Every EMT has run that one call that pegs their personal Weird Shit-O-Meter, and I am no exception. During a career spent working in rural Louisiana, I have experienced enough of these calls to have developed a firm belief in Vuja De.

Now what is Vuja De, you ask? Well, it’s the polar opposite of Deja Vu – the feeling that what you are witnessing has never before been seen in the recorded history of man.

I’m not speaking of the garden variety weirdness that every EMT experiences as a matter of course. Fact is, most any experienced EMT has seen at least one person with a foreign object inserted in a Forbidden Place, or delivered the fruit of an immaculate conception – “What? A baby??? I can’t be havin‘ no baby!” – that such tales told in EMS circles barely merit a polite chuckle and an impromptu game of one-upmanship.

“What’s that you say? A Faberge egg? Stuck where? Yeah well, that’s a good one, but I bet you didn’t know that an egg beater blade could fit in a person’s rectum, did ya? No? Well, let me tell ya what happens when you attach it to the motor and turn the thing on! We had this call one time…”

It’s a time-honored EMS pastime, good for hours of fun and enjoyment.

Well, the call that pegged my meter happened on an early fall night in the not-too-distant past. I found myself kneeling on blood-soaked ground, tending an elderly woman who did not yet realize she was dead. Her husband already was, ripped from stem to stern like a victim from a slasher movie. I’ll spare you the gory details, but suffice it to say that it appeared their assailant had wielded something like a cross between a machete and a potato masher. In dry medical prose, their injuries were Inconsistent With Life.

The woman didn’t know it yet though, and insisted on struggling to the last, as we human beings are wont to do when faced with the prospect of shuffling off the old mortal coil. She lay there struggling to breathe, her hands folded to her chest in decorticate posturing, a hallmark sign of a serious brain injury. While I feverishly did my Paramedic Thing and secured her airway while my partner Mike bandaged her wounds in futile effort to stanch the bleeding, I more-or-less casually asked the sheriff’s deputies if they knew who had attacked the couple. More importantly, was the maniac still on the loose?

You know, important stuff to know.

“Yep,” one of them replies laconically. “Right out there,” he points with his Maglite.

I look out into the pasture, and centered in the beam is our assailant, curiously observing the goings-on. He is a rooster ostrich standing nearly 7 feet tall, and he looks, well…pissed. He might have been even bigger than 7 feet. Maybe eight. Or nine. He was big in the way that a jealous boyfriend looks big when you realize you’ve been fondling the ass of Mongo’s girlfriend all night on the dance floor while he played pool with the rest of the defensive linemen.

Forget the cute fuzzy creature at the beginning of this post. This is not the clumsy, ungainly creature that poor Jim would wrestle to the ground and tag with a radio collar while Marlon Perkins narrated the action from the safe confines of the base camp. No, this critter is an assassin. Picture fangs. And soaked to the knees in blood and gore. If he had a name, it would be Jason or Freddy.

I gape at first, then quickly turn my attention back to my patient, busying myself with taping her endotracheal tube in place and helping get her secured on a spine board. We’re strapping her down when I am frozen by the faint, but unmistakable whisper of six duty weapons being pulled from retention holsters en masse.

I look up, and struggle manfully to retain control of my bowels. Our Avian Assassin is now ten feet away, and he looks MIGHTY curious at what we’re doing. I learned something important about myself that day. I have useful skills other than the healing arts. If you ever need a diamond, give me a charcoal briquet and a pissed off killer ostrich, and I’ll turn it into a diamond for ya. Just don’t ask where it’s been.

“Uh, shoot that thing, will you please?” I request, although perhaps not quite so politely.

“Dandy idea,” sez Mike, his hand twitching in the general vicinity of his right hip. On his days off from his EMT gig, Mike is a reserve deputy.

“Can’t do it,” replies Steve, the shift commander that night. His voice hasn’t even changed. Quite impressive, really.

“Whaddaya mean, can’t do it?” I splutter. How hard can it be? You know – grip, sight picture, trigger squeeze, repeat as necessary. Seems pretty straightforward to me. From the affirmative grunts of several of the deputies, they think it’s a fine idea too.

“We can’t destroy this animal without authorization. Right now, he isn’t posing a threat.”

I pondered the wisdom of that statement as I tended to the (barely) living proof that Freddy the Avian Assassin was indeed a threat. Steve went on to say, “Just don’t make any sudden moves. Slide the board back behind us, and ease her to the ambulance. If he comes any closer, we’ll take him down.”

Cool customer, that Steve. Not the most independent thinker in the world, but cool. As long as there were six .40 caliber Glocks between me and the bird, I suppose I was reasonably safe.

Riiiiiiiight.

An eternity later, we’re headed to the nearest Trauma Center, forty minutes away. Mike hops up front to drive, while I am joined in the back by the Missus and another medic. We get bilateral IVs, pour some fluids into her and keep on ventilating, and still she gets worse. BP now hovering in the 70s (that’s a Bad Thing
, for you non-medical folks), heart rate steadily dropping, and she’s completely flaccid by the time we roll her into the ER…

“Female, mid sixties, attacked by an ostrich. Husband was DOA. She has a wound through her chest extending from her neck to the lower margin of her rib cage that pretty much removed her left breast, and sundry other smaller wounds. Decorticate posturing on scene. Intubated, two liters of fluids, last set of vitals was BP 70/36, pulse 56, no spontaneous breathing,” sez I to the ER Doc as we rolled into the trauma resuscitation room.

“An ostrich you say?” muses Doc as he peels back the bandage on her chest, listens to breath sounds, checks her pupils and such. He lifts her hands and peers over the rim of his glasses at the numerous bruises and lacerations on her hands and forearms. “I dunno,” he says dubiously. “These look like defensive wounds to me.”

Perceptive fellow. They probably develop those superior powers of observation in medical school.

“Uuuuhhh, what don’t you know?” I ask pointedly. If he’s disputing my assessment, I’d like to know why.

“Oh no, don’t get me wrong,” Doc hastens to assure me. He shakes his head, furrows his brow. “It’s just that…well, this doesn’t look like any ostrich attack that I’ve ever seen.”

Long pause. The chuckles begin slowly and become contagious, until the entire ER staff is rolling with laughter. Everyone that is, except the Doc. My head swims with images of packs of killer ostriches roaming the countryside, terrorizing the citizenry and sending them to the ER in need of treatment. Perhaps southern Arkansas has a problem The CDC Needs To Know About.

“Uh Doc? Just how many ostrich attacks have you seen?” I inquire delicately, amidst renewed guffaws. Mike is clutching his sides and gasping, tears rolling down his cheeks.

“Well I’ve seen…actually this would be my first…” the Doc stammers and begins to chuckle himself. Finally, “What I meant to say is that this doesn’t look like any animal attack I’ve ever seen.”

He banishes us promptly from his ER, muttering under his breath something about “only from Louisiana…”

We stop back at the scene to pick up my POV so the Missus can drive it home, and we find six very shaken deputies hovering near the carcass of a very dead ostrich. Steve is sitting on the tailgate of his patrol SUV, shaking his head in disbelief. His hands are trembling, and his voice is no longer very cool.

“We got the go ahead to kill him. I hit him center mass with two .40 rounds. Sumbitch didn’t even flinch…”

“S-s-sum-sumbitch charged us!” chimes in another deputy, his voice quavering. “I had to take him out with the riot gun. Two rounds of three inch, double-ought buck! He p-p-piled up right at our f-f-feet…”

I pat Steve reassuringly on the shoulder, walk over and prod the carcass with a toe. I turn to the rest of the deputies.

“I don’t know about you guys, but I’ve got dibs on the drumsticks.”

Until next time…

A little background on me for my new readers (both of you. God bless ya, LawDog)…

Having worked the better part of thirteen years on a bo-lance spent variously as a street grunt, stuporvisor, educator and critical care medic, within the past few months I went over to the Dark Side.

Now I spend my days working in a hospital ER doing the same things I did on the street, only I get paid more and get to stay dry doing it. I somewhat naively believed that I’d see less BS in the ER, but I have come to realize that 75% of emergency medical care is just thwarting natural selection. We keep the weaker animals in the herd longer, so that they may survive to pass on their inferior genes to the next generation and in so doing, contribute in some small way to the degradation of our species.

Anyhoo, since I’m a medic, I was deemed the person most suited to coordinate and conduct our annual disaster drill.

Sigh…

Note to all those hospital admin types who may occasionally stumble across my little screed in the blogosphere:

1. When it is late December, and you HAVEN’T yet conducted your annual drill, AND

2. The staff know you have been having meetings among department heads over the last month to discuss and plan said drill, AND

3. You change the schedule around to make sure your new Supermedic Disaster Guru is off on a certain day…

Expect the sharper knives in your personnel drawer to figure out exactly when the drill is going to go down.

On the Big Day, several folks came down with Acute Disaster Drill-itis with manifestations of Rectal Myopia. In other words, they just couldn’t see their asses coming in to work on the day of the disaster drill. Those that did show up thought they knew what was in store. Little did they know…

(Insert sinister giggle here)

My middle name is Evil Bastard. Forewarning does you little good when I design a scenario. We’re talking mis-triaged patients, planned communications failures, and the majority of the patients coming in by pickup truck, oxcart or what-have-you, all seasoned by a hefty dose of hysterical family members and obnoxious media. And they were short-handed to boot. It was absolute chaos. Predictably, I was the only staffer who thought it was fun, and I have a mental list of the staff who purposely missed out on the festivities. They’ll have their turn in the barrel in the coming months.

Aside from the little Method Actor who played a hysterical, hyperventilating teenager so well that she actually became a…well, a hysterical, hyperventilating teenager…the kids acting as victims had a blast. Afterwards they all gathered in the cafeteria to pose for photos of their gory wounds (courtesy of Yours Truly and a little theatrical makeup) and made the regular cafeteria diners rather queasy.

Aside from the lessons learned in every drill of this type, we also discovered that your garden variety drug seeking critter will Make Way for a horde of pre-pubescent accident victims, provided said victims have a number of grotesque wounds and foreign objects protruding from their bodies. I may keep a couple of these kids on retainer, just to clear out the ER the next time we have a waiting room filled with variations of “I Have Had The Oochies For A Month But I Can’t Be Bothered With Making A Doctor’s Appointment And By The Way I’m Allergic To Everything But Demerol and Morphine.”

The kids could indeed come in handy.

On a final note, I am pleased to announce the return of Heromedic

Back in the days of UseNet, Heromedic was the hero of the EMS user groups, famous for his C-Spine Injury Sniffing Dogs, Atlas and Axis. Even though UseNet was popular when I was still playing with computers made by Fisher Price, a few of my EMS dinosaur colleagues turned me on to his genius. Go by and check out his site.

Until next time…

Well, it seems another trustee of modern chemistry has died after an encounter with my comrades in blue. Seems that one Terrill Enard took it upon himself to strip down to his birthday suit and accost a Waffle House waitress, and took umbrage at the assertion by Lafayette Police officers that This Was Not Nice Behavior.

Anyhoo, it seems gentle Terrill became violent with the officers and had to be Tasered. According to the press release issued by the department, the Taser had little or no effect on Mr. Enard initially. After being transported to the local hospital however, our boy expired soon thereafter and was admitted to the Eternal Care Unit. According to the official statement released by Layafette PD, “Mr. Enard appeared to be under the influence of an unknown substance.”

I’m shocked.

Obviously, those dastardly Po-leece escalated the situation by daring to apprehend poor Terrill in the first place. According to the family, “He was a good, warm person. He wouldn’t have harmed a fly.”

No doubt poor Terrill was sitting there innocently minding his own bidness, drinking a wholesome glass of 2% milk and enjoying his hash browns, when for no reason, the men in blue descended upon him, hell-bent upon causing trouble.

What is interesting is that prior to the Waffle House incident, our boy jumped from a second floor motel balcony, limped inside and left them his clothes in lieu of payment, and proceeded to hitch a ride to the Waffle house. Nude. In December. More dismaying is the fact that someone actually picked him up and gave him a ride.

Apparently, if Waffle House offered al fresco dining, this whole sorry incident may have been avoided.

Of course, this raises the standard hue and cry that Tasers are deadly weapons and should be banned. Like a choke hold and numerous thwacks with a six D-cell Maglite would have been more humane. Puh-leeze.

I won’t presume to lecture anyone on the proper application of the use of force continuum. I’m no expert. Cops are. But I’ve pulled the barbs loose from enough Trustees of Modern Chemistry to have a somewhat informed opinion on the matter, and I have thus formulated Kelly’s Rules for Transporting Combative Patients:

1. Handcuffed patients got that way for a reason. Leave ‘em that way. If the patient was combative AT ANY POINT, leave the cuffs on. If you absolutely must, have the officer cuff ‘em in front, but leave the cuffs on. Add as many straps as needed.

2. Never transport a patient hog-tied, and never, ever, ever face down.

3. Talk, talk. talk. Verbally deescalate the situation as much as possible.

4. Oxygen is a good thing. Plus, a mask over the face makes a dandy spit shield.

5. If talking and physical restraint fail, sedate ‘em to the eyeballs. It is much easier to assess and treat a patient who is not fighting you.

6. Doctors who disagree with #5 have never been alone in the back of the ambulance with a 300 pound behemoth on PCP. But they should experience it just once, for their own personal growth.

7. Be prepared for bad outcomes.

8. The doctrine of Primum non nocere does not apply when you are getting your ass whipped.

Many folks assume that since a Taser was used and Mr. Enard died shortly thereafter, that the taser was logically the proximate cause of his untimely demise. To quote GatorBlack, one particularly incensed reader of the Lafayette Daily Advertiser, “I hope this shows a lesson to the people that to subdue a human a taser is not needed! The MAN in the resturant didnt need anything i guess he has super human strenght!!”

Please do not let the poor spelling, grammar and lack of punctuation detract from the wisdom of Mr. Gator’s argument. He’s obviously an erudite fellow, well versed in police tactics and human physiology. Plus, everyone knows that double exclamation points always lend extra credence to an opinion.

Well Gator, allow me to fill a gap in your knowledge. There is a medical phenomenon known as excited delirium. The link here is to a scholarly article on the subject, but in deference to your reading comprehension skills, I’ll keep it simple.

PCP, cocaine and methamphetamine are known as stimulants. When ingested, snorted, smoked, injected or pushed up your rectum to hide them from the Po-leece, they tend to do certain things to the human body. Blood pressure skyrockets, as does heart rate. Body temperature may rise as high as 108 degrees, offering one probable explanation for Mr. Enard’s lack of clothing in December. A whole cascade of events occurs with your body’s chemistry, and none of them are good. Quite often, these people are headed for a rendezvous with death that no intervention will stop. It can happen in the back of an ambulance, it can happen in an instant when the rugby scrum of officers needed to subdue the suspect finally untangles to find the patient dead at the bottom of the pile, or it can happen six hours later at a major medical center, as it did in Mr. Enard’s case. The use of a Taser is incidental. Linking the two events is akin to claiming that since 89% of pilots involved in airline crashes ingested pickles in the 24-hour period before the flight, it thus follows that pickles cause airline crashes. Let’s call for a ban on sweet gherkins!

On the other hand, if you’re ever at the airport and see your pilot wolfing down the kosher dill spears…change flights. You can never be too careful.

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My Virgin Blog Entry:

The wonders of medical science never cease to amaze me. Since the days of of post-WWII, we have ushered forth the Age of Penicillin, followed soon thereafter by the Rise of Resistant Bugs, only to be followed by the Super Antibiotics, and of course The Super Bugs. Like the age-old battle between armor and projectiles, every medical advance seems to only bring forth a newer, meaner strain of Super Cooties.

Back in the day, strokes were just things that happened to old folks, and were simply To Be Endured. After the big event, we turned Grandpa toward the sunlight and kept him watered, and hoped like hell he recognized you when you visited. Maybe, just maybe, he learned to feed himself again, and then only if you (and he) were lucky. Now, we have vascular Drano that can circumvent that whole horrific process, if the Drano itself doesn’t finish Grandpa off in the process.

When you’re having a heart attack, you can go to the Roto Rooter man…excuse me, I meant interventional cardiologist…and have the old pipes cleaned out.

If your goober doesn’t work, we have pills to fix that. Ladies, if you weren’t visited by the Titty Fairy in your adolescence, the wonders of breast implants can fix that. Yet, given the paltry funding for Alzheimer’s research, we will soon have a generation of geezers with perky boobs and big erections with absolutely no recollection of what to do with them…

…but I digress.

My point is, we learn more about disease and disability every day. Yet I find myself highly suspicious of some of the latest medical conditions to be identified, not sure if they are legitimate disorders or just the feverish ramblings of Uncle Melvin locked somewhere in the basement at the CDC… you know, perhaps he has gotten out and and has found a forum.

As case in point, I give you Premenstrual Dysphoric Disorder.

I suppose a name like Mad Cow Disease was already taken. Ladies, pardon my dragging knuckles here, but what about this syndrome is any different than PMS?

Bloated? Check.

Bitchy? Check.

Wild mood swings? Check.

Persistent anger? Check.

Fatigue? Check.

Spouse walking on eggshells and offering you large quantities of chocolate? Check.

Spouse whimpering incoherently and bunking with his hunting buddies? Check check.

So what here is so radically different than good ole garden variety PMS? Is it possible, that like alcohol, PMS merely magnifies your less desirable personality traits? Like, if you are already a wee bit bitchy, does PMS make the fangs come out? Or is it a clinical syndrome beyond your control, the dreaded PMDD????

Like a Mel Gibson apology, I ain’t buying it.

Don’t get me wrong. I’m a sensitive fellow. Warm and fuzzy, even. I like sunsets, long walks on the beach, puppies and poetry. I’m also fond of slaying God’s furry little creatures with projectile weapons, but that’s the predator in me. Man can become too civilized, you know.

And lest the distaff persuasion think I am merely picking on them, I also highly skeptical of any child with a diagnosis of ADHD. Don’t get me wrong, I know it exists. Many of us in EMS have all the symptoms – restlessness, need for constant stimulation, inability to focus and complete simple — Hey! A Butterfly! C’mere Mister Butterfly! Hey guys, let’s catch the pretty butterfly! Guys? Uh, guys? —

Oh yeah. Sorry, where was I? Right, ADHD. Even though it may be a legitimate medical disorder, I see mood-altering drugs prescribed to waaaaaaaaaay too many kids with a “diagnosis” of ADHD made by doctors too lazy to truly assess the child, or too scared to deny Mommy and Daddy a panacea for bad parenting.

Back in the not-too-distant past, when I was a schoolboy, parents and school administrators knew exactly what was wrong with Little Johnny when he exhibited disruptive behavior, fighting, talking back to the grownups and poor impulse control. Little Johnny suffered from Chronic Hickory Deficiency, a malady easily cured by liberal topical applications applied by the parents at home. If needed, my principal kept a large, highly polished Hickory Booster hung on the wall behind his desk, and he was not afraid to use it. And it worked. And they hadn’t even heard of things like Ritalin or serotonin levels…

Of course, I’d rant more but I’m sure I’ve already offended enough people, besides which I’ve always been easily distracted. And I have a hyperactive child to beat. Or I could just let the Missus dole out the beatings. She’d enjoy it. It’s that time of the month.

Until next time…