More from The Awase Era!

There are so many good times, some sad times, a few angry times and a lot of fun and funny times during The Awase Period.
A lot of the fun and funny came from the job! I was a night shift supervisor (NCOIC) of the after hours facility which we called an Emergency Room. I say that, in a way, tongue-in-cheek because we were anything BUT a true emergency room. Remember, this was in 1973! *grin*
Well, a Buck Sergeant back in 1973 had about as much "pull" as the cafeteria monitor at your local "Pay 'n' Pack." You've been to one of those, haven't ya?? You go and pay a little too much for the privilege of grabbing a tray, a fork, a couple of napkins and piling on as much chow as you can? You "pack" till ya puke - or at least fear that you will before getting to the sidewalk outside. Have you ever noticed that many of these places don't offer milk at the trough? You can have all the watered down lemonaid, orange drink, cola, tea or coffee that you can drink, but NO MILK! Guess they'd have to add another buck to the cost of grazing.
They offer a senior citizen discount too!! Now that's just plain silly!! How many seniors can there possibly be? If they've been feeding for a few years at the "Scarf an' Barf" then they'd never LIVE to be a senior citizen!! But it's a great public relations thing!
The guy who's at the end of the buffet line is always a high schooler with bad acne and a smile that you know damned well is on his face because his boss has threatened him... "if ya ain't smilin', they won't like ya!! If they don't like ya, they won't take any of this lousy ham and steamship round! And if they don't take that they won't be back!! And if they don't come back, we don't make any money! And if we don't make any money your ass is grassed!!"
So he smiles and a little dribble drips down from one of those really big juicy zits! Makes ya wonder.... is that sweat? Did the steamship round squirt when he cut.... oh, never mind!!! *sigh*
Anyway, the cafeteria monitor can be a very powerful and influential person.... after regular hours, when the bosses have gone home to their cool ones and their remote controls. Well, this "monitor" was "in charge" of the whole danged clinic after 1600 hours - that's 4:00 p.m. to us civilians ! *chuckle* So... here we are - a three man crew. I had two technicians, a couple of ambulances, a whole buncha telephones and even more loose-leaf binders which had sheets of paper replete with instructions on how to make every little thing work in a big clinic after the neon sign comes on for the night. Oh!! And I had a doc. Remember. ... 1973. Didn't matter what kind of doc (s)he was, if there was MD after the name then the name went on the "MOD" roster. The MOD - Medical Officer of the Day. The MOD is the person who is responsible for everything and everyone who happened into the clinic during his tour of duty. Didn't matter if he was a radiologist (most don't deny that taking care of real, sick people frightens 'em! Especially kids!

I once knew an anesthesiologist who would get SOOO anxious about being MOD that he'd get the shits two days before a scheduled MOD shift and wouldn't quit for a day after!) or a pathologist or any other kind of ologist.... if you're a doctor, you pull your share of MOD... unless of course, you're the Big Boss. .. the commander! On the other hand, I recall two commanders I had who pulled their share of MOD. One was an OB and the other was a GP. In other words, the MOD was "in the barrel" and was subject to every imaginable abuse that could be reaped upon a servant of an entitlement-mentality population of beneficiaries! "What is that," you ask? What's that mean? Hey!! The guy who's wearing the MOD hat is subject to being jerked outta bed at any time to respond to the whims and wrinkles of ANY person who came in with ANY complaint. (In those days, clinics stayed open 24-hours a day, 365 days a year and the doc had to stay IN THE CLINIC all night!! No being called from home... had to be right there!!!) The MOST IMPORTANT thing.... our most pressing responsibility was to, by ALL MEANS, avoid generating a complaint. That brings us around to that "entitlement-mentality" thing. What that means simply... it's a mind-set that we instilled in the mind of every GI and family member... a mind-set that dictates that whatever makes you uncomfortable (you don't even have to be ill or injured!) - if you are merely inconvenienced by anything at all that seems to be even remotely dysaffecting your personal well-being, you then have the RIGHT to go directly to the nearest military medical facility and shout, moan, whine, cajole, threaten and do anything else within your capability to make it known that you expect the tax-payer and the ever-maligned military health care professional to lay on hands and heal you. Expense is not a worry! The belief was that there was a bottomless pot of money so it was entirely within your rights to DEMAND - no matter how inappropriate. It was thought to be well within your rights to demand that a specialist be called in to attend to the scratchy throat that started after work while you were drinking your beer and hosing down the dog. It's perfectly within your rights to present at, oh, let's say 4:55am to have this scratchy throat assessed! Why 4:55? Because you have to be at work at 5 and you don't wanna go. That's another favorite ploy that used to be around. Show up just before you're supposed to be at work. Count on forty other people doing the same thing and simply lag behind... drag your feet.... be the LAST in line for sick call and it's guaranteed that even if you don't get a sick chit, you won't be at work till after noon anyway!! Oh, the sick chit!! Those things were like gold!!
So... we used to have generations of people who thought that the medical care facility OWED them good health and that no dollar would be spared to make them Herculean! Don't pay any attention to the fact that you smoke a pack and a half daily and that you're 15 pounds over-weight!
Doesn't matter that your most strenuous exercise is when you work your "abs" while you're puking up the dinner that was 4000 calories more than you needed! We were expected to FIX 'EM! "And don't do anything that makes 'em wanna write up a complaint form!" Okay... I know!! You're wondering what the heck all this has to do with being the clinic "monitor," huh? Well, I'm not finished ranting yet!! Sit back!! Read on!!! There ya go!!! Now, don't ya feel better??
Thank God, the Air Force (and I believe the sister services too) has finally seen the light!! The QUANTITY of care isn't nearly as important as it used to be. Emphasis is now more on QUALITY and responsible use of our resources!! What's that mean now-days? It means that every teen who has acne is NOT ENTITLED to be "healed" by a dermatologist! You can't believe, and I can't remember, how many times in my 28 years in military medicine that I've heard demands that a dermatologist be consulted for plain ol' garden variety zits! Dermatologists can't cure it either!!! Yet, it wasn't uncommon for a parent to want specialty care when their kid's pimples were still there after 2 weeks of doing what "that plain ol' doctor" suggested! And we're not paying for that kind of "demand satisfaction" anymore!! Hallelujah!
Instead, we are spending our dwindling bucks more intelligently and we're doing more for our clients!! We're trying to encourage wellness and prevention instead of intervention after they've already had their heart attack or destroyed their bodies with poor lifestyles!
Well, this isn't about today, is it? This story is about 1973. Fix 'em! Make 'em happy! Get outta bed whenever they demand! Heal!!!
How did I fit into the picture? I wasn't a clinician then... I was a medic. A corpsman. A schmoe! *chuckle*
Most of the docs didn't wanna get up at 4 for a guy with a cold, so what'd they do? They invented technicians who were allowed to look at patients, assess the simple stuff and give them harmless (for the most part) medications - nothing they couldn't have bought in the store... but, Heaven forbid that a military member should have to take his wallet out!! The tax-payer is charged by law to pay his way! Why were we schmoes? Because we stuck our necks out (to say nothing of jeopardizing the outcome of someone who was sicker than we medics were able to recognize!) I think back on those days now and it simply frightens me! *shudder*
There I go again... HehHehHeh... okay! I'll behave!
That mentality has almost gone away!! *sigh* and that is a breath of fresh air! Now-days, the people whom I encounter are better educated, sharper than 20 years ago and are more realistic in their expectations and are generally a LOT more informed and responsible for their health. I think we can thank the Surgeon General, the Centers for Disease Control and countless other Public Service initiatives which teach the younger generations of Americans some of the things they need to know to live healthier lives! Now THAT's where the tax-payer is getting his money's worth!!

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