Scalpel, do you know this guy?

Re: Your Christmas Card

That was the Subject line of an e-mail I just got from my sister. Here is the e-mail. This conversation only happened in her head.
***********************

No, I'm not referencing the Christmas card I got from you; I'm referring to the one I sent to you. Yes, I sent you a Christmas card.

"But I never received it."

Yes, I know, but I did send it.

"When did you send it?"

December 17. I mailed it with all the others.

"But I never got it. Are you sure you mailed it?"

Of course I'm sure I mailed it. I drove up to the fancy little blue box outside the post office at the god-forsaken time of 4:25 a.m. on December 17 on my way to work. I was wearing my green scrubs, and I know this because it was an odd-numbered day and the green scrubs are worn on odd-numbered work days. I wasn't late to work that day, I just had to drive really really fast and say prayers that the policemen that might be on duty would be distracted by hookers or donuts or whatever the hell distracts them when they should be pulling over the jackasses that constantly cut me off. Anyway, I digress. Yes, I mailed it. I'm positive.

"Oh. Well, then, where is it?"

It's sitting on my lap as I type you this message. Apparently, I used the wrong address and the post office was unable to deduce by magic brain telepathy where your correct address in Hicksville actually is. Thus, they returned it to me (although, not post-haste, might I add, as it has taken over 10 days to get it back from them) for clarification as to where I want them to stick this.

"Oh. I guess that's ok. I hate Christmas anyway. Um, did you send money?"

No. Instead, I sent you a handmade card that is supposed to make you laugh so hard that you forget all about how cheap I am and instead focus on how very clever I am. Of course, the cleverness factor was just decreased by a power of 10 based on the fact that I didn't send it to the right frickin' address, but the card is clever, none-the-less.

"Oh. Well, before you send it back, will you put some money in it?"

No. Merry Christmas.
*******************

As you can see, my sister is very much like me. Too bad she doesn't have a blog.

Oops.

Here, Honey. We thought we'd give you nightmares for Christmas.

Conversation of the night

MonkeyGirl: What brings you in to the ER tonight?

12-year-old parents of not-sick acting child (Ok, maybe not 12. But they were definitely young) : My son has a fever.

MG: How long has he had a fever?

12YOPONSAC: Almost 20 minutes!

MG: What was his temperature when you took it at home?

12YOPONSAC: Well, I don't actually have a thermometer. But he feels really hot.

MG: Did you give him any Tylenol or Motrin?

12YOPONSAC: No, I wanted you to see how hot he was!

Rectal temp: 99.9
Patient observed as he slept for 30 minutes.
Repeat Rectal temp: 99.7
Patient discharged home with instructions on how to purchase and use a thermometer and antipyretic medications.

Why you should know CPR

Mr. and Mrs. John Q. Public are sitting on the couch relaxing after a busy Christmas. All of a sudden Mr. Public clutches his chest and falls over onto the floor.

Mrs. Public calls 911 and starts CPR. 10 minutes later, EMS arrives with their portable electricity and shocks Mr. Public's VFib into asystole. Two rounds of drugs get him back. By the time he gets to the ER, he has a pulse of 80, a pressure of 120/50, and he's trying to breathe.

A diagnosis of MI with resulting cardiac arrest earns him a transfer to the Cardiac Hospital in the Big City, where they are much better equipped to handle mostly dead guys.

Mr. and Mrs. Public are in their early 50's. They have been married for 34 years. If he ever says the words, "Happy 35th Anniversary, honey," it will be because of his wife.

Cardiac arrest with a 10 minute down time and no CPR prior to EMS arrival results in a funeral 99.9% of the time. Cardiac arrest with a 10 minute down time and immediate bystander CPR gives him a fighting chance.

His vitals remained stable throughout the transport and into the cath lab.

Strong work, Mrs. Public.

A tale of two MVCs

Years ago, when I used to drive the big white taxi in the Republic of California, we would refer to a car crash as a TC, or Traffic Collision. Later, working in the ER in various locales, it was referred to as an MVA, or Motor Vehicle Accident. I hated that acronym because the majority of them were not accidents. They were the direct result of an intentional, but ill-advised, move by the dumbass who caused the crash. We have merged those terms into the current acronym, MVC, or Motor Vehicle Collision. I'm happy with the compromise.

On Christmas night, the waiting room was packed, the average wait for a bed was 3 1/2 hours, and everyone was cranky. At around midnight, there was an MVC with 6 patients, 2 of which required stabilization and transfer to the Real Hospital in the Big City for definitive treatment. You can imagine what that did to the wait for the non-emergent "emergencies" that were circling in a holding pattern in the waiting room.

But there was no Christmas Spirit to be found in this crowd. Jackass after jackass threw a fit because they were waiting so long. The desk clerk explained to the room at large that there had been an MVC with multiple casualties, and the resources of the EMERGENCY ROOM were being utilized for said EMERGENCY, sorry for the incovenience, we'll get you back as soon as we can, etc, etc.

There was a definite lack of comprehension from the waiting jackasses. The temper tantrums continued, the wait increased, and the misery multiplied. Many hours later, as my shift ended, we were still digging out from under the joy that was Christmas.

Fast forward 24 hours from the first MVC. It's midnight, and it's completely empty in the waiting room. Not a single soul is even waiting to be triaged. An MVC results in 3 patients, one of which needed to be stabilized and transferred to the Real Hospital in the Big City.

We were working short, so the triage nurse was assisting with the trauma. As people arrived and signed in with their non-emergent "emergencies", the front desk clerk warned them that there would probably be quite a bit of a wait (even though it appeared to be dead) due to the MVC.

The response from every single patient (and there ended up being 6 or 7 by the time the triage nurse made it out there) was a polite, "That's OK." They all sat quietly for well over an hour, with not one single complaint or question about how long it would be.

You see, this MVC had occurred fairly close to the hospital, and every one of the patients in the waiting room had driven past the scene. The mangled metal of two cars that had been utterly destroyed by the force of the collision served as a sobering reminder that their dental abscess, migraine, sprained ankle, finger laceration, sinus infection and UTI could have been much, much worse.

Popularity Contest Revisited

Sometime over the last coupla days, StatCounter hit 100,000. I didn't notice it at the time, so there will be no Grand Prize Winner like on all of those damn blinky sidebars on the porn educational websites I visit.

I've achieved the level of Adorable Little Rodent in the Truth Laid Bear Ecosystem. Once upon a time I was bacteria, now I'm a hamster. Talk about one of life's little success stories.

I'm not even ranked on the Healthcare 100 website this week. *sob* I think I've been blackballed. #126 to >#600 in three weeks.

I've reached the end of Technorati's first 6 month block, so my Technorati number is slowly crawling backward now.

I remember when I used to care about these numbers; it seems like so long ago.

MonkeyGirl's short attention span rears its ugly head......

Christmas Dinner at the San Francisco Zoo

Tatiana, a 300-lb Siberian tiger, decided that instead of the traditional ham, she would have a serving of people; the other, other white meat.

Merry Christmas from the Hooters Nursing Home

This is one of those moments when I have to choose between being the good girl that my mommy tried to raise and being the rude, crude pain in the ass that she wished I wasn't. As usual, rude and crude wins. Sorry mom. Skip this post. Come back tomorrow.

Those of you who read MDOD will remember 911Doc's idea for a retirement home. I have found what appears to be said retirement home's Christmas Party. Enjoy.

In which the Grinch gets tagged with a Christmas meme

Jeff B tagged me for a Christmas meme. I find that to be a bit ironical, because I am the original Grinch.

However, I'm sitting up front right now, it's raining and there's nobody signing in. Nobody wants to come out in the rain, so they're all calling 911 for their non-emergencies, and letting the big white taxi bring them in comfortably. Subsequently, triage is dead, and I have nothing to do at the moment. So I figured, what the hell.

I'm not tagging anyone, though. You wanna do it on your own, go for it.

1. Wrapping paper or gift bags? Wrapping paper. I only get gifts for the brat, and she’s 6, so I use wrapping paper and as much tape as I can, in order to impede the whirlwind unwrapping process. I tape boxes shut on all of the seams, too. My parents used to do that to me and it drove me crazy. If I get a gift for anyone else, I rarely wrap it. But I almost never get gifts for anyone else. I’m not a giver. I’m a taker. Giving is for suckers.

2. Real or artificial tree? OK. About the tree. See, I kinda think that Christmas trees are retarded. Well, except other people’s. I love other people’s Christmas trees. I just don’t feel the need to have one myself. It’s really not worth the effort. Or the price. I’ve only had a tree one year out of the last 5. And that was 2 years ago when the 4-year-old said, “Daddy, how come you don’t have a tree? Santa can’t find where to put my presents without a tree!” So I caved and we got a tree for the kid who wasn’t even going to be there for Christmas Day anyway, so Santa took her presents to her mom’s and put them under the tree there, but how do you tell a 4-year-old they can’t have a Christmas tree? You don’t. You just suck it up and get the damn tree. Thankfully, she doesn’t need two trees anymore.

3. When do you put up the tree? Never, if I can manage it.

4. When do you take the tree down? Well, since I didn’t ever put it up, then it would follow that I don’t ever need to take it down, do I?

5. Do you like eggnog? No. Like is not nearly a strong enough word to describe the feeling I have for eggnog. I absolutely adore eggnog. I would almost choose a glass of eggnog over a Bacon Cheeseburger. Almost. I don’t like spiked eggnog, though. Just regular, rich, creamy, straight-to-your-hips-and-stay-there-in-the-form-of-a-roll-of-eggnog-colored-fat-until-next-Christmas goodness. And I had never even tasted eggnog until about 2 years ago. Think of all the years I wasted. *sigh*

6. Favorite gift received as a child? I don’t remember last week, much less Christmas as a child.

7. Do you have a nativity scene? Nope. My husband tends to display atheistic tendencies when religious items are placed within his line of sight. (I think it comes from those torturous years in Catholic School.) He’d probably feed Baby Jesus to the cat. Come to think of it, the cat might eat Baby Jesus on his own. Maybe if he ate Baby Jesus it would cure his Chronic Fatigue Syndrome. Hey, I may be onto something here.

8. Worst Christmas gift you ever received? I don’t even remember the good ones. Why would I remember the bad ones? I do remember that my mom Santa always put gummi bears in my stocking. I hate gummi bears.

9. Mail or email Christmas cards? This year I mailed Christmas cards to my 3 siblings, my grandparents, and my parents. Usually I skip that tradition. Not worth the effort. Similar to Christmas trees.

10. Favorite Christmas movie? Die Hard. And Die Hard 2. Yes, mom, they are too Christmas movies.

11. When do you start shopping for Christmas? Since I only buy gifts for the brat, I pick them up whenever I feel like it and stick them in the closet. Then a day or two before Christmas, I send my husband in to get them all so we can wrap them. There’s usually a huge pile of kid crap to wrap.

12. Favorite thing to eat at Christmas? Pistachio Baklava and Pumpkin Ice Cream. Neither of which I can ever find anymore, so I have to make them myself. But that’s ok. Because they’re better that way.

13. Clear lights or colored? Clear. Not icicles. I hate freakin’ icicle lights.

14. Favorite Christmas song? The VeggieTales version of “Feliz Navidad”. And anything from The Trans-Siberian Orchestra’s first album, “Christmas Eve and Other Stories”

15. Travel at Christmas or stay at home? Work. Always.

16. Can you name all of Santa’s reindeer? Only if I sing the song. And you don’t want me to sing the song.

17. Angel or star on the top of your tree? Jeez! What is the deal with the damn tree?

18. Open your presents Christmas Eve or Christmas morning? I don’t get Christmas presents. The brat opens hers on Christmas Eve because her mom has her on Christmas morning.

19. Most annoying thing about this time of year? Muzak Christmas music that starts on October 21st. The rude assholes out shopping are there year-round.

20. What do you leave for Santa? I drink a Guinness and leave him the empty bottle. Maybe that’s why I never get any Christmas presents.

21. Least favorite holiday song? Dunno. Prolly that stupid "Grandma Got Run Over By a Reindeer."

22. Do you decorate your tree with any specific theme or color? Oh, for crying out loud! Enough with the damn tree!

23. Favorite ornament? I used to have an Oscar the Grouch and a Wicked Witch of the West ornament, each given to me by people who felt secure enough in our friendship to provide a physical representation of my personality traits. They burned up in the trailer fire, but the traits they represented are still alive and well.

24. Family tradition? The week before Christmas, my mommy gives me her annual “If only you didn’t live so far away…” guilt trip.

25. Ever been to Midnight Mass or late-night Christmas Eve services? HAHAHAHAHAHAHAHAHAHA! I was raised Mormon. There is an invisible force-field in place outside Catholic Churches that prevents Mormons from entering the building. I haven’t tested if its power has faded any, but I’ll bet it hasn’t.

And those are the details of my MonkeyGrinch Christmas joy. I hope you enjoyed it as much as I did.

I *heart* Dilbert

Sumdood Strikes Again!

The other night we had a rash of Sumdood sightings. Three different SPAKs (Status Post Ass Kicking) signed in within a 2 hour period. All three of them were on the receiving end of a serious beat-down, one of them with facial fractures serious enough to necessitate transfer to the Real Hospital in the Big City.

I heard three variations of, "I was just hangin' out, minding my own business, and Sumdood jumped me." Sumdood was wearing his usual Cloak of Invisibility, rendering his victims incapable of providing a description of any type.

But Sumdood wasn't done. After opening three different cans (Or maybe it was the same can three different times. I'm not sure.) with the expected results, he pulled a gun on a young gentleman I will forevermore refer to as The Luckiest MotherF&$#*r On Earth.

TLMFOE came into the front lobby stating (in a hysterical scream-like-a-girl voice) that he had been shot. Upon his prompt removal to a trauma bed, it was discovered that he had a single entry wound on the lateral aspect of his upper arm, with no exit wound visible.

Further examination revealed a bullet-sized lump lodged in the muscle of TLMFOE's upper back, less than an inch from his spine at the T4-ish level.

Visualization of the path that said bullet must have taken resulted in the activation of the "Oh Shit" protocol. (As in, "Oh Shit, this appears to be a real patient. Prepare for stabilization and transfer.")

But after poking a few 14 gauge holes in him and giving him some high quality diagnostic radiation, we discovered that TLMFOE was the proud recipient of.... a flesh wound.

The bullet went in the outside of his bicep, traveled through his arm, missing the humerus and all of the important blood vessels, entered the top of his chest, deflected off a rib, and traveled through the muscles of his back to its final stopping point, one inch from paralyzing him.

TLMFOE should have ended up with a shattered arm, a hole in his lung, and a motorized wheelchair at taxpayer expense for the rest of his life.

Instead, he walked out with a sling and a 9mm souvenir in his pocket.

Sumdood needs some time at the range.

Tonight on ESPN

As I was watching the fantastic game between the Pistons and the Celtics tonight, I had two thoughts.

The first was courtesy of the BottomLine. Does anyone else find it amusing that Bill Parcells is going to be the VP of Football Ops for Miami? (insert various Dolphin and Tuna jokes here...)

The second was courtesy of Rajon Rondo.
Would this man not make a great transvestite? Seriously. Look at those cheekbones. Wig, makeup, dress... To Wong Foo, baybee! Wesley Snipes ain't got nothing on him!

Several observations, one article

Attackers chop off man's 'magic' leg

1. My mind hit the gutter in a record 0.2 seconds upon reading this headline.

2. Thank god I don't have any "magic" appendages. Removal of said appendage by machete/sickle/whatever seems like it would hurt, drunk or not.

3. Do you think the leg still heals? How about chronic pain? Do you think the "migraineurs" and "fibromyalgeurs" would give up their Dilaudid for a touch of the decomposing leg? Along those lines, where in the ER would you store it? The Med Room or the Dirty Utility Room?

Yeah, right.

I guess geniuses aren't as smart as they used to be.

Careful what you wish for

OK, I'll take the week off in a minute. Delicious irony supersedes time off.

I support gay marriage.

I think that you should be able to marry whomever you want.

I also support thinking things through.

If you are intelligent enough to circumvent the laws of your home state by going to Massachusetts to get married, you should be intelligent enough to plan for what you're going to do if/when your fairy tale dissolves.

And if your home state doesn't feel the need to assist you in the dissolution of said fairy tale, well, I can't say that I blame them. After all, they aren't the ones that got you into this mess.

Taking the week off

Tired of the internet.

Nothing to say anyway.

Back in a week or so.

Maybe sooner if I get out of this funk.

Maybe later if I don't.

Go visit Nurse K in the meantime.

She's poppin' out blog entries like governmentally supported losers pop out kids.

Today's Lesson

Nursing home nurses across the pond are retarded, too.

See, it's not just MY cats....

Obviously, there are other cats out there with Chronic Fatigue Syndrome.

This could be the new bird flu, people.

News Flash

This just in: working at night might make you tired.

Wow. Who woulda thunk?

Between this and the cancer, I think I should be getting hazard pay.

This used to be my playground.....

This is an overpass going over I-5 in Chehalis, WA. On the very edge of the right side of the picture, in the middle of all of the flooded buildings, you can just barely make out the roof and familiar circular sign of my favorite Starbucks.

When I drove south to California to visit my parents, this was my first caffeine refueling station. It was a little over an hour into my trip, so my mug from home would be empty, with the previous contents of said mug putting pressure on the inside of my bladder.

My friends and former co-workers are currently trying to staff and run the hospital in a city with no power and most of the roads blocked by fallen trees. There is no end in sight.

So, again with the praying; if you're one that does, please do for them.

Popularity Contest

OK, so I pretty much ignored the Healthcare 100 when it came out a few months back, mostly because I was in the #200+ range. Contests are only fun when you're winning, and popularity contests are only fun if you're a cheerleader popular.

I paid some attention today because the link showed up on my Technorati page again, so I looked just out of curiosity.

I've leapfrogged up a mile to #126. Curious.

But even better is the the curious ratings of some of my favorite bloggers.

WhiteCoat is all the way up to #156 already. Damn over-achiever.

Kim, Mother Jones, GruntDoc, AD, Scalpel, and Dr. Dino are all in the top 100. No surprise there.

Two of my favorite bloggers of all time are immortalized at #82 and #141. *sigh* I miss them both.

In typical fashion, MDOD has snagged both #210 and #233. Greedy bastards.

And just to prove that their ranking system is totally whacked: The Speaker is #181 and Nurse K is #232.

Curious.

Holiday Cheer

I took my husband to the ER Christmas Holiday Party last night.

I could not drag him away. We were one of the last couples to leave. He was fascinated, and disturbed, by the intoxicated ER folk. He said it was like a train wreck.... horrific, yet he just couldn't look away.

I didn't notice much of a difference from their normal behavior.

One of the more terrifying entertaining women actually sat down between us and proceeded to make passes at both of us at the same time. Hubby said later, "That's the first time a drunk chick has ever kissed me while she was rubbing my wife's thigh."

Same drunk chick a couple of hours later terrorized one of the PA's to the point that he actually ran upstairs and hid in a closet until she went back out to the poker game in the garage. And then, when she came back in, he ran out the front door and around the house in the dark to the back door in order to escape her.

He happens to be of Hispanic ethnicity. When he got back inside, he said, "I haven't had to run in fear and hide in the dark like that since I crossed the border."

I love drunks.

You don't say....

Quotes of the weekend:

"The ultrasound tech told me I was six weeks along, but my doctor told me on Friday that I was a month and a half."

"My pain.... It hurts."

(On the phone) "My girlfriend is 9 months pregnant, and her contractions are 3 minutes apart and I think she just peed herself or something. What should we do?"

And.... she's BACK!!!!

It's about freakin' time.

No, I'm not going to explain the above picture. If you know what it means, consider yourself in the "Inner Circle". If not, well, sorry.

PS: Scalpel, do you have any idea how hard it is to find a picture of mud-wrestling chicks that I can put on my blog and not cause my mommy to have an MI?