Say What???

How I Roll

Probably the best thing about writing (my wife thinks it has now crossed over into pathological territory) is that I can say whatever stupid thing I want, AND it keeps me from saying whatever stupid thing I want in conversation, in public and ESPECIALLY Facebook.

Contrary to popular opinion, ADHD does not suck. I love it. You should try it.

I should amend that. ADHD does not suck for me. ADHD DOES suck for people who are trying to communicate with me.

That is why I am slowly realizing that "the movie playing on his screen must be something really different than what all of us are watching". (Thank you Bill Engvall)

I love this movie. I don't know what the hell you guys are watching, but I bet it's Grey's Anatomy re-runs. I don't have any time for re-runs. The lame-ass NBC slogan for re-run season, "IT'S NEW TO YOU!" really pissed me off. Why? I don't know. Sooner or later EVERYTHING pisses me off.

At the start of our shift every night at the ambulance service, EVERY conversation for the next 48 hours with my partner Cole started with the words, "You know what REALLY pisses me off?" and every conversation ended with the words, "....BY GOD!"

I'm starting to realize that maybe (extremely unlikely) that the REST of the world isn't trying to piss me off. In fact, I would go so far as to speculate that the way all of YOU communicate actually serves a purpose. Maybe I'm the one that is pissing you off because I am functionally paralyzed in social conversation.

I'm Just a Simplex Man

In EMS work (ambulance) there is an extensive amount of communication necessary. We communicate all day long, every day, sometimes for 24 or 48 hour stretches at a time. Most of that communication is "simplex" which I will explain in a minute.

While working, except for face to face conversation, all of our communication is done by radio. Many people are uncomfortable with this handheld device because of it's extremely poor sound quality and inability to stream Netflix.

For paramedics, though, it is an invaluable tool. I don't know if anyone reading remembers "party lines" from childhood. When we were young, there was no conference calling, Facetime, googly hangouts and that kind of stuff. We didn't even have anything that started with a lower case "i".

When you made a phone call it was PRECISELY one other person. It's kind of like that thing your Grandma does with the little box with the curly wire at her house.

There was also this thing called a party line. You could dial a number and be connected to a whole group of other adolescent idiots, who dialed the same number, and have "conversation". This was a horrible idea. I dialed the number once in seventh grade. It was stupid. It sucked. I hated it. I hung up.

What was stupid about it? It was like this chaotic unregulated place where ANYONE who had a phone could connect and have a conversation. But, there were NO conversations. Everybody's voice had the same volume and if there was a lull in the stupid noise you, if you acted quickly, could shout out a message.

The message had to be short, like 140 characters. And it couldn't "mean" anything because 140 characters is ONLY long enough to bitch about somebody or ridicule them. Pair that with all the other short messages being shouted, each only long enough to communicate stupid shit or shout-outs to your 'crew' and you get the most  fucked-up, pointless and ineffective method of communicating ever devised.

I never wanted to call back. If people had important stuff to say, kept it short, and took turns I would have loved it. But they didn't. It was a huge fucked-up pile of fecal matter that was complete chaos where people just devolved into seeing who could scream the loudest insult about someone or something else.

Thank God for Facebook. It fixed all those defects in the original system.

What the hell am I talking about?

Simplex communication refers to communication that occurs in one direction only. Two definitions have arisen over time: a common definition, which is used in ANSI standard and elsewhere, and an ITU-T definition. The ITU definition of simplex is termed "half duplex" in other contexts.

What it really means is I have a box and you have a box. I push my button and talk and you hear me. I release my button and you push yours and talk and I hear you. (You must never ever push another person's button, unless they are into that sort of thing. Just be forewarned that pushing someone else's button results in a horrific squealing noise.)

Radios are perfect for technical communication. They are perfect for paramedics. And they are perfect for ADHD because we don't have to listen "while" we are talking.

They are perfect for paramedics, cops, firefighters etc. because when you push your button (unless you are a total dick and ramble) you have the entire audience's attention. Because EVERYONE in the audience has a radio, and because all of the shit all of your are doing is presumably VERY important, you have to make it short and sweet.

Message. Break. Reply. Break.


Beautiful.


Eliminating stupid stuff like manners and social graces makes life much easier.

• Go to 123 Main Street
• We are at 123 Main Street
• What is your name?
• Where does it hurt?
• How in the HELL did you get THAT stuck in THERE?
• Do you have any history of mental illness or are you just "ate up with the dumbass"?
• We are on our way to the hospital.
• We are bringing a patient to your hospital
  
  
  1. He is x years old
  2. His x is really swollen and it hurts like a x!
  3. He inserted an x in his x and now it is stuck.
  4. By 'stuck' I mean he may have to actually marry it now.
  5. He has no allergies.
  6. He takes medicine for ateupwiththedumbassosis
  7. We will be there in 5 minutes 
• Done

This type of communication, simplex, is simple and elegant. Message, Response. Message, Response. When you leave out the greetings, the niceties, the smoke-blowing and ass kissing you wind up with a PERFECT technical communication technique.

Unfortunately...... (There is always an unfortunately....) when you are talking to the hospital, you are most likely speaking to a nurse. In general, nurses and paramedics like each other. In fact, I had a partner that liked a nurse in the bathroom WHILE I was getting all the paperwork together for a patient transfer. 

Unbelievable right? No. The unbelievable part was that he liked her and she liked him and when they came out of the bathroom it had only been 30 seconds!

As a sidebar, THIS is the exact reason that I think nurses from Canada should not be allowed into this country. In the early '90s we were facing a nationwide nursing shortage of catastrophic proportions. Canadian nurses literally poured in by the millions. 

Do you think Canada thought to send us ugly, old nurses that actually knew what they were doing? Hell no! The tiny hospital in my town was populated entirely with young, hot, (polite) Canadian nurses. There was absolutely ZERO healthcare taking place in the 1990s in rural Texas. Too much LIKING and not enough WORKING!

Anyway... it's not the hot, polite, young, hot Canadians I'm talking about.

The thing about nurses is this: They are smarter than you. Literally smarter. They know more stuff and they know Jedi mind tricks like making Doctors think "they" are the ones who actually diagnose and treat patients. 

When there is a jacked-up, trainwreck cluster of a patient, they make the Doctor think "he" is the one that came up with the smart idea to actually TURN OFF THE LIDOCAINE DRIP that is hooked up to the patient with 3rd Degree Heart block. 

As far as the Doctor is concerned, some clueless nurse hooked that IV up on her own without any orders, and although he can't remember "which" nurse was the dumbshit who did it, they DO remember the bright flash, the clap of thunder and the Voice of... well.. themselves that spake unto him that somebody made a huge mistake and the patient will die if he doesn't DO something; followed by a spontaneous hypnotic suggestion that... what the hell is the nurse pointing at... the suggestion that his super power of super smart medical shit... WHAT IS SHE DOING? Yeah! It's a fucking IV PUMP. I get it. JESUS!...  his super smart... HOLY SHIT THAT CRAZY BITCH IS RUNNING LIDOCAINE INTO THAT PATIENT! I MUST SAVE HIM FROM HER INCOMPETENCE!

My point is this. Nurses are smarter than you, and they can do more than one thing at a time. 

Nurses use "duplex" communication which has all these nuances and crazy details that SOMEHOW actually result in finding out what's wrong with the patient, taking care of it for what is likely an EXTENDED period of time (which is mostly due to the fact that you were with him a total of SEVEN minutes, asked him THREE questions and still managed to give him FIVE different drugs, TWO of which were ones that they just added to the ambulance drug box last week, and the in-service training isn't until next month, and you were specifically told to only administer them in ONE SPECIFIC INSTANCE when you are ABSOLUTELY SURE it is smallpox and then only by itself because THE HALF-LIFE IS THREE MONTHS!).

And then you left.

Technical communication is simple communicated. It is simplex. I say this. You say that. 

It is necessarily terse. Adding so much as a "thank you" or farting into the microphone results in the Sheriff screaming at your boss, which makes your job hard to do because you are effectively BANNED from talking to the radio and only have telepathy to communicate patient reports.

Sometimes nurses get frustrated because (oh let's face it, nurses ALWAYS get frustrated) because you call in on the radio without even so much as a "Good morning" or "How was your day?" or an "I'm sorry I didn't call you, it was a tough week, my grandpa died three times and my iPhone would up in his casket. How crazy is that?" and you just start transmitting data.

Mostly that's how my life goes too. The second I know someone is monitoring the channel I open up a one way laser beam of streaming data, oblivious to social protocol and politeness, and then release the transmit button. It's not that I don't WANT to have meaningful verbal intercourse, it's just that I am clueless that someone might actually want or need to transmit important data to me that I didn't even ask for!

For that, I apologize. I will try to do better. I just have to do one little thing first. That stupid smoke detector is beeping again. I could have sworn that they said it changed it's own battery every six months. THAT REALLY PISSES ME OFF, BY GOD!

-----

A while back a brilliant EMS educator, who had to teach both manners to paramedics and self-esteem to nurses got sick of trying to translate how the two groups communicated over the radio.

For my EMS system, the problem was solved with three simple words inserted in big letters at the top of the patient report communication protocol.

COURTESY IS IMPLIED