I read an interesting piece yesterday which explored a couple of aspects of what people who live in the Land Of The Big PX might do in the event that they have to defend themselves with deadly force. I have just a couple of thoughts to add, but they're pretty uninteresting and more focused on brain preparation than the bang-bang-shoot-'em-up stuff. So to steal a phrase from my betters, if that ain't your bag, move along, nothing to see here. To set the stage, very long time ago, back when I was just incredibly young and incredibly full of energy and testosterone (not the same thing as Toblerone), I went well out of my way to train. It was not as if the navy wasn't providing me with a great deal of training to begin with, but I had, in addition to all that youthful energy and testosterone, a great deal of curiosity about various aspects of the military service which were in some way related to my primary military occupation but were also rather different. I also wanted to do exciting and technically difficult stuff, and even more, I wanted to excel at such things. What I'm talking about specifically is military shooting, both square range and complex live fire, rifle and pistol. I did it enough and enjoyed it enough that eventually I became marginally competent. In some circles I was thought of and treated as if I were nearly adequate. So imagine my surprise when, engaged in my first two-way range experience while buzzing along over the cedar-covered hills and dales northeast of Beirut, I found myself closing my eyes and cringing while jerking the infernal machine to life via the volume switch. What the hell? I tried not to do it. But I did do it. Again! And a third time! In the moment a torrential flood of thoughts and emotions roiled through my head. With monumental effort I was finally able to revert to training. Support--sight alignment--sight picture--breathing--trigger control. The shock of an unexpected emotional response abated. I put out aimed fire, and that fire might possibly have been almost marginally effective.
Not, obviously, in the vicinity of Beirut.
At the time I was engaged in internationally lawful military action. I was part of a huge team, and if stuff went sideways thousands of good guys would bring unimaginably vast quantities of skills and assets to bear on my behalf. The "firefight" we engaged in lasted less than thirty seconds and in truth was more about protohuman dick-beating than anything else. If anyone actually got shot it would have been more by chance than by skill, though there was no lack of deadly intent on either side. As a "baptism of fire" it was real and the five of us in the helo were mightily impressed with ourselves, but on this day and in this place it was arguably no more dangerous than training. My point is that you can be very good during training, but the real stuff is not training, and you might struggle a bit getting your feet under you the first time. ########## In my opinion, if you are actually an American -- not a person who simply lives here and has never developed a sophisticated set of foundational principles -- then you have a responsibility and obligation to arm yourself and train well so that you can defend your sovereign personal liberty. But before you pick up a bang stick and head for the range, you also have a responsibility and obligation to train your brain. You can run those things concurrently, but don't neglect the thinker! If you are an American, you believe that all men are equal and endowed by their creator with natural rights, including but not limited to life, liberty and the pursuit of happiness. If you get to a place where you're going to take one or more of those things from a fellow human, it's exactly as big of a deal as if someone else is taking your life, or your liberty, or your pursuit of happiness. That person you're shooting in the face isn't a thing, isn't simply a libtard or a fascist pig. That person is precisely the equal of you. You might indeed have to kill them to survive, but if you're really an American, you have a responsibility and an obligation to know exactly what you are doing and that both of your immortal souls are among the chips on the table. Firetrucking dick-beating buzzkill, innit? So if you are an American, arm yourself and train your ass off, but don't forget to do the fundamental thinking part, which if you're like me, comes from your ass too. Finally, at the end of the piece, we get to the rules of the non-military firefight. At this time and in this place, the first rule is this. Head up, eyes out, if you see some scary shit RUN THE FIRETRUCK AWAY.
Yes, it's possible that this, that, and the other thing might happen and you might have to defend yourself with deadly force.
That's why we're armed and why we train. But in the absence of widespread and deadly civil unrest, if you walk yourself into a gunfight you've violated the first rule. You've almost certainly fucked up.
And those chips on the table are fucking real, baby. I'm just sayin'. I'm unlikely to revisit this topic in detail. Far too many downsides. Besides, real Americans have access to all the stuff needed to get foundational and don't need any advice from me.
The day started like dogshit. Not the yummy (for certain values of yummy) kind I used to enjoy on the boat in the form of autodog, either. Ahh, autodog. There was the white kind, the brown kind, and the pink kind. You might imagine the flavors would be vanilla, chocolate and strawberry. They weren't. The flavors were white, brown, and pink. It was great!
Anyway, the day started like the kind of dogshit that comes with dealing with people who choose to behave as assholes because they are extremely egocentric, have made specific plans, and you are nothing but an object interfering with what they wanna do.
It happens. In such cases it's somewhat satisfying to shut them down and tell 'em to come back when they can behave like a grownup, and not before. As satisfying as it is to more or less politely tell an asshole to firetruck off, it's still a dogshit experience, and starting the day that way sucks.
It's a choice to stay in the suck zone though, and nature and or nature's god is/are good about slapping me in the face with some serious non-suckage. I mean the exact right stuff exactly when I need it.
And all I gotta do is observe, experience, and appreciate. That's it.
I am so incredibly blessed. Some days it's easier, some days it's harder. I suspect that I've won the lottery though because I don't have to go looking for non-suckage. I'm surrounded by it. And that's a fact. Nature even does cool 'speriments and demonstrations for me.
For those playing along at home, the Gang of Three Opus is still in the works, but it covers a lot of interesting ground and should be rather carefully edited before I turn it loose on the interwebs. Edited for clarity, flow and readability, not for scary or non-pc content, of course. As I was checking cows this morning and daydreaming about leadership stuff, an unexpected memory popped up. The memory was of a moment in time near the front entrance of a particular Navy Exchange. Of itself, that particular moment makes for a rather interesting story. The weeks leading up to that moment in time are interesting too, as were the weeks following. ########## Anyway, there I was, striding toward the Navy Exchange entrance aboard Naval Shipyard Philadelphia.
It's all different now...
I'd just been released from the Philadelphia Naval Hospital. Unfortunately I'd been released to limited duty/convalescent leave and wouldn't be allowed to rejoin my unit until medically cleared. The medical authorities I was dealing with were very nice people, and I'm sure their parents were very proud of them. They were even reasonably competent World Class Physicians. But nary a one had ever been to the fleet, and they didn't understand my medical condition as it related to the fact that at my unit's present location, some shit was fixin' to go down, and keeping the world safe for Democracy would likely depend on my presence in theater. As I strode toward the exchange I was physically in tip-top condition and felt fantastic. I was in a dark mood mentally from trying to reason with the fools the physicians who had fixed me good as new but now wanted me to rest and relax instead of jumping back in the Big Game. Bastards! I was an E-6 at the time, and decked out in nicely salty, faded cammies, which was the uniform of the day back where I'd come from. My boots were mirror polished, my eight-sided cover was three sizes too small (salty) and rode atop a closely cropped, nearly hairless scalp. My 1980's porn star slash Naval Aviation mustache was completely non-reg and unsat, my collars sported a caduceus and three-chevroned crow, both in subdued black, and on my left breast glowed shiny gold aircrew wings. Compared to the sand crabs and dungaree/khaki-clad shipyard sailors I stood out, shining like a diamond in a goat's ass. And I knew it. So did the matrons of Philadelphia, who were presently keeping their daughters locked away behind thick, bolted doors. But that's another tale entirely. Ahem. You've never heard me talk about Philadelphia. That's mostly because I only ever spent six days in the blighted city of scrapple, hard by the Delaware and Joisey. How and why, you may ask, did I come to be there? I will tell you. Up to a point. This was an interesting and dynamic point in history, though most people either missed it or have no idea. Book-ended by the wall coming down and the year following the CNN War, there was some freaky shit going down as the Soviet Union teetered near the abyss and a lot of frisky firetrucktards began flexing their peace dividend muscles. I was due to PCS for shore duty which was at the time and for various reasons rather unappealing. I called the detailer asking for an extension of sea duty and he countered with 6-12 months of overseas C-SAR (Combat Search and Rescue) field evaluations. Sign me up! "We'll do that, but first you have to sign this." The "this" I signed means that I'm not going to say when and where and what and why and who and all like that. I signed, and no one has ever formally and officially told me it's okay to blab, so there you go. Anyway, I get there and we're flying some fun missions in some upgraded iron with really cool bells and whistles. Lots of night work with new and improved stuff. It's fun and interesting and often quite challenging. It's a reasonably large effort, and while we're indeed evaluating capabilities in the field, the line between evaluation and operation gets blurred from time to time. During a particularly blurred moment in the middle of the night our trusty olden (but goodun) aircraft is invaded by a single piece of metal which crunches the PRC-90 radio in my survival vest. It crunches it hard enough to shatter the radio and send several pieces of radio case and pulverized radio battery into the tissue of my chest wall. Several pieces slip between ribs and one or more of them nick the lung, causing it to deflate. Some stuff followed, including insertion of a chest tube and a couple of plane rides, a couple of days in the Philly Naval Hospital, de-insertion of a chest tube, and shazam-bam, there I am, ready to jam. I'm now good as new, in superb health, and striding toward the Navy Exchange in all my splendor and ire. I take a couple more strides toward the door and watch as a Chief Petty Officer steps out. He glances at me with curiosity. He's probably never seen anyone in cammies in person before. But the Chief is doing something I've never seen a Chief do. He's uncovered. I can see the piss cutter in the pocket of his his khaki jacket. In the pocket of his unzipped khaki jacket. And he's waddling down the sidewalk eating a fucking ice cream cone. I was rather taken aback. I'd never before seen a Chief looking so unsat. I was very slightly surprised at how much it pissed me off. Something of my displeasure must have transmitted itself non-verbally to the Chief, because he took another glance at me and and his demeanor instantly changed. I could clearly see the change as it happened. I knew what the Chief was thinking. His eyes latched onto the gold wings on my chest, and while he had no idea what that black Marine shit on my collars was all about, he knew that gold means officer and that he'd better salute. I could see it coming from a mile away. The Chief quickly shifted the ice cream to his left hand and rendered a fairly shaky, fairly sloppy, and completely uncovered salute with his right hand. I stopped directly in front of him and glared balefully into his beady little watery eyes. He swallowed, and a couple of rivulets of sweat spilled down his face. He held the salute while I looked him up and down. He was fat and his uniform was over-tight. Ten pounds of shit in a five-pound sack. There were ice cream dribbles on his shirt, on his right trouser leg, and on both shoes. I locked eyes with him again, then slowly returned his salute with parade ground precision. With a head jerk I indicated that I wanted a private word with the with him, off the sidewalk and away from prying eyes and ears. He began to hoof it over to a stand of coniferous shrubs about 25 yards away, on the grass and well out of earshot of passersby. What the firetruck was I doing? Why the firetruck was I firetrucking with a Chief? I was asking myself that very question as we walked toward the shrubs. The thing is, I wasn't really firetrucking with him. I was pissed at him, because he was walking around in uniform eating ice cream, uncovered, wearing the uniform wrong, and looking like a bag of shit. For perhaps the first time in my naval career I had a good idea what what various Chiefs had actually been thinking when they rang me up for wearing the uniform wrong or looking like a bag of shit. Now maybe this Chief assumed I was an officer. No doubt he did. But I was in the correct uniform, and I was wearing it correctly. As a Navy Chief he should be familiar enough with naval uniforms to know a Navy E-6 from a Marine Officer. Finally, the salute is certainly owed by the enlisted to the officer, but the return is owed by the officer to the enlisted. It is a sign of mutual respect. And as a sign of respect, it's perfectly appropriate for a senior to salute a junior. So I was in the clear. Probably. And I was pissed. The Chief stopped at the shrubs and turned to face me. He'd pitched the ice cream as we passed a shitcan and shoved the piss cutter back on his head. He zipped up his jacket while I paused, thinking about what to say and how to say it. The momentary fright I'd seen in his eyes was gone. He still looked like a bag of shit, and I realized that I was pissed because I was disappointed. But he looked me in the eye and he was clearly ready to take his lumps. "Jesus Christ, Chief," I said, "what the hell?" "I ain't got any excuse, sir." "I know that Chief." I looked hard in his eyes and what I saw there made me feel better. "Do we need to discuss this further?" "Nossir," said the Chief. "Very well, Chief. Carry on." "Yessir." Sharp salute, returned sharply. ########## A couple hours later I was sitting at a table in the EM Club, drinking a beer. I was still rather cross about being in Philly and not heading back to the unit. But it had been a good long while since I'd sat in an EM Club drinking beer and I was kinda digging it. It was a small club and carried a lot more nautical flair than an Air Station club. I liked it. It was a weeknight and the crowd was small and quiet. Across the room a very well constructed female type person got up and sauntered to the jukebox. She clinked in some coins and after a moment or two began delightfully moving in time to The Pretenders. "Brass in Pocket," as it happened.
She moved and sipped from a long-neck. It was a nice distraction. She turned and scanned the room, still moving and sipping. Her eyes came to rest on me. Still moving, she took another sip and began to saunter in my direction, softly singing the lyric, finally stopping across the table from me. "...gotta have some of your attention, give it to me!" Hell of a performance. Why the firetruck, I wondered, did I ever stop going to the club? "Check please!" ########## The next morning I caught the bus over to the Naval Hospital. I'd hatched a plan overnight, and all I needed was an Aviation Medicine Section, or at least a Flight Surgeon willing to listen. "Nah," said a fellow HM1, "closest aviation medicine is Pax River." "Well, thanks anyway," I said, wondering about the logistics of zipping down to Maryland. The HM1 must have seen my disappointment and threw me a bone. "I think there's a flight surgeon over at the shipyard clinic, if that's any help." "Thanks!" ########## The Flight Surgeon was a girl, which I thought might possibly be a slightly negative thing, considering the fact that she was stuck in a shipyard clinic, and considering what I was gonna ask of her. By girl, I mean of course a female Lieutenant, MC/USNR (FS). No disrespect intended. But still. I was gonna ask for an "up chit," or formal clearance to return to duty involving flying. I figured that if I had an up chit, and I hadn't formally started C-leave, and if I could bullshit good enough, I could maybe get travel orders cut returning me to my unit. Seemed worth a try anyway. I didn't bother bullshitting the Flight Surgeon. She was a Flight Surgeon. She'd seen this kind of shit before. I laid it all out, told her I was fine, and sat back and shut up. She tisked at the bruising, thumped the hell out of my chest, and listened carefully to my lungs with a high-dollar cardiac stethoscope. "Who's gonna take the sutures out?," she asked. "Dr. Lipshit," I said, "the unit flight surgeon." "Harry Lipshit?" "Yes Ma'am." She snorted, then paused for a moment. "I want X-Rays." Twenty minutes later she peered carefully at the X-Rays. She seemed to look at them forever. Finally she sat down at her desk and looked at me. She looked at me longer than she'd looked at the X-Rays. "I think all that garbage is in the subcutaneous tissue and intercostal space. I don't think it's going to go anywhere. You're a First Class Corpsman and a paramedic. I'm trusting you to be smart. Are you going to be smart?" "Yes Ma'am!" She snorted and reached for an up chit. ########## I rolled into the travel section of PSD just after 1000. I had my orders in hand along with my medical records and up chit. Showtime. As I stepped up to the counter a JayGee greeted me. "Can I help you, uh, Doc?" He'd started to make the cammies/aircrew wings mistake, but this was no pimple-faced JO. This was a Mustang. He'd been around, and he'd spent time in the fleet. "Yessir," I said, "need travel back to my unit. I'm cleared medically and packed and ready to go." He perused my orders and carefully read the up chit. "Not going on Convalescent leave?" "Nossir." Keep it simple. "Okay," he said, "We can get you on the 1400 if we hustle." He turned, noticed an empty desk, glared at his watch, then yelled at a doorway. "Chief!, where the fuck is Rowntree?" (Yep, Mustang). "He's at medical, Lootenant," answered the invisible Chief. "Well Doc here needs to make the 1400, can you do that?" "I'm on it," called the still invisible Chief. "Damme I'm good," I thought. Then the Chief walked in. You guessed it. It was the Ice Cream Man. He walked up to the counter with a quizzical look on his face, then thumbed through my orders as a slow grin grew on his face. "Damme I'm firetrucked," I thought. "Goddam, Doc," said the Chief, "I thought you wuz an officer yesterday!" "Ah, well Chief, that is..." "Hey Lootenant," said the Chief, "Doc here ripped me a new asshole yesterday for looking like a ragpicker!" "Good for him," said the JayGee. "But he still needs to make the 1400, so..." "Right, Lootenant!" Ten minutes later I had travel orders and tickets in hand. "You wuz right Doc. I 'preciate that." "My pleasure Chief, and thanks." ########## As I walked back into the unit's spaces on the flight line the eastern horizon was just turning pinkish. Skeds was scribbling on the flight schedule at the SDO desk. Otherwise the ready room was empty. "You up?," he asked. I waved my hard-won up chit. "Arright," he said, scribbling furiously, "Varmint 6-6, 2100 brief. Kay?" "Roger that." "Welcome back, Doc." "Thanks." I'd been gone 11 and a half days. It was good to be back. ########## Still have the scars.
Yes it is. Navy Corpsmen have been accused of having a sick sense of humor. Well, back in the day they were frequently accused of that. I've no idea how it all plays out today. Nevertheless, I wouldn't have argued with my naval peers bitd. I wouldn't have called our sense of humor sick, exactly, but I could certainly see how it might be viewed that way from a non-corpsman/non-medical perspective. Here's the thing, from my perspective. I have closely attended the death and life-changing injury of young sailors. My main purpose for being, at that time, was to stave off death and mitigate injury. There were more times than I like to remember when I failed in this mission, and when that happened, it was a double kick directly in the balls of the soul. My personal failure was the lighter of the two blows. The searing knowledge that a shipmate was gone forever or that his life was now unalterably changed for the worse and forever, well, it's a crushing thing to live through. Those blows are hard to take. We took them, because that was part of our job, and because our shipmates (and many of us) routinely operated millimeters and moments from catastrophe, and the call could come at any time. None of us could afford to wallow in regret when our skills and best effort were liable to be needed at any moment. We had to grow tough skins, as it were, and part of that tough shell was reflexive humor. It was almost always dark and stark, and could seriously shock the non-corpsmen. Sometimes it looked as if we were laughing at the misfortune of others. And we were. But a large component of our mirth attended the fact that we were laughing at (relatively speaking) mild misfortune. At survivable misfortune. The pain and fright of injury is real, and it will leave a scar. We knew that. But having seen much worse, and having attended soul-smashing tragedy, our laughter at mild(ish) misfortune was in part safety relief valve, and in larger part a celebration of certain survival. The fellow in question was having a bad day, and it sucked to be him at the moment, but he was gonna be okay. Compared to the alternative, it was a lovely thing indeed. And probably called for some of that dark and stark corpsman humor. ########## I've written about tree farming before, specifically about the navy retirement tree program in the Tidewater area of Virginia. I have no idea if it's still a thing. Back in the olden days, it was very much a thing. At the tag end of that post I noted that it was one of many amusing emergency room happenings I've experienced over the years. Here are a couple more. ########## I think it was a weekend, but it might not have been. I'm quite sure it was daytime. As I recall, the Emergency Room at the medical clinic at Naval Air Station Oceana was hopping. I liked to stand at the L-shaped counter of the ER check in desk to write up my medical notes on the patients I saw. This location gave me a good bit of situational awareness. I could see the waiting room and the entrance doors as well as observe and listen as the staff checked people in and out and discussed cases. At this particular time and place I didn't have a formal need to maintain situational awareness. I was just one of the duty corpsmen and didn't have to worry about the big picture. I'd learned over time, however, that paying attention and being prepared could give you a vital head start if an emergency developed, and a head start could not only make a significant difference for an ailing or injured patient, but could also help you avoid looking like a flailing dickhead. Which was important. So there I was, writing in a chart, when the entrance door slid open. I must have been trying to spell a two syllable word or something because I didn't actually look at what was walking in. I sure smelled it though. A stench of raw and combusted gasoline with strong component of burned hair and clothing rolled over me. That got my attention and drew my eyes. The apparition standing in the doorway was -- and remains -- nearly impossible to describe.
He was of average height. He was wearing only tatters of clothing; a shirt collar and one sleeve and jeans shredded (and largely missing) from the belt-line down. Taking in the state of the tattered denim, I imagined that the leather belt was the only thing keeping the sooty, grimy cloth in place. His, uh, "stuff" was swinging in the breeze, but rather diminished. His skin, and I could see most of it, appeared to be angry red with a heavy charcoal overlay. There wasn't a hair on his head or face, though a collapsed layer of gray ash looked as if it might have been a beard. There were fewer but similar traces atop his now hairless pate. I peered at him for a long, suspended moment as he stood there. His eyes swiveled about, looking at us looking at him. It seemed as if he hadn't planned what to do once he got here, and he was having a hard time deciding how best to proceed. As his eyes darted around small tendrils of smoke rose from the tattered remains of his clothing.
Just as I was about to launch into action Boards came sauntering out of the treatment room, scribbling on a chart. As he passed the apparition, and without taking his eyes from the chart, he delivered a stern admonition. "No smoking in medical!" From that point on the hardest part of helping the poor fellow was keeping laughter at bay. Cutting to the chase, the fellow was another naval tree farmer. His wood lot was a bare 300 yards from the Clinic's emergency room entrance.
The wood lot is still there, bottom right next to the "Oceana NAS Pass/ID" shack. Which wasn't there in 1982. At the time even the clinic was outside the main gate. 9/11 changed all that.
He'd been clearing debris, and surprise-surprise, drinking a good bit. He'd shoved a pile of tree limbs, leaves, and other detritus into a low spot, doused it liberally with gasoline, and then started throwing matches. His fire triangle was lopsided though, and he needed to apply more heat than was available in your standard cigarette-lighting match. He eventually pulled out a propane torch, and that did the trick. Of course he touched off a fuel-air explosive, which deflagrated rather more energetically than a standard campfire. At the end of the day the recently retired and nearly exploded sailor was fine. His worst injuries were small second degree burns around his ankles where his cheap Navy Exchange plastic sneakers had melted. Other than that he had some first-degree burns and he'd destroyed a good third of his wardrobe, but all in all he'd come off remarkably well. The Lord takes care of drunks and sailors. Ask me how I know. ########## Five or six years later a somewhat similar odor invaded the treatment room on the boat. The fuel stench was subdued, old and stale kerosene rather than petrol, and with a strong admixture of hydraulic fluid, lithium grease, canopy cleaner, box lunch horse cock, and body odor. The scent of the Plane Captain. Far more powerful was the reek of burned hair. This fellow paused just inside the treatment room too. The left side of his face was red and grimy and sported the ashen remains of eyebrow, eyelashes, and mustache. The right side of his face was normal. If you can call a half-mustache normal. As he stood there, tendrils of smoke arose from the left sleeve of his flight deck jersey and from the left side of his float coat.
I gave him a mock-severe glare and the now famous (in my mind anyway) admonishment. "No smoking in medical!" My fellow corpsmen roared with laughter and had great difficulties as they tried to succor the singed plane captain while maintaining proper emergency medical decorum. I was secretly disappointed with my performance though. I wasn't Boards, and I simply lacked the thing that made him a legend. In a way I felt kind of dirty. I was pretending and it just didn't feel right. As it turned out, the plane captain had been pulling external power from a Bug and for some reason the circuit had remained energized. Someone had failed to secure power or a switch crapped out. I forget which. When he pulled the plug a substantial wave of freed electrons washed over his left side at the speed of light, giving him a light toasting. Aside from the 'stache singeing, he wasn't even mildly injured, but the Bug's Bugtronics got fried and so there was a mishap investigation. It was a close call for the plane captain and could have been much, much worse. In the end it only cost several hundred thousand dollars to reanimate the dead Bug, so no harm, no foul. ########## The following bit is long and tedious. It's not exactly about grim and dark navy corpsman humor, but it has a component of that. It's more about the friction of competing ideas and the fact that sometimes, even in a very good system, stuff falls through the cracks. The fact that these things happen is one of the main reasons you can't have mindless plug-n-play enlisted automatons. Not without courting disaster anyway. It was a Saturday afternoon in Virginia Beach and in the Emergency Room at Oceana we were getting hammered. It didn't happen often, but sometimes the medical gods arranged things so that everyone and their pet monkey wanted to come to the circus. This time I was Chief of the Day, and having just returned from a deployment found that I was not well pleased with one of the recent changes. When I'd left on deployment some eight months previously, there had been a nice, glassed-in waiting room just to the west of the ER check in desk. Patients could sit in there and watch television or read magazines and wait their turn for care. They were comfortable, out of the way, and close. The big windows allowed us to keep eyeballs on, just in case someone developed a serious problem or needed assistance. When I returned, the waiting room was devoid of furniture, dark, and empty. This was the work of the Gang of Three, or the three navy Nurse Corps officers assigned to the clinic. I'll get into their story in more detail in future, but for now let's just say that imo, they were ill-led, underemployed, and prone to do stupid shit because reasons. As with every other thing in the world, the story isn't that simple, but for the purposes of this tale it's a good starting point. Anyway, patients desiring to utilize emergency medical services after hours and on weekends were now required to check in and wait in a different area of the clinic entirely. Let's see if I can describe the previous and new procedures.
Branch Medical Clinic Oceana. This is the front of the building with a (relatively) south exposure. The main entrances are offset to the east. The left or west doors open into the active duty side while the east doors open into the dependent or family care side. Back in the 80's-90's anyway.
First, the clinic was a big rectangular building. There were two main entrances on the south or front side of the building. The southwest doors led into a big, open area with lots of chairs for waiting. Medical records was on the immediate right, with Pharmacy on the other side of a broad east-west passageway. Along the west side of the big waiting area were the multiple check in counters for active duty sick call. Behind the check in counters and extending all the way to the dental side of the house were three passageways lined with individual exam rooms and offices. This set up was mirrored on the east side, where family care and pediatrics resided.
Back or north side of the clinic. Everything to the right or west side of the right elevated section is dental and therefore doesn't count ;). The elevated sections are mechanical spaces btw. The ER entrance is the dark cutout to the left or east of the portico where ambulances were parked. The covered extension just to the left appears to be a wheelchair elevator and was not there back in the day. It's located at the northwest entrance, which was the "new" ER entrance as conceptualized by the Gang of Three. The two white sheds and the slightly larger roofed structure next to the ambulance/ER driveway weren't there. The entrance behind them with the small overhang is the northeast entrance into family care. The bump-out section of the building is supply. On the day in question there was a long aluminum radio antenna leaned against the building halfway between the "new" ER entrance and the family care entrance.
On the north or back side of the clinic there were also two main entrances which opened on to the same large waiting areas. If you came in via the northwest doors the active duty sick call waiting area was to your immediate front. A passageway to your right led to the Emergency Room. To your left was the lab, and across from lab was x-ray. If you came in through the northeast door you'd be entering the family care side. Also on the north or back side of the clinic, farther west than the "main" entrance doors, was the Emergency Room, which had its own separate entrance, complete with automatical sliding glass doors. During the clinic's normal hours of operation -- that is to say, M-F, 0700-1700 (excluding Royal Federal Holidays), you could enter the building through any of the doors, front, back, or emergency. After hours and on weekends/holidays the four main doors, front and back, were locked up. The only after hours entrance was through the Emergency Room. The way patients gained after hours access to medical care before the Gang of Three worked their magic was by entering the clinic through the Emergency Room doors and presenting themselves to the check in counter which was, like, right in front of them. From there they'd either be immediately whisked into a treatment area or spun out to the waiting room, which from their perspective, was just through a door to the immediate right of the check in counter. The new and improved Gang of Three method was different. Patients were no longer allowed to use the Emergency Room entrance. They were now required to enter the building via the northwest entrance. There they would find a tiny little stainless steel check in desk, manned by a single tiny little non-ferrous corpsman. The corpsman would begin the process of filling out an emergency care form with patient information and a "chief complaint." He (or she) would then invite the patient to have a seat in the large waiting area (which happened to be the sick call waiting area during normal business hours). At some point, when the tiny little corpsman had finished the paperwork, they would hand carry said paperwork down a passageway through a couple of sets of double doors to the actual check in desk in the actual Emergency Room. Makes sense, right? Except for a couple of problems. For instance, think about this. The clinic is a very large building. After hours the staff is concentrated in the Emergency Room only. Why physically separate patients from the staff? What if a patient has an actual medical emergency out there, away from the ER? Why take that risk? Along the same line, why separate one of the staff members? Why stick that tiny little non-ferrous corpsman out there with the separated patients and away from immediate assistance and emergency medical equipment? Why make things harder and more risky than needed? How does that support the mission? But wait. It gets better! The after-hours staff of the Emergency Room is the duty section plus a duty physician. Six or eight corpsmen and a flight surgeon. That's not an overly large crew. On days like the day I'm describing, it's enough, but only barely, and only if everyone works very hard and very efficiently. And now we've got to take a sixth or an eighth of our manpower and park them "out there" in the sick call waiting area? Not feelin' it. A complicating factor is that corpsmen aren't really interchangeable. In most duty sections you'd have two -- possibly three -- who were experienced and certificated in emergency care. They'd be doing the hands-on patient care stuff. They'd be assisted by the less experienced and non-certificated junior members of the duty section, who would be learning and gaining experience while writing and fetching. If you do the math, that leaves one or two on the desk to push paper, answer phones, manage patient check in and check out, etc. If you're still following the math, you might wonder (as I did back in that long ago moment) who exactly is going to be the tiny non-ferrous corpsman sitting at the tiny stainless steel check in desk. Because eight minus three minus three minus two equals zero. Fortunately, in this case, the beginning number was actually nine. My duty section had a brand new, freshly minted corpsman. This fellow was an E-2, or Hospitalman Apprentice. He'd graduated from Hospital Corps School a couple of weeks before and the Oceana Clinic was his very first duty station. He'd doubtless be a good fit for check in duty. The job wouldn't be too taxing to his freshly learned but never before practiced medical skills, but would also be challenging enough to be interesting and provide a steep(ish) but surmountable learning curve. A seemingly perfect solution to the problem of who to put out there on check in duty. Beware perfect solutions. As it turned out, the new corpsman was, to be charitable, severely challenged. I'm trying to recall what he looked like but I'm drawing a blank. Something makes me think he was tall, skinny, and goofy looking, but I may have him confused with a different E-2. Or many dozens of different E-2's. Not that it matters. His job was to do the "Can I help you?" thing whenever a prospective patient would enter the building. He'd get their ID card and transcribe their info onto an emergency care form. He'd also ask them the nature of the malady which had prompted their visit to the Emergency Room, and write it as a "chief complaint" up at the top of the notes section of the form, something like this: CC: Patient states "I poked my eye out with a fork while changing spark plugs on my car." With the chief complaint recorded and patient information filled out, he would invite them to have a seat in the waiting area, attach the emergency care form to a clipboard, and then carry the clipboard back to the ER check in desk, making sure to hand it directly to the desk corpsman. If the patient was in distress and needed immediate attention he would of course escort them directly to the ER or call for help. The new guy's job would be relatively simple but also fairly challenging for a fellow who'd only had training under direct instruction so far and had never done ER triage. He'd have to use a little bit of common sense and be able to think on his feet. Aaannddd... It didn't work out that way. No one could read the kid's writing. It looked like the penmanship of a writer deep in the throes of a grand mal seizure. He also couldn't figure out the concept of handing off the clipboard directly to the desk corpsman, thereby alerting her to the presence of another patient in the waiting area. He somehow managed to sneak in and stack the clipboarded forms on the end of the counter when no one was looking. Finally, he couldn't do the common sense thing. Thirty minutes into the watch he had three guys sitting in the waiting area trying to staunch bleeding lacerations with paper towels they'd found in the head. Which none of us knew. We thought we were finishing up with the half-dozen patients we'd inherited from the off-going duty section, and thought we were rapidly closing in on coke-n-joke time. The final straw was when the kid showed up at the check in desk mumbling something about "there's a guy laying down on the floor out there..." "Patient down!," yelled the corpsman at the check in deck. Several of us scrambled out to the new and improved waiting room, where a young fellow in civilian clothes was sitting on the floor near the tiny check in desk, shaking his head and trying to get his bearings. A pair of bleeding sailors were standing by, trying to render assistance. I glanced around and took in a surreal scene. There were far more people in the waiting area than I'd expected. Most of them, I was sure, were waiting for care. There were also blood trails everywhere, deposited by the lacerated sailors as they searched for paper towels. The blood trails reminded me of the aftermath of a claymore initiated ambush. The "down" patient was a sailor from my own airwing. I'd seen him around the boat. He had a severe chest cold with a pretty high fever and had fainted while waiting to be checked in. I fumed for a few moments while assessing the situation. This new waiting area concept was a loser, and it clearly put the patients at unnecessary risk by separating them from the ER staff. So firetruck it. "Okay, listen up," I announced to the crowd of patients. "This (air quotes) 'new waiting area' idea isn't going to work out. I apologize for the inconvenience and confusion. The people who came up with the brilliant idea don't ever work weekends or stand duty so they're obviously not here, but we're gonna go ahead and go back to the old way. Everybody grab a chair and follow me." When I went to unlock the old/new/reinstated waiting room door I noticed that the Gang of Three had gone so far as to remove the key from the Chief of the Day's key ring. Since they had decided to behave like stupid bitches they had completely failed to understand the concept and utility of the master key. Fully reinstating the waiting room to its past glory was a snap. Open the door, flip a light switch, click on the wall mounted television. I took personal charge of the sailor who had fainted. I looked at the emergency care form and couldn't read a word of the chicken-scratch recorded by the new guy. It looked kind of like Chinese, 病人说他有阿米妈妈, but it wasn't Chinese. It was chicken scratch, made by drunk chickens. I called for the new guy and asked him to translate. He couldn't read it either. I shit you not. "What do you think it says?" "He said he has ammimomma," replied new guy. "What the fuck is ammimomma?" "You know, like a really bad cough thing." "Pneumonia?" "Maybe." My mind quickly spun through thousands of leadership events and options. I had to see if this kid was reachable and teachable. For that, I needed... An attention getter!
Outside a steady rain was falling, attended by the grumbling of thunder. The worst of the storm had passed, but there was still a bit of lightning flashing from time to time. Also outside, leaning against the north side of the clinic, was a radio antenna which had just been replaced by a new and actually functioning antenna. "Okay," I said, "I've got a job for you. Go grab the radio antenna out there and carry it around to the front of the building. Put it in the exact location it's in now, only out front. Don't walk on the grass, stay on the driveway. And carry it vertically. Okay? Now go."
He went. When he returned he was soaking wet. I told him to stand by and walked through the building to the front doors to see where he'd placed the antenna. He'd done a credible job of it, but of course we couldn't leave it there in front of the building. It was an eyesore. "That's not gonna work," I told him. "Go put it back. Stay off the grass and on the driveway. Carry it vertically." We went through this exercise several times with several variations. The lad got very wet and chilled, but he followed instructions quite well. I spent several hours with new guy, trying to assess his medical skills and potential. Which was hard, because he had none and didn't seem interested in developing any. He'd gone to Hospital Corps school because that's where the recruiter sent him. After expending a lot of time and energy I decided that he wasn't short-bus special or, to put it in politically correct terms for 2019, a retard. He was plenty bright. He was simply completely passive and didn't seem interested in learning or doing. He knew he was an E-2 and would more or less do what he was told to do, but without any real effort or initiative. In the absence of orders or direction he'd simply stand or sit quietly. He was one of the strangest cats I ever met. My Chief of the Day log entry was long and detailed regarding the "new waiting room" fiasco. I didn't record anything about new guy in the log because that was a personal personnel issue and didn't belong in the log. When I turned the watch over to Sam (actually Dianne, you had to be there) the next morning she happily agreed with me and decided to continue using the old/new/reinstated waiting area. On Monday morning I reported to the Senior Chief bright and early and explained my actions, logged and unlogged. I rather expected to get a blast for moving the waiting area, but I never heard a peep, and it never got moved back. New guy got moved from medical records to supply and came off the clinic watch bill, though he went on the Air Station three-section watchbill as a supernumerary. I came clean with the Senior Chief regarding my "attention getter" as well. Again I expected a blast and again I didn't receive one. The Senior Chief seemed to find it amusing and appropriate. I think he understood what I was trying to accomplish, though I'm not sure I understood it entirely myself.
