta-tree country I had to develop new skills and tricks to keep my internal gyro from tumbling. It was a struggle at first.
I grew accustomed to the crowding trees of lotta-tree country and eventually grew to love the place. I loved the smell and the micro-climates and the woodland ecosystem and the sound of wind moving through the trees. Sure, there might be murderous savages hiding in the forest, but it's also a lot more fun playing hide and seek in the forest than on the prairie. More challenging, too.
Once I settled in at Oceana and had a few deployments under my belt and a tiny bit of experience in meeting and visiting with the natives I began to appreciate that the folks living in and around Virginia Beach were more than paper cutouts, that they were real and interesting people who led real and interesting lives. I met some local farmers, and for some reason was vastly surprised to discover tiny (by Great Plains standards) corn and soybean fields being cultivated just on the other side of the NASO fence. I also met folks who grew and marketed timber for a living. That was a new one on me, but with my background it wasn't hard to do the math and realize that a cash crop is a cash crop.
And one of the most astonishing things I discovered about these Virginia Beach farmers was that quite a few of them were retired sailors. Not a majority by any means, but a good solid naval representation.
So you might be wondering where this disjointed tale is going...
I don't remember exactly, but I believe it was the autumn of 1984. It was likely a weekday afternoon, and I was working in the ER at the Oceana Clinic. The ER was on the back side of the clinic building, and the building was oriented with the front facing southwest and the back facing northeast. Which doesn't matter at all to this story.
NAS Oceana Clinic. The ER entrance is under the portico to the rear. And look, trees and farm fields! |
I was standing at short leg of the L-shaped counter of the check in desk, scribbling notes in a chart. The ER entrance doors were about 10-15 feet to my immediate right, and the four-bay treatment area was behind me and just slightly to my right.
As I stood there scribbling I heard the loud blat of an approaching Harley. It pulled to a stop just outside the automatic doors, which, unsurprisingly, opened automatically. One glance was all it took to shift me into high emergency gear. The rider was wearing jeans and boots and a tee-shirt and one of those black biker vests. His hair was long and tangled and he sported an even longer and even more tangled beard. He looked to be about 35 years old. A real scruffy looking cat. Obviously not military.
The bike stopped and the moment seemed to freeze. Bright red blood flowed in a steady stream from the scruffy civilian cat's neck. His tee-shirt was sodden, as were his jeans, and the stream of blood was dripping off his boots and puddling on the ground. I took in the scene, decided to act, and after a seeming eternity my motor neurons began receiving the "move your ass!" message.
As I turned and began to dash toward the injured man I shouted for assistance from the corpsmen behind the counter. As I took my second or third step the bike and rider slowly toppled over and crashed to the concrete. The engine on the bike gave out a final blat and was silent.
Reaching the downed and heavily bleeding man I instinctively slapped my hand down on his neck in an attempt to find the wound and staunch the flow of blood. My shipmates lifted the nearly-unconscious man and bodily carried him into the treatment room where they deposited him on the nearest gurney. All the while I was frantically trying to locate the neck wound. This guy was going to exsanguinate if the bleeding wasn't stopped.
Then two interesting things happened. Well, three actually. Firstly, the man loudly groaned, "Oh, my leg!"
Oh my leg? WTF?
Secondly, as he groaned out his misery he exhaled great clouds of booze breath. What we charted as "heavy odor of ETOH on breath."
Thirdly, I couldn't find a neck wound, but did find that his left ear had been neatly and nearly completely sliced off. It was attached only by the earlobe. This was the source of the spectacular but not-quite-so-catastrophic hemorrhage.
This combination of discoveries served to lower my pulse rate.
The scruffy civilian was clearly in a lot of pain, and kept moaning about his leg, by which he meant his ankle. It must have really hurt, because he was also as drunk as a three-eyed rat. And had a cut-off ear. Now what the hell do you do with a patient like this in a military clinic emergency room?
Well, first of all, you don't let 'em die. Secondly, you try to figure out what's wrong with the guy, and formulate a plan for "turfing" him to the appropriate civilian facility. We immediately set out to do these things. In the course of executing the evolution a few things became more clear.
"ID's in my wallet," he groaned. I extracted his wallet and fished out a...
Wait for it...
A retired Navy ID card.
Hmmm. Our responsibility then. Well, the responsibility of the military medical establishment as opposed to the civilian medical establishment anyway.
So with the bleeding controlled and stable vital signs, we were no longer dealing with a real emergency. That's always a good thing. The patient's continued moaning about his leg prompted me to remove his boot for a better look. Because his foot and ankle were massively swollen, I actually had to cut the boot off. And the guy's ankle was trashed, clearly badly broken. Interestingly, he had no idea that his ear had been sliced off or that he was bleeding.
Over the next few minutes we pieced together his story. He was a recently retired E-6 who had decided to buy a large wood lot southwest of Virginia Beach and spend the rest of his working life as a gentleman tree farmer. He'd been out working his land and had somehow got his foot caught in a tangle of felled trees. He'd "had a few nips" while working. When his foot became trapped and he realized how stuck he was, he panicked, braced himself, and pulled back with all his might. His ankle snapped but his foot came free. As the foot trap loosed him he fell over backwards. He'd apparently been holding his razor-sharp ax in his left hand, and as he went down, inertia caused the ax to travel through a short arc which intersected with his ear. He struggled to his bike, somehow got it started, killed the rest of the fifth of happy juice for pain control, then blatted his intoxicated, broken and bleeding self to the closest medical facility he knew of. Surely a remarkable feat of navigation.
After we got him cleaned up, got a splint on his leg and a dressing on his ear, we loaded him in the duty ambulance and turfed him on over to Portsmouth Naval Hospital (which at the time was probably more properly Naval Regional Medical Center Portsmouth).
As far as I know I never saw the guy again. I've often thought about him and I hope he recovered completely and has had great success in the tree farmin' business.
Over the years I saw a zillion funny things in the ER. This one was and remains a favorite and cherished memory.
Thursday, December 15, 2016
Should be a Corpsman Chronicle: Pus in polite conversation
##########
A couple of comments to yesterday's missive reminded me of a pair of events from my naval aviation/medicine past.
The comments were in regard to the gory image I showed of my post-surgical foot. One commentator didn't like the gore, one didn't like it but was fascinated by it, and one asked for more!
The first one reminded me of an old mess-deck adage (which may still hold true in 2016 -- possibly even in 2022), "never eat chow with corpsmen, and never sit at a table where corpsmen are talking shop."
It's an interesting phenomenon. Corpsmen (and other non-administrative medicos) see and deal with all the "icky" stuff that most of the rest of modern society is shielded from. Everything from boo-boos to bad trauma; spit, mucous, shit, pus, vomit, blood; shattered limbs and bodies, disarticulated parts, enucleated eyeballs, bones and brains and guts, dead bodies, rotting dead bodies -- all of it. It's all part of the job, and to do the job you have to be able to deal with that stuff.
That doesn't mean that corpsmen or the rest of the non-admin medical troops are somehow special or different. Not so many years ago, pretty much everybody had to deal with that stuff. Before the advent of hospitals and emergency medical services and mortuaries and government regulation of corpse handling and disposal, stuff happened to everybody and everybody, at some point or other, had to deal with it.
Today most folks living in the first world never see more than a glimpse of the reality of human disease, trauma and death. They are traumatized when confronted with such things. This is neither good nor bad, it's just a fact. In some ways it's a form of developmental retardation. I believe that there's a cost associated with being sheltered from icky stuff, and that cost is a reduced ability to put many events into a healthy and useful scale and context. I'm not on a crusade to rub everyone's face in gore, I'm just pointing out a feature of modern society. There are plenty of other things modern, first world humans are sheltered from. Most people don't know how food is grown or how weather and climate work or where water comes from or how energy is generated. We all live in bubbles of artificiality, protected from the elements and protected from darkness, hunger, cold, silence, etc. Most people in the first world see nature and reality on the tee-vee or via some other artificial construct, and are often shocked when confronted with real reality. It can be an extreme trauma to see and recognize the enormous difference between what one knows and what one thinks one knows.
Wow. I wasn't really planning to go there. Ah well.
So anyway. USS Birdfarm had departed home port at 0800, heading out on long overseas deployment. The weather was dogshit and the mighty aircraft carrier was heaving around in all three axes. It was the kind of motion that old seadogs hardly noticed. Neophyte sailors noticed it though. Most noobs found it a unique and enjoyable sensation, but some found it quite nauseating.
At zero-dark my fellow flight deck corpsman and I took the rare opportunity to head down to the mess decks for midrats. Midrats are "midnight rations," the fourth meal of the day served on navy ships which, believe it or not, operate 24/7. Or did, anyway, bitd. As it was the first night and the weather was bad, flying was secured, which meant that we denizens of the flight deck battle dressing station could sneak below and have a sit-down meal, rather than remain above and subsist on the infamously bad box lunches which were our usual fare.
For the pedantic, yes, the first night usually means a full flight schedule as aircrews bag enough night traps to regain currency. For a number of reasons, including the weather, this evolution was put off for 24 hours as we steamed in an undisclosed direction and into calmer seas.
Midrats was always a crap shoot. Sometimes it was excellent fare, and sometimes it was awful. An example of awful might be dried out roast beef served with mushy rice and petrified gravy with a side of industrially boiled brown green beans. It was technically nutritious, and you could eat it as long as there was plenty of Trappey's hot sauce. And so long as you were very hungry.
Then there was the excellent version. My second favorite was pork adobo. My all time favorite was eggs to order served with hash browns and SOS gravy. Heaven on a steel mess tray!
And what style of midrats did we get on this, the first night of the cruise?
Heaven.
My partner and I sat at an empty table and I tucked in, and within a few minutes were joined by four or five noobs. You could tell they were noobs by their uniforms; unfaded, non-wrinkled dungarees with crisply stenciled, legible names above the shirt pockets. They were all slick-sleeves, most likely E-2's. They looked a bit lost, and as they sat there looking at the scrumptious meals in their stainless steel trays, they began to look a bit green as well.
Spotting the greenness, my partner launched into a fictitious but gaudily explicit tale of lancing a boil. He described the look and the feel and the smell of the thing, and when he got to the part about pus squirting across the compartment, one of the noobs leaned forward and deposited his barely tasted meal back onto his try. This was my partner's cue.
"Oh man," he exclaimed, "you don't want that?!?" Then he reached across the table and shoveled up a big spoonful of the noob's vomit. Which immediately caused the rest of the noobs to imitate their leader.
Ah, it was priceless.
A few years later I was deployed on a different carrier. Seeing sick call one day, a fellow from my squadron showed up with a big boil on the back of his ear lobe.
It wasn't really a boil, just swelling and backed up oil from a sebaceous gland, so properly an aseptic sebaceous cyst.
It was pretty impressive, about the size of a ping pong ball and just at the point of draining on its own. Which was nice for me, because I could basically just squeeze it and clean it up and he'd be good to go. I had the fellow sitting on the exam table in the treatment room and while I grabbed some sterile gauze I explained what I was going to do. I put the gauze over the lump and gently pressed from the other side. The cyst opened painlessly and deposited a ping pong ball's worth of sebum in the gauze, along with a tiny bit of blood.
"There," I said, "all done."
"That didn't hurt a bit," said the sailor.
"Good," said I. I showed him the gauze and sebum, then turned to toss it in the shit-can. As I turned away, I saw him start to go down, and inertia and momentum prevented me from turning back fast enough to catch him as he toppled off the table in a dead faint.
"Thwack!"
His chin was the first thing to hit the tile-covered deck. I quickly knelt down and, hoping against hope, gently turned him over.
"Whew," I thought, "no damage."
But then his chin erupted in a welter of blood. In striking the deck he'd opened up a large, complex stellate laceration.
Shit!
Long story short, he ended up on a backboard and cervical collar while we x-rayed him to make sure he hadn't broken his neck. Then he got his chin sewed up. From a professional perspective, the complex laceration was fun and challenging to suture, but it was a completely unnecessary and preventable event.
Instead of a 15 minute trip to sick call, the poor guy got x-rays and stitches and several days off work.
I still feel terrible about that.
The comments were in regard to the gory image I showed of my post-surgical foot. One commentator didn't like the gore, one didn't like it but was fascinated by it, and one asked for more!
The first one reminded me of an old mess-deck adage (which may still hold true in 2016 -- possibly even in 2022), "never eat chow with corpsmen, and never sit at a table where corpsmen are talking shop."
It's an interesting phenomenon. Corpsmen (and other non-administrative medicos) see and deal with all the "icky" stuff that most of the rest of modern society is shielded from. Everything from boo-boos to bad trauma; spit, mucous, shit, pus, vomit, blood; shattered limbs and bodies, disarticulated parts, enucleated eyeballs, bones and brains and guts, dead bodies, rotting dead bodies -- all of it. It's all part of the job, and to do the job you have to be able to deal with that stuff.
That doesn't mean that corpsmen or the rest of the non-admin medical troops are somehow special or different. Not so many years ago, pretty much everybody had to deal with that stuff. Before the advent of hospitals and emergency medical services and mortuaries and government regulation of corpse handling and disposal, stuff happened to everybody and everybody, at some point or other, had to deal with it.
Today most folks living in the first world never see more than a glimpse of the reality of human disease, trauma and death. They are traumatized when confronted with such things. This is neither good nor bad, it's just a fact. In some ways it's a form of developmental retardation. I believe that there's a cost associated with being sheltered from icky stuff, and that cost is a reduced ability to put many events into a healthy and useful scale and context. I'm not on a crusade to rub everyone's face in gore, I'm just pointing out a feature of modern society. There are plenty of other things modern, first world humans are sheltered from. Most people don't know how food is grown or how weather and climate work or where water comes from or how energy is generated. We all live in bubbles of artificiality, protected from the elements and protected from darkness, hunger, cold, silence, etc. Most people in the first world see nature and reality on the tee-vee or via some other artificial construct, and are often shocked when confronted with real reality. It can be an extreme trauma to see and recognize the enormous difference between what one knows and what one thinks one knows.
Wow. I wasn't really planning to go there. Ah well.
So anyway. USS Birdfarm had departed home port at 0800, heading out on long overseas deployment. The weather was dogshit and the mighty aircraft carrier was heaving around in all three axes. It was the kind of motion that old seadogs hardly noticed. Neophyte sailors noticed it though. Most noobs found it a unique and enjoyable sensation, but some found it quite nauseating.
At zero-dark my fellow flight deck corpsman and I took the rare opportunity to head down to the mess decks for midrats. Midrats are "midnight rations," the fourth meal of the day served on navy ships which, believe it or not, operate 24/7. Or did, anyway, bitd. As it was the first night and the weather was bad, flying was secured, which meant that we denizens of the flight deck battle dressing station could sneak below and have a sit-down meal, rather than remain above and subsist on the infamously bad box lunches which were our usual fare.
For the pedantic, yes, the first night usually means a full flight schedule as aircrews bag enough night traps to regain currency. For a number of reasons, including the weather, this evolution was put off for 24 hours as we steamed in an undisclosed direction and into calmer seas.
Midrats was always a crap shoot. Sometimes it was excellent fare, and sometimes it was awful. An example of awful might be dried out roast beef served with mushy rice and petrified gravy with a side of industrially boiled brown green beans. It was technically nutritious, and you could eat it as long as there was plenty of Trappey's hot sauce. And so long as you were very hungry.
Then there was the excellent version. My second favorite was pork adobo. My all time favorite was eggs to order served with hash browns and SOS gravy. Heaven on a steel mess tray!
And what style of midrats did we get on this, the first night of the cruise?
Heaven.
My partner and I sat at an empty table and I tucked in, and within a few minutes were joined by four or five noobs. You could tell they were noobs by their uniforms; unfaded, non-wrinkled dungarees with crisply stenciled, legible names above the shirt pockets. They were all slick-sleeves, most likely E-2's. They looked a bit lost, and as they sat there looking at the scrumptious meals in their stainless steel trays, they began to look a bit green as well.
Spotting the greenness, my partner launched into a fictitious but gaudily explicit tale of lancing a boil. He described the look and the feel and the smell of the thing, and when he got to the part about pus squirting across the compartment, one of the noobs leaned forward and deposited his barely tasted meal back onto his try. This was my partner's cue.
"Oh man," he exclaimed, "you don't want that?!?" Then he reached across the table and shoveled up a big spoonful of the noob's vomit. Which immediately caused the rest of the noobs to imitate their leader.
Ah, it was priceless.
A few years later I was deployed on a different carrier. Seeing sick call one day, a fellow from my squadron showed up with a big boil on the back of his ear lobe.
It wasn't really a boil, just swelling and backed up oil from a sebaceous gland, so properly an aseptic sebaceous cyst.
It was pretty impressive, about the size of a ping pong ball and just at the point of draining on its own. Which was nice for me, because I could basically just squeeze it and clean it up and he'd be good to go. I had the fellow sitting on the exam table in the treatment room and while I grabbed some sterile gauze I explained what I was going to do. I put the gauze over the lump and gently pressed from the other side. The cyst opened painlessly and deposited a ping pong ball's worth of sebum in the gauze, along with a tiny bit of blood.
"There," I said, "all done."
"That didn't hurt a bit," said the sailor.
"Good," said I. I showed him the gauze and sebum, then turned to toss it in the shit-can. As I turned away, I saw him start to go down, and inertia and momentum prevented me from turning back fast enough to catch him as he toppled off the table in a dead faint.
"Thwack!"
His chin was the first thing to hit the tile-covered deck. I quickly knelt down and, hoping against hope, gently turned him over.
"Whew," I thought, "no damage."
But then his chin erupted in a welter of blood. In striking the deck he'd opened up a large, complex stellate laceration.
Shit!
Long story short, he ended up on a backboard and cervical collar while we x-rayed him to make sure he hadn't broken his neck. Then he got his chin sewed up. From a professional perspective, the complex laceration was fun and challenging to suture, but it was a completely unnecessary and preventable event.
Instead of a 15 minute trip to sick call, the poor guy got x-rays and stitches and several days off work.
I still feel terrible about that.
And then there was the time I was seeing sick call at NAS Oceana. I was an E-3 at the time and got called to task for my charting.
"HN Evertson," said the LT/NC/USNR who believed herself to be in charge of sick call, "We chart 'purulent discharge'. We never chart 'pussy discharge'."
Wednesday, December 14, 2016
An update
I don't know how Sarge does it. He's actually blogged from the hospital a number of times whilst he was engaged in being the main course on the surgical table.
Now when I saw that, I thought, "cool, if I ever fall afoul of the surgeon's knife I'll blog the hell out of it! Show these non-medical types how the surgical blogging is done, I will."
Heh.
As I said, I don't know how Sarge does it. But I do know how I do it -- I don't!
As you may recall, or if you're new here, I developed osteomyelitis (why doesn't blogger know how to spell this simple word, btw?) in my left calcaneus (or this simple word?) back in September. Osteomyelitis is a bone infection, and the calcaneus is the heel bone. Turns out that the infection was most likely caused by common skin bacteria (Staphylococcus aureus) which migrated through my blood stream from superficial barbed wire scratches and took up residence in the detritus left behind following surgery nearly 10 years ago.
That 2007 surgery was to repair the Achilles tendon in my left foot -- to clean up some bone spurs and reattach the tendon to the calcaneus from which it had become partially detached. The surgery and rehab went well, though in the succeeding years I had occasional bouts of tendinitis at the surgery site. As it turns out, these painful bouts may have been more than simple tendinitis.
In reattaching the tendon they implanted a pair of Mitek anchors in the heel bone in order to have something to suture the tendon to, thusly:
Anchors:
All well and good and a miracle of modern medicine this anchor stuff. However, the anchors and suture material are retained in place and can potentially cause some problems down the road.
For one thing, they are foreign objects, and even though they are made of "non-reactive" stainless steel and nylon, the body's immune system will sometimes try to reject them. Immune rejection looks an awful lot like inflammation, and it's now looking like my bouts of tendinitis were actually an ongoing series of rejection attempts. This is not terribly unusual and isn't necessarily a real problem, but it does cause scar tissue to develop, and being mostly avascular (without blood supply, and another word blogger can't spell), scar tissue can become a home for bacteria.
The anchors themselves also provide a potential home for bacteria, and being screwed into the bone, also provide a potential conduit through which bacteria can enter the inside of the bone.
Finally, the suture material left behind also provides refuge for homeless bacteria.
So, in general, the inflammatory rejection response is occasionally painful but mostly benign. So long as there are no bacteria running around loose in the blood stream, looking for a place to squat.
In the decade since the initial surgery, I continued to be a rancher, and I collected hundreds of barbed wire scratches while doing rancher-type stuff. I didn't realize it at the time, but I was taking a gamble with each scratch. Fortunately, my immune system seems to have smashed all the bacteria that invaded my body with each scratch. This is unsurprising, it's what the immune system does. It's what your immune system does whenever bacteria invade your body.
But this time was different. I don't know why, and it doesn't really matter. Somehow enough scratch-bacteria survived my immune system to take up residence in the section eight bacterial housing project in my heel.
Thus began an extended odyssey to treat the infection. Oral antibiotics didn't work, so we got an MRI, which showed osteomyelitis. We switched to IV antibiotics, installed a picc line and continued the IV antibiotics, and scheduled surgery.
Then the surgery was put on hold by bureaucratic fumbling and bumbling. In the mean time, we continued the antibiotics.
Here's an interesting aside. The antibiotic I'm receiving costs the hospital $42 per one-gram dose. That's pretty pricey. But by the time it makes it onto my statement, the hospital charges $587 per dose. The total bill for antibiotics thus far is north of $50,000. I'm not going to expand on the topic here, but it's worth thinking about the how and the why of that price inflation. Clearly it's not just "greedy" pharmaceutical corporations driving up the costs of health care. Let's just say that there are a lot of people "dipping their beaks" in the political-medical complex trough.
Anyway, finally, the surgery was rescheduled for December 9. That surgery took place, and it was successful in removing the anchors and suture material.
Actually had a civilized show-time for the surgery -- 11 a.m. I did the usual check in stuff; signed a bazillion forms and recited my date of birth a bazillion times, had my vital signs taken, then was assigned to a pre-op cubicle in the surgery department. Excitingly, the next thing that happened was a wait of about an hour. I was in...
Finally the nurse came in and told me to change into the backless nightgown. They hooked up an IV to my picc line and trundled me off to anesthesia.
The anesthesiologist was quite interesting. About 15 years old, red hair, coke-bottle glasses, but very pretty and a very nice and engaging personality. She examined me and said she thought we'd go with general anesthesia, unless I had an objection to that. I stated my objection and opined that in my perfect world we'd just do a nerve block.
She really perked up at that. "Oh, I like doing nerve blocks. They have a lot of advantages over general. Let me check with the surgeon and see if he's good with that."
Well, the surgeon wasn't good with that because, depending on what he found when he opened things up, he might need to extend the incision up the back of my leg, and that might go too high for a nerve block.
The anesthesiologist's counter offer was a spinal, and I agreed to that. Putting the spinal in was about like you might expect. I sat up and bared my back, upon which they slathered copious quantities of icy-cold anti-bacterial skin prep. The anesthesiologist then injected local anesthesia and let it do it's magic. She then proceeded to jam a huge needle into my spine, poking around until she found the right spot. This wasn't exactly comfortable, but it wasn't that bad, either. When she'd hit the right spot she squirted in the juice.
My legs immediately began to tingle and feel warm and within about 20 minutes everything from about the belly button down was a dead lump. The surgeon wanted 1:45 of anesthesia so they gave me a two hour dose and I'll be darned if it didn't start to wear off right at two hours, about the time they were wheeling me back out of the OR.
In the OR I was flat on my belly and all the action was taking place six feet behind me, so I don't really have any story to tell there. I never heard an "oh shit!" which I took to be a good sign. I could occasionally feel some needles and pins in what felt like my left foot, and I interpreted this to mean that there was something going on down there. On two occasions I felt a an electrical jolt -- kind of like a shock from an electric fence -- from the same place. None of those sensations hurt in any way, but they did make me a bit anxious. From what I could overhear I had a reasonably good idea of how things were progressing, and after about 1:45 they were finished and a few minutes later they delivered me to recovery.
The spinal experience, I have to say, was freaky as hell. Perfect for pain control but, man, that must be what paralyzed people have to live with. I really wanted it wear off in a hurry. That numb, dead feeling is kind of awful.
One of the really strange things as the spinal was wearing off was that when I tried to move my legs they would move but I didn't have any sensory feedback. This make sense, because with this kind of anesthesia the sensory nerves go first, followed by the motor nerves, and when it wears off the motor returns first, followed by the sensory. It's hard to describe, but I'd lift my leg and watch it come up but it was almost as if it was moving independently and without control. That's the way it seemed anyway. A very strange feeling. Within about 90 minutes of the end of surgery the anesthesia effect was completely gone. That's when I took this picture:
A couple of hours later I was home. They gave me a prescription for pain meds, but when I took it it made me dizzy and sick. Luckily I had some ratty old expired pain pills in the bathroom closet and they worked fine.
I changed the dressing on Sunday. I was supposed to wait until Tuesday but I got it wet showering and figured I was qualified enough to handle the changing on my own. That's when I took this picture:
Yesterday (Tuesday) I followed up with the surgeon. Everything was looking fine and he pulled the drain out. The cultures they took during surgery showed no change in the bacteria so there's no resistance developing. There is and will continue to be a lot of drainage from between the stitches. There's a lot of infection in there and now that the old hardware is gone my immune system will be doing everything it can to "get the bad out." The drainage is kind of gross on the one hand but a good sign on the other hand.
I'm feeling quite a bit better and nearly all the pain is gone. I'll continue the IV antibiotics for another 10 days at least, depending on how the healing progresses. I'll see the surgeon again next Thursday.
Sooo... So far so good!
Thursday, December 1, 2016
Spirit of '62
Blog reader NavyDavy (a retired AVCM) emailed me with wishes for my recovery the other day, which was a very thoughtful thing to do and much appreciated.
Dave served with VF-84 a generation before I did, back when the squadron was flying F-8C Crusaders from Independence. This was in 1962, when Indy (CV-62) was a mere three years old. They made the ship and airwing's second Medeterranean Deployment and returned just in time to spend 37 days in the Caribbean while the world hung on the brink of disaster. The cruisebook, from which I shamelessly stole the images below, was/is titled "The Spirit Of 62."
While I said above that the Jolly Rogers operated F-8C's on that cruise, they started the deployment flying F8U-2's, and finished in the Charlie models. And they did this, believe it or not, without swapping a single aircraft! How can this be? Two words. Bobby Strange.
I thought it would be fun to post up some images of that cruise. It's kind of cool to think that in 1962 the Independence was newer than Nimitz would be when I joined VF-84 17 years later.
I actually spent some time underway in Independence -- a couple of weeks in 1982 and about the same in, IIRC, 1984. Having become accustomed to the shiny, newer, nuclear Nimitz, I thought the Indy was a real ancient rust bucket. The damme thing even had water hours!
I believe that I've previously mentioned that I was pretty stupid back then.
It's also cool to think about the evolution of the aircraft flown by the Jolly Rogers. They began during WWII flying Vought F4U Corsairs. Fewer than 20 years later, in 1962, they were flying the F8U/F-8, having recently transitioned from the North American FJ-3 Fury. Less than two decades later they flew Grumman F-14A Tomcats, having recently transtioned from the McDonnell-Douglas F-4J Phantom. Pretty mind boggling.
In 1943 the squadron was VF-17, skippered by Tommy Blackburn and including Ike Kepford, who downed 16 enemy planes.
Ike Kepford in 29. |
This VF-84 Crusader must have spent a bit of time on Saratoga (CVA-60) during the turnover as Independence relieved her in the Med. The graffiti appears to say "RELAX I IS HERE CATCC CVA 60 SENDS" |
03 level knee knockers, a constant in naval aviation |
Douglas AD6/A-1H Skyraiders of VA-75 |
Punchers! |
Crash and Smash silver suits in the days before cranials |
A VF-84 F-8 at the ramp. The ship appears to be towing a bombing spar |
Servicing an F-8 with LOX |
The cool kids wear orange flight suits |
2.75" rocket pod, AD4-2HA-4C in background |
Fighter pilots make movies, Attack pilots make history |
F3H-2N/F-3C Demon of VF-41 |
Signing for the jet |
Plane Captain |
Jolly Roger Crusader on Cat Three |
Shooting an A3D/A-1 Skywarrior (Whale) off the bow |
A VMF(AW)-115 F4D/F-6 Skyray (Ford, get it?) launches from Cat Four |
Scooter passing gas to an F8U-1P/RF-8A Photo'Sader of VFP-62 Det 1 |
Fords! |
Grumman WF2/E-1 Tracer takes a waveoff |
Whale at the ramp |
Cutting into a Centurion cake, check out the flag! |
North American A3J-2/A-5B Vigilante |
After the missile crisis. Such behavior wouldn't fly in 2016. Hasta la vista, fidel |
Freedom is never free |
Subscribe to:
Posts (Atom)