Discourse on Discourse

7/2017

As most of you know, I am not always the most loquacious fellow and tend to be laconic or taciturn, to say the least.  If one were to assign rules to having a conversation with me they would be something like this;

1. The subject has to pique my interest.
2. I have to be in the mood to talk.
3. I have to be comfortable with the person to whom I am talking. (meaning I feel they deserve my conversation)

And then there might be a yes or no answer.

But, come on, there are limits.  I think I might have been bested as I recently contacted a family member with 3 questions. The answers; Yes, Yes, No. And this was by one of the most garrulous of the bunch!

Your grumpy Uncle/Brother Dave.

Weary

We Survived the Weather Despite…

7/2017

On another topic, whew!! We survived.

Wife and I went on a road trip.  I had looked at the weather online before leaving, while on the road I just stuck my nose in the air every day.  By the 3d day, snow and ice hit, as expected.  It wasn’t much, but about 3 inches of snow fell just about the time we hit Salina, with little to no ice.  But it wasn’t until Topeka, on the way back after the worst had passed, that I fully understood the ramifications.

Just east of Topeka (100 miles later), was a KDOT text message board telling me to be careful because there was a Winter Weather Advisory out.  And to think I might have made it all the way back home without knowing that!  We are so lucky to live in a state that cares, seeing that they used Obama/our money to keep us safe.

Let’s be safe out there, don’t text and drive.

Your grumpy Uncle/brother Dave.

Weary

Pilots in The Good Old Days

7/2017

This may sound outrageous to those reading it today, but they were the good old days.

I can remember when pilots thought nothing about flying after a drink or 2.  I remember military pilots flying despite what they had been doing the few hours before takeoff.  I remember a commercial pilot, co-pilot and navigator sitting in the airport bar having drinks while waiting for the plane to be readied.  The pilot carried the last drink with him as they walked to the loading gate.  He set a low ball glass on a table and walked close enough to me that I smelled whiskey on his breath.  But, that was the good old days.

But, we didn’t have depressed co-pilots flying the plane into the Alps and killing everyone on board.  In fact, the safety statistics then were better than today.  But, that was the good old days.

Musings from your grumpy uncle/Brother Dave.

Weary.

BFF, Friends and Enemies

7/2017

The first known written occurrence of the statement, “Keep your friends close and your enemies closer,” was by Don Corleone in Godfather 2.

So, when someone texts you BFF, what exactly are they saying?

More on quotes from your grumpy Uncle/Brother Dave.

PS  Oh sure, some say it comes from Sun Tzu in the Art of War, but it’s not the same (“It is said that if you know your enemies and know yourself, you will not be imperiled in a hundred battles…).

Weary

T

Weary’s New Job

7/2017

I applied for a new job today.  Yeah, I guess 29 years of this emergency room business kind of led to this move in more ways than one.

I’m getting older and could use a slower pace.  I’ve built up a lot of motivation that will apply to the mission of the new position.  It will still provide the 0-190 mph rush in the blink of an eye that I’ve always loved about Emergency Medicine.  It will have a deeply satisfying ambiance that will help soothe my soul.

Chuckle, chuckle.

Having worked for the last 18 years on predominantly night weekend shifts, I have an extreme amount of experience dealing with colleagues that don’t work in the emergency department; calls under very trying conditions.  Meaning, I have had to call them at odd and usually inconvenient hours to discuss convoluted, complex and often baffling situations.  These are not trifling conversations.  These are about transferring care of a patient that usually involve critical thinking and decision making that will affect life or death and at least the well being of the patient.  People could die from wrong decisions.  People have died from wrong decisions.

In making these calls, I have met with irritation at being bothered (even though it is their job), failure/difficulty in communication (on both ends), anger, indifference, petulance, petty one-ups-man-ship, narcissism, sleep talking and even vindictive attitudes that have been so severe that they almost led to physical confrontation.

Just the other night, one of my Emergency Medicine colleagues ran into the well known (to us) ass-chewing situation.  Whatever the wrong perceived by the non-emergency medicine physician, it was felt that an ass-chewing was in order.  My colleague, being the usual emergency department diplomat, apologized profusely, tried (in vain) to explain in various ways what the ass-chewer did not grasp about the situation but in the end proffered contrition. Cowered. Rolled over and peed on the floor.

Yeah, it sounds wimpy but it is only one method of backing out of a situation at 3 am when you have a packed ED and mad inpatient patients (there has got to be a story in that contradiction of meanings) waiting on you to get off the phone.  There are actually several techniques for dealing with these situations.  No medical school teaches them, except for the school of hard knocks.

One of my favorite, learned by chance years ago, is what I can only compare to a “bait and switch” technique.  In this situation, it is quickly obvious that the non-ED physician is going to be a butt-head.  I immediately insert a calm, cool tone to my usual professional manner.  As the conversation/ass-chewing proceeds, I interject comments that are highly relevant to the care of the patient but have nothing to do with the ass-chewing I am getting at that second. I change the subject with redirection. The ass-chewer, partially asleep, takes a second or two to catch up with my thoughts. But as soon as he/she does, I change the direction again. Eventually, they figure out that I am doing this on purpose and calm down, hang up or explode. When they ask if I am doing this on purpose, I say, “Yeah, I Don’t care how long you yell at me, I don’t plan to get any sleep tonight.”

But, I’ve strayed from my topic and need to get back to my new job prospect. There isn’t actually a position for this job, yet. But I’m hoping that the higher-ups will see the advantages and get on board.

I want to be a 24 hour, 7 days a week, on call any time of day or night, anywhere ass-chewer first-responder.

See, how it works is that when an ED physician starts getting what they perceive to be an undeserved ass-chewing, they can hit a button on their smartphone that links my smartphone in a 3-way call mode. Off I go, hell-bent to mirror the chewing of ass. In the other direction. It can be set up so that the ED physician can choose a variety of flavors. For instance, with or without colorful language on my part, depending on their tolerance of such language.

I’ve submitted the proposal so keep your fingers crossed, I hope to hear back soon.

Your grumpy Uncle/Brother Dave.

Weary