Yesterday & 44th in the Amanda Saga” Imaging:

Good Morning Ted and Jody:

I missed the inauguration on television.  I did read the text of his speech late in morning.  I quite frankly got caught up in taking photos and breakfast (I had pancakes).  I got home long after the swearing and speaking.  I did not turn television on after Nancy left at 7 yesterday morning.  When Nancy left the house, she stuck her head back in and reported that it looked like a photographable sunrise was in the offing.  So, I took off for the boat landing and got a few shots which are attached below.  One of the shots is of a fellow in a boat.  He is a duck hunter.  The images are in the order taken with the last one being on WA 504 near the five mile marker.  7:20 A.M. to 8:10 A.M.

He pulled his rig up and spent about five minutes getting it ready. Then the backed it down the ramp and hit the brakes.  The boat floated free.  He had 75 feet of rope to keep the boat from drifting away.  He used the rope to secure the boat to a dock and then put his truck in the parking area.  I have watched dozens people launch boats there when I am taking photos.  This guy was the best—he made a science of it even to the construction of his boat trailer.  This fellow, unlike a lot of sportsmen was friendly and talkative as he got his boat ready to go after ducks.  He is 62, retired steam fitter.  He works out once a week with the kids (weight room at the High School).  His philosophy is if one doesn’t keep moving he won’t be able to do what he wants.  He was the kind of positive person one might want to sit down and have a cup of coffee and conversation with; but he would be moving too fast.

After the duck hunter and photos, I went to breakfast.  There was a fellow in a wheel chair at breakfast who just sits and stares.  He is a regular and only seems to get coffee. Then a van with a chair lift comes and picks him up.  His name is Bob, but that is literally all I know about him.  Someday, I will have to go in early and ask to join him when he comes in.  Then I might get the counterpoint to the hunter.

Nancy finished two more projects yesterday at the three-day sewing event—a tea cozy and a table runner.  I do not know what specialized sewing machines she did these on (may be the Swiss Army knife one). One more project today.  I suspect she will have a long lunch or get out early.

I do hope this finds you warm healthy and happy.

Another episode in the Amanda Saga follows.

Warmest Regards, Ed

044 Imaging

Fiction in 1676 words by T. Edward Westen, 2017

 

Dr. Randolph R. Benjamin, neurosurgeon, at St. Lucy’s trauma unit, scratched his head.  A head trauma not caused by a vehicular incident was in route.  ‘The term car accident trivializes the harm they caused the human body, especially the head’ he thought looking at the case report transmission from the ambulance on his tablet.  ‘A device, they call it.” Hefting his tablet. ‘An emergency room visit waiting to happen when used while driving.  Since this patient was not involved in a vehicular incident why is a policeman accompanying him.  And why for heaven’s sake is the police officer requesting a conference prior to any imaging of the patient’s head?’  It had been a long day for Dr. Benjamin, but this case was intriguing. 

Dr. Benjamin put his tablet down and picked up his cell phone. Speed dialing his home number, he waited while the connection was established “Hi Honey.  I am going to be a few more hours.  We have a non-vehicular head trauma coming in escorted by a cop.  Looks like it will take a delicate touch.”  He listened for a few moments to his wife’s lament about a cold filet mignon.  “Yes, that is my favorite.  What say you slice it into strips and I’ll have it with a bagel and some of that divine spread for steak sandwich you make.  You know how I love that stuff.”  His wife was not letting to easily.  “I know dear.  But, I don’t have to come in at all tomorrow and we’ll drive out to the marina and spend the day where they can’t reach me.”  His wife was sounding a tiny bit mollified now he thought. “OK it’s a date then.  Bye, I love you.”

Grabbing a hot cup of coffee from the machine in ER was not something that Dr. Benjamin did very often, but it had been a long day.  ‘They say this is hot coffee. Well, it is hot.’  As he sat in what he thought of as the ER ready room sipping his coffee, his cellphone chirped.  He took it out of his pocket, swiped the screen and thought ‘Ah, the patient and his police escort have arrived.’ He got up, picked up his tablet abut left his cup of coffee on the table and headed to the examination room corridor.

When he entered the exam room, the admitting nurse had already hooked the patient up to the monitor and was still entering information in her ‘computer on wheels.’  Dr. Benjamin chuckled, they give me a five-year-old android and she gets a ten-year-old desktop on wheels with a surge protector power backup that she moves between rooms.” He chuckled again. ‘I’ll just bet the chairman of the board gets a new Apple.’  Then he saw Special Agent Fleishman in the bed.  “My God, man, what did they hit you with a folding chair or a refrigerator?”

“It was a steel door.  And, they hit him twice.  I am Detective Batan.  I’m assuming from your white coat and well-worn stethoscope you are a doctor.” 

“Dr. Benjamin, chief of neurology here at St. Lucy’s.  Now what is this nonsense about no imaging without talking to you, Detective?

Detective Batan sighed. “Your patient has an implant in his skull.  I do not know the exact nature of the implant but it could be a problem for an x-ray, MRI, millimeter wave scanners, and even backscatter X-rays . . .”

“Excuse me.” Said the admitting nurse.  “I will need to see your id before I can finish processing this admission.”

Detective Batan pulled out his credential case and handed it to the nurse.  Then he turned back to the doctor.  “As I was trying to say, it could be a problem if it is imaged.”

“What kind of problem?  Will the MRI cause it to spin and turn his brain into mush, will the millimeter wave scanner heat it and cook his brain?” Asked Dr. Benjamin.

Detective Batan shrugged his shoulders and said, “Hell for all I know it could set of a small nuke.”

The admitting nurse looked a bit concerned.  “Do you think there is an explosive in his head?”  She handed his credential back.

“No, what I am saying is he has an implant and I do not know what it is made from or how it is connected.  There must be a non-invasive way to look in his head.” Said Detective Batan.

“Good God man, imagining is non-invasive.  We could skin his head to check for fractures.”  Replied an exasperated Dr. Benjamin.  He turned to the admitting nurse. “There is no bomb in his head.  You will not start any rumors.  Your lips are sealed.  Do you have that?”

The admitting nurse nodded and started to leave.

Dr. Benjamin put his hand on her shoulder.  “I want to hear you say you will not pass on the nonsense you just heard.  Say it.”

The admitting nurse looked frightened and ran her hand across her lips and said, “My lips are sealed, I heard nothing, I know nothing, I will say nothing.”

Dr. Benjamin nodded and gave a backhanded wave to the nurse indicating she was free to leave the room.  As her body was half in and half out of the examination door he added.  “Silence.  And I mean it.”

When the nurse had left, Detective Batan walked to the door and shut it.  “I think the next pieces of information might best be handled privately.”

Dr. Benjamin was looking intently at his android computer tablet.  “I see a man who has so little information that he might not exist.  No next of kin, no address, no age, nothing expect you here to tell me I can’t image the head of trauma victim because of an unknown implant.  That means I can’t start treatment because I don’t know what damage was done.”

Detective Batan said.  “Here is what I know about his accident.  He was standing outside of a door when someone came through at high speed slamming the door in to his forehead.  He fell down.  As he was on his knees trying to get up, more people ran thought that door slamming him in the head again.”  Looking at his watch the Detective continued.  “That was 35 minutes ago.  I was in my car pulling into the parking lot where he was standing and saw it all.  When I got to him I called the ambulance and ascertained he has some memory issues.”

Dr. Benjamin asked “What kind of memory issues?”

“He doesn’t remember me; and we are working on a case together.  I have not fully explored what he doesn’t remember, but I suspect quite a bit.” Replied Detective Batan.

Dr. Bemnjamin looked at the monitor the admitting nurse had hooked Special Agent Fleishman to for monitoring heart rate, blood pressure, oxygen levels and the like.  He then took out a penlight and shine it in the Special Agent’s eyes.  Putting on his statoscope, he listened to the Special Agent’s chest for a few minutes and then announced.  “This man is fairly stable.  So tell me when I can image him?”

Detective Batan bore a puzzled expresion on his face as he watched Dr. Benjamin examine Special Agent Fleishman.  During the examination Detecrive Gatan took a few glances at the monitor.  “First I have a stupid question, Dr.”  Said Detective Batan.

“I’m missing a filet mignon dinner with the most beautiful woman in the world, so why not a stupid question too.” Replied Dr. Benjamin.

“If a patient is hooked up to all that monitoring equipment why do you then listen to his heart?  Doesn’t the machine tell you want you need to know?”  Asked Detective Batan.

“Largely, yes.  I get details about his heart beat” said Dr. Benjamin point to the graph on the monitor. “However, I would also like to know a bit more about his breathing and if there are any obstructions that make noises.  Listening is one non-invasive way to find out if a patient on oxygen is having breathing problems.  You will notice we have him on oxygen, so his oxygen levels will be high enough, but that could mask a pulmonary problem. I’d hate to have a man come in with a head injury and end up with lungs filled with fluid because I didn’t check.”

“Thank you.  I have wondered that for years.” Replied Detective Batan.

“Your man has a concussion.”  Dr. Benjamin said.  “I don’t know how severe, but given memory loss, I would think a couple of linebackers ran over him and rang his bell.  Let’s see how much of a memory problem he has.”

Looking at Special Agent Fleishman, Detective Batan said, “He’s asleep.” 

“Did he converse immediately after the trauma?” Asked Dr. Batan.

“Kind of, that is to say, he didn’t remember me nor others, but he did talk.” Replied Detective Batan.

“I see he threw up in the ambulance.”  Said, Dr. Benjamin looking at the EMT’s admitting report.

“Yes, and he talked after.  He didn’t make sense, but he talked to me and the attendant.” Said, Detective Batan.

“I’ guessing that he is undergoing post-traumatic amnesia.  His memory could be missing or foggy for an hour or so, or it could be up to a day.  Sleep is good for him. Let us hope that there is no breaks or cracks in his skull along with the shocks to this brain.”  Said Dr. Benjamin. “now, tell me more about this implant.”

Detective Batan looked at Special Agent Fleishman sleeping.  He turned to Dr. Benjamin. “OK, but you are not going to believe what I am about to tell you and like your nurse, I must insist you keep the information absolutely under wraps.  You may not even tell that beautiful woman you were to have dinner with tonight.”

Dr. Benjamin shook his head in disbelief and nodded agreement.

“This one I learned from you.  Let me hear you say you will not repeat anything I tell you to anyone ever. Now say it.”  Said, Detective Bat