ER/Treatment Room

When I trot out bits and pieces of my naval career here, I like to talk about the exciting stuff. Flying, Flight Deck, spectacular medical stuff, etc. I was involved in a lot of that and it was all exciting and spectacular. I've got lots of good memories and lots of memories perhaps more remarkable than good.

Reading the local doggy news

Whether on the beach or on the boat, however, most of the stuff I did was pretty ho-hum. Mostly interesting, at least from my perspective, but strictly routine. Working the ER/Treatment Room at sea and ashore was fundamentally the same experience. On the boat we wore dungarees, on the beach the uniform was either working blue or working white. On the boat there were no weekends, on the beach there were. On the boat you didn't "go home" at the end of the day, on the beach you did. Other than that, the job was pretty much the same, only without the daily cheap beer hangovers.

She really likes the funnies

What filled most of my days was seeing patients in the ER/Treatment Room. On the boat, with limited and cramped space, we saw sick call there, morning and afternoon. Colds and coughs and sore toes and sore backs and tummy upsets and STD's. All the maladies that people develop which are relatively non-acute and certainly non-emergent. On the boat the Treatment room was also the Emergency Room, where we saw acute injuries/illnesses and all of the real emergencies. Those last obviously had head of the line privileges. If a serious illness or emergency cropped up during sick call the routine patients heard "come back tomorrow or, if you're really ill, come back later after we've finished with the emergency."

I AM taking it easy!

On the beach with an entire dedicated clinic building,10 times the "crew," and dependents to boot, we typically saw only acute or emergent patients in the ER/Treatment Room. Sometimes on a slow day we might see sick call overflow, but that would usually be a matter of the clinically-trained corpsmen seeing patients in spare exam rooms over on the sick call side of the building. In the ER/Treatment Room proper, 90 percent of the traffic was acute and relatively minor trauma, with perhaps nine percent acute-but-not-quite-emergent illness. That last one percent would be real emergencies, where life hung in the balance. We averaged about one of those per day.

Watch your step now!

All of the foregoing is to preface the following.

A couple of years ago when I was having my foot problems -- IV antibiotics followed by surgery and more IV antibiotics over a period of seven months or so -- I noticed a great many similarities between the way our little western Nebraska hospital operates and the way navy medicine -- in my experience -- operated back in the stone age of the 1980's.

I don't say stone age in a disparaging way -- quite the reverse, actually.

What I found at our little hospital is great people. Physicians, PA's, NP's, RN's, LPN's, CNA's, lab techs, xray techs, clerks, Paramedics, etc. Really, really, really good at clinical and emergency medicine.

I felt right at home. So much so that I occasionally have dreams where these local folks appear as members of the naval service in the clinic of my past, and where some of my fellow 1980's sailors appear in this local 21st century hospital as staff members. As do I.

Freaky, innit?

I'm going to try to do a series here on our local hospital. Don't know if it'll fly, but we'll see.

Some days

are busy.

Good workout this morning.

A number of hours spent trying to arrange for medical supplies through medicare.

Other medical stuff.

Pasture lease stuff.

Tax stuff.

Writing project stuff.

Draining Dad's abdomen.

Morning will be here very soon.

Variable variability

Guys at the coffee shop this morning: "Freezing fog again! Never seen so much freezing fog! Must be the global warming!"

Gals at the coffee shop this morning: "Ditto!"

Women who were born men at the coffee shop this morning: "Ditto!"

Men who were born women at the coffee shop this morning: "Ditto!"

People descended from at least 17 various races and ethnicities... "Ditto!"



Since I'm one of those goofy bastards who not only knows how to look up the comprehensive local weather history but has also been recording the weather on a daily basis for more than a decade, I happen to know that freezing fog in February is quite common. On average we've seen freezing fog seven times each February over the last 126 years. For those keeping score at home, that's one out of every four days, and January and March boast similar numbers.

Does it matter? No, not really. Most of those conversations are just morning placeholders as people shake off their overnight lethargy and charge up on legal and socially acceptable drugs.

Do they really believe what they're saying? Do they even care if they believe it? Again, probably not. It's just noise and filler. There's always a lot going on in coffee shop conversations. Gossip and deals and arrangements and touching base.

If the new green wave of social justice rolls over them, takes all their stuff, and moves them into labor/reeducation camps will they understand what's happening, why it's wrong, and what to do to save themselves?

No chance. They'll just shuffle aboard the train, and future historians will wonder why they didn't put up a fight.

Is the new green wave of social justice likely to happen? Probably not.

But in my estimation it's a lot more likely than it would have been five years ago.

##########

I hammered out a five-miler this morning with an emphasis on sprints. I threw in 50 flights of stairs for a bonus. It was a good one.

When I crawled out of bed before the sun I knew, as I know most mornings, that there would just be no way I'd be able to work out. Too old, too tired, too stiff and sore. But as always (at least so far), once I got moving and got the juices flowing my body walked itself over to the workout gear and dressed appropriately.

One motivating factor was the weather report. We're supposed to see high winds today and tomorrow and I hate working out in the wind. Especially if it's a cold wind. As I set out the wind was out of the south and quite cold, but it was also only about 5-6 mph. Better by far to hit it before the gale arrives.

Nona went with me part of the way and acted like she was feeling pretty spry. The aspirin seems to help, but in addition to that the vet said to keep her from going too far and too hard. Therefore my first two miles were a circuit that ended back home, where I delivered her before cranking out the last three miles. We'll see how she responds.

If the 7:1 ratio of dog years per human years is approximately true Nona will catch and pass me in age by the time her eighth birthday rolls around in July. She doesn't do anything by half measures, her motor is either off or at full speed. She doesn't associate physical exertion and activity with the pain that comes later, and she'll just keep on going as long as I keep on going.

*I wuz rong! She'll only be 56! Damme spring chicken! But better at math than me!

As I continue to take the fitness path, I continue to learn what works and what doesn't, what causes and what eases the post-workout aches and pains. I get to decide what I will and will not do. Nona doesn't have any of that, so I have to figure it out for her. It's little enough price to pay in return for all the joy she shares with me.

Just another old-guy Sunday

Mookie Wilson, John Kruk, and me.

One of these men is not like the others,
One of these fellows just doesn't belong.
Can you tell me which one's not like the other,
By the time I finish this song?

That's right boys and girls, Krukie only has one testicle!

In addition to being MLB All Stars, we three also share a February 10 birthday.

Admittedly, I played my MLB career in a different dimension, but that's such a minor difference that it really doesn't count. Besides, my blog, my rules.

Whilst engaged in my morning workout I received a delightful electronical missive from a farmer friend in Herefordshire.

To which I replied,







And,

Spring will arrive in five weeks. Here on the High Plains at 41N, the daffodils won't come until a month later, but they'll come. And we will see snow encrusted tulips in March.

Poor Nona though, she's been having a problem with hip arthritis. She wants to go with me so bad, but she needs to rest and rehab.

Such a beautiful day, here and in England.

The road not taken

Every decision, every day, all the way. Some people might think this simple burden constraining and unbearable. I disagree. 

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;

Then took the other, as just as fair,
And having perhaps the better claim,
Because it was grassy and wanted wear;
Though as for that the passing there
Had worn them really about the same,

And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.

I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.

Is it the path that makes the difference?

Or is it choosing the path?

Or is it the way you walk the path?

It's all three, innit?

Bombers, boats, and byques

Before we get to the good stuff (?!?), I did five weight room circuits, 2 miles of sprints, two miles of walks (sprint a block (circa 150 meters), walk a block), and 80 flights of steps. Took just under an hour.

Working out in the cold can be miserable at the beginning. It was -3 when I began in the weight room at 6 a.m. Twenty minutes later when I hit the road I was nicely warm, and after the first mile I was warm enough to flip my sweatshirt hood back. The temperature had soared to zero.

Lots of compressed and very slippery snow on the streets, so the challenge is finding sure traction where I can and exercising appropriate caution where I must. Sometimes I fall, but that's okay for me. I'm pretty good at falling and my muscles haven't yet forgotten their Professional Naval PLF Training. When I do fall -- which isn't that often -- I bellow a loud OOH-RAH in hopes that people will mistake me for a washed up Marine.

I've even taken a couple of tumbles on the concrete steps, but other than a smashed phone and a few bruises and scrapes, those mishaps have been extremely unremarkable. Just part of the workout. I do recognize that there's always potential for disaster but I think I've struck a good balance between recklessness and over-caution.

As a slight aside, there was a house fire in town yesterday and this morning I decided to bend my exercise path by the scene to see what I could see. Excellent plan for seeing a burned out house, but I'd forgotten that they use dihydrogen mono-oxide to extinguish structure fires. There was a LOT of ice. Several slips, but no falls!

##########

I think I've written about this here before, but way back in the day when I was on my very first deployment and absolutely certain I was encrusted in salt, I saw my very first Rooskies. I knew they were our cold war enemy and that they posed a real threat. I knew there was some likelihood that I'd end up facing off against them in combat, most likely as a member of a naval task force being attacked by naval and air assets of the Warsaw Pact. I didn't worry about it, and I didn't spend much time thinking about it (twenty-something male human, do the math), but the possibility was real and ever present.

Early in the deployment there were several flyovers featuring Soviet bombers closely escorted by Tomcats. Witnessing those always gave me an eerie feeling. Those same bombers might one day nuke the shit out of us.

Then one day, sometime after the midpoint of the deployment, a Soviet Kashin Class destroyer made a close pass on us from stern to bow down the port side. We'd just finished a landing cycle so things on the roof were momentarily quiet, and the entire flight deck contingent rushed to portside vantage points in order to get close and lay eyeballs on the enemy.

I elbowed my way to a good location and looked. The destroyer was nautically elegant but also quite menacing. She was obviously a warship, fitted with guns and missile launchers fore and aft and a wild thicket of radar illuminators and receivers amidships.

There were a dozen or so sailors on deck going about their nautical duties. I was shocked to see that they were actually human beings. Some part of me had expected evil monsters -- whatever those might be. Perhaps the last thing I expected was human beings who looked and dressed almost exactly like us. It seems silly in retrospect, but the clear and evident humanity of those Soviet sailors shocked me in a surprising way. It took me a while to process this new and unexpected reality. Somewhere along the line I gained a better understanding of the phrase "all men are created equal." It was one of those times when I actually grew up a little bit.

Many of our guys waved at the Soviet sailors. I couldn't bring myself to. They were, after all, the enemy. Some of our more enterprising (or perhaps more stupid) sailors tossed box-lunch oranges onto the deck of the passing destroyer. The Soviet sailors looked at us but none of them waved or smiled or shouted.

Those guys were the enemy. Period dot. But...

They were also human beings. Men who were my equal in humanity, neither better nor worse than I. They weren't subhuman or protohuman, and I was not superhuman or ultrahuman. They weren't monsters, and I wasn't an angel.

In some ways it made things harder for me. It's much easier to fight monsters than it is to fight fellow sailors.

In some ways it made things better, though, or at least more clear. It's one thing to go out and kill monsters, but if you're going to have to kill fellow sailors, you'd better have your principles suitcased and know what you're doing. The sainted heavenly gate guard Pete isn't going to be impressed by any song and dance of justification.

Just knowing it isn't enough though. I have to practice living that way, living as each and every one of my fellow humans are fully my equal. It's easy to make those who might be my enemies out to be monsters. That's the path of evil though, and while I've trod it for short distances, taking that bath always smashes my heart and soul. It's not a path I'll follow. Not if I can help it.

I'll be okay as long as I stick to the simple reality of my principles, and own both my principles and my actions.

What's that? Oh, Byques!

These are my boys!*



*

Chilly

A little puff of Arctic air arrived yesterday and it got cold overnight. Yesterday was pretty cool, with the high temperature hitting 17 degrees at 1:30 a.m. and falling off thereafter. The daytime high was 15 at 8:30 a.m. At midday it was 8 degrees and by sunset the mercury had tumbled to 3. At midnight it was minus 2, at 4 a.m. minus 10, and at 7 a.m. minus 16.

Then it started warming up. It was still minus 12 when I got out to scoop snow at 7:30 a.m., but it was only -8 when I finished.



I did five circuits in the weight room and ran an easy two mile jog and when I wrapped that up it was minus 4. Just now at 10:45 a.m. it's zero degrees, but an 8 mph northwest wind makes it feel like -12.

As I said last time, it's winter.

Out at the ranch yesterday a basement window somehow opened in a closed bedroom, leading to a minor indoor snowdrift and an influx of cold air. With the heat turned off in that unused room the cold managed to freeze a couple of water pipes, but not to the point of bursting. Closing the window, moving the snow, and turning on the heat soon melted the slush in the pipes and we were golden. Winter.

At 1 p.m. we'll bundle Dad up and take him to town to have an albumin infusion and lab work. It'll be interesting to see if his labs have improved with a medication change started last week. He was getting quite low in the sodium department, and that's just not a good thing.

Just another Thursday in winter.