While cruising along the other day and listening to Willie’s Roadhouse on XM I heard the following song.

Yes, Ray Charles singing Country music. Or at least his interpretation of a country classic originally sung by Buck Owens.

What’s up with that?

A little research was in order on my part.

Turns out that in 1962 Ray Charles produced an album in which he sang a number of country music classics which had been rearranged to suit his style of music. Which was not very different to what is now known as The Nashville Sound.

Modern Sounds in Country and Western Music included the following songs,

(from Wikipedia)

Side one

1. “Bye Bye Love” (Boudleaux Bryant, Felice Bryant) – 2:09
2. “You Don’t Know Me” (Eddy Arnold, Cindy Walker) – 3:14
3. “Half as Much” (Curley Williams) – 3:24
4. “I Love You So Much It Hurts” (Floyd Tillman) – 3:33
5. “Just a Little Lovin’ (Will Go a Long Way)” (Eddy Arnold, Zeke Clements) – 3:26
6. “Born to Lose” (Frankie Brown, pseudonym of Ted Daffan) – 3:15

Side two

1. “Worried Mind” (Ted Daffan, Jimmie Davis) – 2:54
2. “It Makes No Difference Now” (Floyd Tillman, Jimmie Davis) – 3:30
3. “You Win Again” (Hank Williams) – 3:29
4. “Careless Love” (Traditional, Arranged by Ray Charles) – 3:56
5. “I Can’t Stop Loving You” (Don Gibson) – 4:13
6. “Hey, Good Lookin’” (Hank Williams) – 2:

That’s some pretty impressive country music right there, folks. All done in Charles’s R&B and Jazz style.

So, how country was Ray Charles?

Buck Owens, Ray Charles, a Steel Guitar. The only way it could be more country is if they were on a show like Hee Haw.

Oh, they were.

One last Country song from Ray Charles.

Country, Pop, Blues, it’s all in the arrangement folks.

 

Note: I almost deleted this post because I thought it was kind of lame. Let me know what you think.

I’m going to try to make Sunday posts, or at least one of them firearms related. This is the first in what will hopefully become a regular feature.

The Ruger 10/22 has been around since it was introduced in 1964. It’s still in production by Sturm, Ruger & Company and comes in a wide variety of models. It’s even available in calibers other than .22 Long Rifle. There are also a dizzying assortment of after market parts available for it. Many people have bought new rifles just for the receiver and have replaced every other part with upgraded components. Along with the 1911 pistol and AR15 rifle, it is probably the most modified and customized firearm out there.

Which started me thinking. How much could one spend on a customized 10/22? I’m not including the price of a new rifle because it’s notw possible to buy a receiver alone and build a rifle from scratch. So, I went to MidwayUSA (you can do the same thing with Brownells) “built” a rifle from scratch. I used retail, not dealer prices, because not everyone has access to dealer pricing. I didn’t choose the most expensive pieces in all cases, instead I picked the ones I liked the most. Who knows, I might actually do this some day, although that’s not likely.

Note that the receiver is the “firearm” part of a firearm. That is to say that this part is what the BATFE considers the firearm and must be purchased from a Federal Firearms Licensed Dealer (FFL). Every other part can be bought by anyone with a credit card and computer access. For this exercise, I’m assuming that I could find a FFL to do the transfer for me.

Receiver. Tactical Solutions X Ring Receiver and Bolt. This is a bargain, since it includes the bolt as well as the receiver. Plus it’s tacticool with an integral Picatinny rail. $399.99

Barrel. Tactical Solutions Barrel Ruger 10/22 22 Long Rifle Keeping with the tactical theme, I picked the lightweight black tactical barrel for $234.99

Next, the parts for the action. Trigger, trigger guard,  disconnector, springs, shims, and so on. Volquartsen Trigger Guard Assembly 2000 Ruger 10/22 Magnum Black has all the parts you need to build the action for $214.99

Stocks. Not from Midway, but I like the looks of the E. A. Brown M1 Tribute stock for the 10/22. $109 plus $19 dollars for the matching sling.

Sights, we have to have sights. For me, with my aged eyes and that the barrel is not cut for a front sight, a scope it is. I’ll limit myself to one designed for rim fire rifles only. Leupold FX-I Rimfire Rifle Scope 4x 28mm Fine Duplex Reticle Gloss for $219.99 will do nicely thank you. Must have the matching Leupold 1″ Mark 4 Picatinny-Style Rings Matte Medium for $140.99

Small parts, Volquartsen Hex Head Takedown Screw Ruger 10/22, 10/22 Magnum Steel $3.99, Shooters Ridge Magazine Ruger 10/22 22 Long Rifle 30-Round Polymer Smoke $21.99 times as many as you want. Also, a muzzle compensator is required Tactical Solutions Compensator .920″ Outside Diameter Ruger 10/22 Aluminum Matte Black for $34.99.

The total, minus shipping is $1399.92, which is actually pretty inexpensive considering the options out there. Then again, you can buy a brand new similarly built 10/22 for a retail price of $316.00 minus a scope. The street price is likely to be somewhat less, but you get the idea.

I’m sure that some of my readers will have their own ideas of how they would build their own 10/22 rifle. That’s the neat thing about this rifle, there is virtually no end to the options and variations you can build.

And of course that is nothing compared to what one can pay for a build it yourself AR 15 or 1911.

 

Now that I’ve had some sleep and can write semi-coherently, I’ll tell you about my morning.

I worked a double shift Christmas Eve/Morning. The first part was to let one of my co-workers have the night off with his young kids. That shift was pretty quiet all things considered. Of course the devils in dispatch did send up to the other end of Sort Big City the second I paid for a meal. Fortunately, the call was silly in it’s entirety, someone who didn’t want to go to the hospital, didn’t ask anyone to call 9-1-1, had no reason to go to the hospital, and just wanted to go home. So, we let her and I went back to fetch my dinner.

Then, I smoked a really nice cigar because it was that quiet. Outside the station of course because we have rules about that.
The rest of the shift passed without incident and I drove over to my regular assignment for my regular shift.

We drove around a bit, got coffee, drove around a bit more, then went back to the station because we were bored and no one was out. Which is as it should be on Christmas morning. People want to be with their families, so they aren’t out and about. The college kids are mostly home, so we don’t have a lot of calls for them, most bars and restaurants are closed. Nothing much going on.

We lounged around the station for a bit and I thought about closing my eyes for a short nap. No such luck.

We were sent to one of our regular addresses for one of our regular patients. We see him every couple of months for some ailment or another. Don’t get me wrong, he has a lot of legitimate medical problems. Much of that is because he doesn’t take good care of himself, signs out of the hospital a lot, doesn’t seem to follow up, and so on. So, we see him a lot. I was resigned to having to deal with him yet again for one of his non specific ailments that make it frustrating to try to figure out what to do for him. Usually, we just drive him to the hospital and monitor him because there’s nothing else to do.

Today was no different. He had sharp-dull chest pain that did or didn’t radiate, might have had some shortness of breath, the pain had gone then it came back. Got that? The 12 lead ECG was interesting only in that it looked like a paced rhythm only our monitor didn’t pick up the pacer spikes like it should. Which might mean that he has a demand pacemaker and his rate was above the settings. Or it might mean that there was a problem with our monitor. Or it might mean that there was a problem with the pacemaker itself. Nothing to be done but treat his vague chest pain and go to the hospital. So we did what we do for vague chest pain and went to the hospital.

It’s telling when the triage nurse knows the patient by name and brings his chart up before you’re all the way into the triage area. He was duly assigned a bed and we moved him over. Then I finished my report and we once again went back to the station.

I was channel surfing desperately for something to watch when we were dispatched for a report of a person shot. Off we went listening to the police radio on the way. The first units arrived and found no one outside. Then the BLS arrived and stood around while the police looked for a victim or any indication that any shooting had been going on. There was a crowd of people standing in front of the address, all playing Mickey the Dunce. Or whatever that is in Creole. One of the eagle eyed police officers noted some blood, actually a good amount of blood, on the ground and front porch of the house. This caused the police to go into the house and all the way up to the top floor. Where they found more people with blank stares, including the man with the gun shot wounds in his leg and foot.

Yeah, he had been shot and then run a block or so and up three flights of stairs just to make the call more challenging for us. We gave him a quick exam, did some vital signs and went down to the ambulance. Where we took off the rest of his clothes, did a more thorough exam, found three wounds, and went off to the hospital. One bullet had gone through his wallet and grazed his ass, another was in his thigh and the third was in his foot. Seems that when the shooting started he wisely ran away, just a bit too slow. He wasn’t hurt so badly that he couldn’t make several phone calls on the way to the hospital. Normally I take the phone from the patients since it interferes with my conversation with them, but this time I didn’t bother.

Off to the trauma center we went. They weren’t too excited since they already had a bunch of patients and this particular one wasn’t that severely injured. Oh well, they had a nice Christmas buffet set out and invited us to partake. Which was nice of them.

While my partner was finishing his report another call came in, this time for another chest pain. Off we went to one of the city’s more convoluted housing projects to play find the address because some genius thought using black lettering on red brick would be just fine at night. Really, I think you have to be a moron to work for the public housing agency.

We finally found the patient sitting on his couch. Dull pain in the middle of his chest, which radiated up to his left jaw and arm. Oh-oh. He also mentioned that he was out “for a walk” when this happened and that he had almost fainted because he got so dizzy. Oh, that. Fall of of that, he was an incredibly stoic patient, the exact opposite of our first patient. He had already taken aspirin, so that was good.

We started him on some Oxygen and attached the cardiac monitor.

As we looked at the screen we noticed that Lead III had some elevation in ST segments. “That will probably disappear when we do the 12 lead.”, said my partner optimistically.

“Nooo, I think it will be worse when we do the 12 lead.”, said I pessimistically.

Sometimes I hate being right.

Our stoic gentleman was having a pretty decent Myocardial Infarction, with ST elevation in Leads II, III, and AVF, as well as reciprocal changes in leads I and AVL. Now, every good paramedic knows to look at Leads II and III and see if there is more elevation in III than II. If there is, the patient is likely having a right Ventricular MI as well as the more prevalent left Ventricular MI.

Guess what our patient had? So, we did a quick V4R which looked fine and meant that he likely wasn’t having a right Ventricular infarct, which was at least something positive.

While my partner and the BLS guys got the patient into a stair chair, I went out to the hospital to give them a head’s up. Same hospital we had just left because it was the closest one with a cardiac cath lab. The staff of which had to be called in because no one staffs their cath lab 24 hours a day and on nights we try to give early notification so they can wake people up and get them in to activate the lab. I called on the radio and a bored sounding nurse answered. She handed the radio off to the bored sounding charge nurse. Who is really only bored because he’s been doing this as long as I have and nothing much phases him.

My radio call went something like this,

“Good morning ED, we have a STEMI alert for you this morning, yada, yada, yada, blah, blah, blah.” I omitted everything after STEMI alert because that was what they needed to hear. The bored sounding charge nurse didn’t sound so bored when he acknowledged my traffic.

Back to the patient. He still had chest pain, so as my partner started the IV I again asked the patient if he had any previous medical problems, took any medication, or had any allergies. Negative to all of the above he assured me.

Time for another 12 Lead. Not that it was going to change anything we did, but it would be nice to see if there were any more changes.

Pretty much the same, but his heart rate did have this disconcerting habit of slowing down to about 50, which almost had me putting on pacer pads just in case. But, I held off and his rate stayed where it should be.

Since he was clearly having an MI and his blood pressure was a bit low, we decided to skip Nitroglycerine and just give him Morphine. Which we did while we were driving him to the hospital. We got a grand reception at the hospital and a couple of minutes after we arrived the cath lab team started to show up. Pretty impressive since less than 30 minutes before they likely had been all snug in their beds with visions of sugar-plums dancing in their heads. Or something.

Oh, remember that Nitroglycerin we didn’t give? Good thing, because apparently our stoic little gentleman had plans when he went out for his “walk”. Which plans involved taking some Viagra, which he hadn’t wanted to mention in front of his wife. Not that I blame him. So, I don’t know if the pain actually came on while he was walking or doing something else. Not that it matters, but it might have been bad if we had given the Nitroglycerin.

That’s enough good calls for a week, let alone a single shift, but we weren’t done yet because we were only a bit more than halfway through our shift.

We finished the paperwork, restocked, went back to the station. Once again, we were sitting around being bored when I heard the police call for an ambulance in a hurry for a man “shot or stabbed in the neck bleeding very heavily.” That got our attention and since it would take a couple of minutes for the message to get from their dispatcher to ours we called in and told the dispatcher we were responding. Which, being a nitwit dispatcher, torqued her off, but well, to put it bluntly, screw her. We have a scan function in our radios for just this sort of situation and it’s reduced our response time often in the past.

We were just about a mile from the location so it took us no time to get there. Or it seemed that way the way my partner was driving. We arrived along with a BLS crew to find the police waving frantically and pointing to car which had the patient in it.

Whichever cop said he had a bad neck wound was right. At first I wasn’t sure the patient was alive, but he was. And covered with blood. With a nasty wound to the left side of his neck from the lower jaw down almost to the back of his neck. Nice anatomy lesson since we could see the base of his tongue, his external carotid (intact), lots of muscle, and lots and lots of blood. We got him into the ambulance and stuffed a multi-trauma dressing into the wound and I held pressure while my partner called the other trauma center and told them we were coming in. Then he took over pressure while I started an IV. Not that an IV would do all that much in the field, but at least they could give blood through it.

We stopped, or at least slowed down, the bleeding enough to keep the guy alive until we got to the hospital. The trauma surgeon took one look at the wound and took the guy right up to the OR. He’ll probably live, but he’ll have a story to tell. At least I think he’ll live, but that was one nasty wound.

While there I did a bit of follow up on the first patient. They admitted him to rule out unstable Angina, which was odd. Not the diagnosis, but the fact that he allowed them to admit him. Usually he signs out against medical advice and goes home with a new prescription.

We cleaned up, did our report, re stocked and went back to the station to wait out the remaining two hours of our shift. Which mercifully passed without incident or another call.

For those of you looking to get into EMS, this is not a typical shift. It’s actually more like a month of shifts all rolled into one. No wonder I was so tired when I got home.

Follow Up to 2007 Audit of Philadelphia Fire Department EMS

If you want a shorter version read,

Butkovitz finds EMS responses still badly inadequate

I’m going to include this quote because it underlines what happens when non medical people try to help improve EMS systems.

Butkovitz called on the department to cross-train paramedics as firefighters. Unlike ambulances, fire engines usually arrive at emergency calls within three minutes of calls. But they are not staffed with paramedics

If the problem is not enough available ambulances to meet demand, wouldn’t the answer be to add more ambulances. Sending fire fighters, whether trained as paramedics or not, is a band aid approach to the problem.

Speaking of the problem I am compelled to add a second quote.

Butkovitz echoed the sentiment, saying the department needed to bring its financial resources in line with its need: EMS incidents account for 82 percent of the department’s workloads, but EMS receives only 17 percent of the department’s budget.

Soooo, Mr. Butkovitz correctly identified a need to resource mismatch, but then goes on to recommend a fix that isn’t a fix.

Other cities have had success with paramedics on engines, Butkovitz said.

Define success, Mr. Butkovitz. I’ll be it has something to do with response times, but little to do with outcomes. Has anyone ever done a study to see if there is an advantage to having paramedics on fire trucks. I mean a peer reviewed, blinded, study, not a “White Paper” issued by the hacks at the IAFF.

If there is one, please point me to it. For that matter how many fire based EMS systems publish their cardiac arrest survival rates? But I digress.

Last quote,

Even though more than half of the calls flooding in are for non-emergencies, the department does not have a priority dispatch system, Butkovitz said. Rather, it operates “robotically” on “first come, first served.” And the city’s 311 system has not eased the load on 911, he said.

Even though I very recently pointed out that priority dispatch type systems aren’t always very accurate, they are better than a system that amounts to little more than pulling a number out of a hat.

My thought would be not to get sick or hurt in the City Of Brotherly Love EMS Chaos.