Fine Print

The pager went off, instructing us to pick up a patient for transport to a psychiatric facility. Pickup was at Biggish Hospital, room 4.

P. Artner is teching the call, and stops the cot halfway down the hallway. There’s a bed above which is affixed a large cardboard sign, “4H”.

DTs: “Um –”

P. Artner, to woman in bed: “Hello!”

DTs, sotto voce: “cough cough room 4 cough…”

P. Artner: “How are you feeling today?”

Woman: “Fine. Who are you?”

DTs, sotto voce: “cough ROOM 4 not HALL 4 cough…”

P. Artner: “We’re from the ambulance company.”

Confused Woman: “Well, what do you all want?”

DTs, softly humming: “Roooooom 4, once more, as we stroll further on, to room foooooour…”

P. Artner, ignoring DTs: “We’re going to take you to the mental hospital!”

Woman: “What!”

DTs – gives up and watches.

P. Artner: “Yes, the doctor wants you to go to the psychiatric ward.”

The woman does some wide-eyed, head-shaking, mouth opening-and-closing sputtering.

P. Artner: “So, how long have they had you here? A while, huh? Well, we’ll get you over to your nice room at HappyLand Asylum shortly. I need to talk to your nurse for a minute first, though.”

DTs: “Excuse me, Mrs…?”

Woman: “Jones! What’s all this-”

P. Artner: “Jones! You’re not Mrs Smith?”

Woman: “No!”

P. Artner checks the patient’s hospital ID bracelet. “Well. Uh. Um.”

DTs to woman, leading P. Artner away: “Sorry, ma’am. Mistaken identity. I’m sure you’re not imagining whatever you’re really here for.”

Big Finish

I think this is going to be it for a while with 3-lead strips. I’ll try to start grabbing more 12-leads. In the meantime, check out Prehospital 12-Lead ECG in the sidebar to the left – there are some very good posts there.

More EKG Strips

Fluent Virginian

Our patient was in the clinical ED exam room, awaiting transport with his father and uncle.  They were from the West Coast, in town for a march or protest or something like that, when appendicitis struck.  Time to go to Nearby Hospital for surgery.

DTs entered the room as he usually does, to speak with them for a brief moment and let them know transport was here, what was happening next (me getting report from the nurse), how long it should take, and so forth.

“So y’all relax for just a few minutes and I’ll be right back”, says Our Hero.  And for the umpteenth time noticed the good-natured smirk and barely-concealed eye-rolling.  No offense taken, these folks weren’t even Yankees, and Yankees don’t know better.  But…

There’s something I’ve wanted to get off my chest for some time now, and that is the grammatical correctness of speaking good, plain Virginian.

Now, before my learned colleagues in the more Southerly- and Westerly- states protest, let me explain – Virginia is, traveling southbound, simply the first state encountered where grammatical English is spoken.  One can certainly be understood in Delaware, or Maryland, to be sure.  And good English can be found in the Carolinas, Tennessee, Alabama, and yes, Texas.  But I think a traveler, let him be from Maine, who let us say stops for fuel, will in Virginia first be greeted with the ubiquitous and highly grammatical conjugate, “Y’all”.

“Y’all” is of course a contraction of “You-all”.  As contractions go, it is no less legitimate than “Isn’t”, “Wasn’t”, or “I’ll”, notwithstanding that the exemplars provided are subject-verb combinations.

“Y’all” is homey and warm.  It is embracing.  Y’all.  “Y’all come back now, hear?”  You will hear it at your better coffee stops.  “Y’all want a refill on that?”  But notice that any waitress asking that is already pouring as she smiles at you.  We’re a friendly folk – Y’all is what you will hear.

The uncontracted form is uncertain, uninviting – “You all from around here?”.  It can be menacing.  Virginians do not use this form.  Even worse is just plain “You”.  “You ready to order?”  Abrupt.  Cold.

“DTs”, you say, “You jest.  Y’all is wrong no matter how you slice it.  It bespeaks low educational values and a penchant for inbreeding.”

I disagree.  My arguments are many and completely invalidate this narrow-minded perception.  For the Virginian-impaired, I will illustrate.

If you have studied any other language, you will recall perhaps seeing a little table displaying the conjugates of verbs:

Spanish listar, “To Listen”
“I” form	(yo) listo	“We” form	(nosotros) listamos
“You” singular	(tú) listas	“You” plural	(vosotros) listáis
“He” form	(él) lista	“They” form	(ellos) listan

Verbs have different forms depending on the subject of the sentence – remember the phrase “subject-verb agreement”?  One does not say, “I am, she am, he am, we am, they am…”.  The verb form changes to agree with the subject of the sentence, therefore: “I am, you are, he is, we are, you are, they are…”

In most languages, there is a separate verb form for second-person plurals.  “You” speaking to a person, and another “You” form when addressing a group.

A Spanish-speaking cop, for instance, addressing a large group with the above-tabled verb, will say “You listen” (tu listas) when addressing the group leader, but “You (ALL) listen” – (vosotros listais) – when addressing the group as a whole.   An English-speaking cop lets the entire group know he’s addressing them by raising his voice.  That’s all English has, for the plural “You” is lacking, in English – but not in Virginian.  We cut out a lot of confusion that way.  “Y’all go home now” has broken up many a riot, I’m sure.

Also, in most languages, there are also two forms of address – the informal, used for persons one knows and, in some cultures, children; and the formal, used to address persons one does not know, and as a sign of respect when addressing elders.   Y’all is terribly versatile, and can be both, depending on inflection and tone.

In short, Y’all expands English to include second-person plural.  It is a refinement.

So y’all keep smirking if you want.  We know perfectly well who’s speaking well.

Y’all hear, now?

Wolf!

I like the TED talks, small mini-lectures on a variety of fascinating subjects.  Great way to spend a few minutes before getting back to work.

Yesterday I was watching one such talk comparing avian flu to the 1918 flu epidemic.  The speaker was very knowledgeable and there was certainly an “oh-jeez-we’re-all-doomed” tone to the whole thing.  I then caught myself – “Wait a minute, it’s swine flu today”.  And got a little ticked off.  Not at the speaker, but at the fact that the same exact tone she was using is the one in use today for H1N1.  Well, fine.  But H5N1 turned out to be a bust, dinnit?

And then there’s THIS little gem, from today:

“The swine flu pandemic could kill millions and cause anarchy in the world’s poorest nations unless £900m can be raised from rich countries to pay for vaccines and antiviral medicines, says a UN report leaked to the Observer.”

Certainly raising public awareness about these things can, in some cases, be contributory to lessening their expected impact.  For the most part, though, it turns out to be mere fear-mongering on the part of the media – and I’ve seen some articles in the past few months which could be viewed as trying to insert that fear into EMS.

Not caution, mind you – caution is a good thing.  It’s the whole, “Look out or it’s gonna GET YOU” bullshit that’s continually shoveled our way.

So, for the younger of you, take my hand as DTs returns us to those Thrilling Days of Yesteryear and see a few of the things which were going to kill us… but not too far back or we’ll be here all day.  DTs dons the cloak of The Ghost of Bullshit Fearmongering Past.

In 1972 it was Global Cooling.  Yes, we were all going to be buried under massive sheets of advancing glaciers…

In 1976 it was Red Dye #2 – “My God, Henry, don’t EAT that M&M!”

Skip the eighties, I wasn’t there much of the time anyway…

In 1993 it was the Hantavirus.

In 1997 every time it rained, or if the sun came out, or if the wind blew it was… El Nino, come to kill us all.

Lessee here, West Nile was unavoidably 100% fatal in 2002, got that… SARS in 2003, okay…  Mad Cow also in 2003, busy year… Bird Flu in 2007, well well… now Swine Flu.

Kee-ryst.  And of course, I left out Anthrax (check your mailbox, 2001), Ebola, Dengue fever, Global Warming.

DTs has survived ‘em all, so either he’s one tough mother, or -

but wait, the news is on:

“Tonight on the 6 o’clock news: This common household chemical will kill you – while you sleep.  We’ll tell you what it is, right after traffic and the weather!”

Shhh.  This might be important.