Bullets 2 Bedpans
Ep:16 Scotty Bolleter - Lessons from a Cadaver Lab
Scotty Bolleter, chair at the Centre for Emergency Health Sciences Center in Bulverde, Texas, joins us to talk about medical education and the EMS community. We delve into the emotional impact of medical practice, the respect owed to those who donate their bodies to science, and the personal growth that comes from both triumphs and mistakes in the medical field.
Nurses and Medics: This is your platform! We want to hear your stories of the good, the bad and the ugly. Send us an email at cominghomewell@gmail.com
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Special Thanks to
Artwork: Joe Weber @joeweber_tattoos
Intro/Outro/Disclaimer Credits:
Pam Barragan Host of 2200TAPS Podcast
"Racer" by Infraction https://bit.ly/41HlWTk
Music promoted by Inaudio: ...
Scotty Bolleter, chair at the Centre for Emergency Health Sciences Center in Bulverde, Texas, joins us to talk about medical education and the EMS community. We delve into the emotional impact of medical practice, the respect owed to those who donate their bodies to science, and the personal growth that comes from both triumphs and mistakes in the medical field.
Nurses and Medics: This is your platform! We want to hear your stories of the good, the bad and the ugly. Send us an email at cominghomewell@gmail.com
Do you know a health worker that needs a laugh?
B2B N.F.L.T.G. Certificate click here
Get the ammo you need to seize your day at Soldier Girl Coffee Use Code CHW10 for a 10% off at checkout!
Special Thanks to
Artwork: Joe Weber @joeweber_tattoos
Intro/Outro/Disclaimer Credits:
Pam Barragan Host of 2200TAPS Podcast
"Racer" by Infraction https://bit.ly/41HlWTk
Music promoted by Inaudio: ...
Alright, you ready to rock and roll? Yeah, man, let's do it. Alright, let's do it. Well, I heard that you were walking down the street or in a hospital somewhere and you found this person and you thought he was really interesting and you were like, hey, we need to bring you on our show. Facts, facts.
Speaker 1:So today we have with us the one that only Mr Scotty Bulleter. He is the chair at the Center for Emergency Health Sciences Center in Belverde, texas. I ran into Scotty doing training several years ago with my unit at the time. So unit would go out there and do a cadaver lab where we would brush up on skills. You know, try new things. Inevitably somebody would almost pass out Hashtag pneumatics.
Speaker 1:But after going through a few of Scotty's classes I grew a love and appreciation, not just for him as an individual but for medicine, for EMS and learning how we do this better. And that's really what the mission of this place is is how do we learn? Because the dead have a lot to teach us If we just take the time to slow down and learn. Medicine is advancing all the time. So that's what they're doing out at the Center and Scotty is leading the way. He's an educator and just passionate about what he does and I've thoroughly enjoyed going to those classes. I'm not part of that unit anymore but definitely miss getting to participate in those and from what I understand, I think the Center does some on the side education for families as well, and maybe we can talk about that a little bit later on, but without further ado. Mr Scotty, happy to have you on to bullets, to bedpans, how you doing today.
Speaker 3:It is my pleasure to be here and I am fantastic. Thanks for inviting me. Thanks for making me part of your program.
Speaker 2:I'm just thrilled to be here, thrilled Well, we're definitely thrilled to have you. I have to. I have to interject a little bit here. I actually told MZ I'm like I'm going to be more quiet on this and here I am yapping, but we have to. She made a comment about how she's not part of that unit anymore. Mz, why are you not part of that unit anymore?
Speaker 1:Because I'm officially, officially, part of club DD 214 baby retired. She is.
Speaker 3:And there's a whole lot of the sun on the civilian side. I really appreciate the fact that you joined us, but that you gave so much at the office. So welcome, welcome over to the other side. I can't tell you that it's going to be better. I can't tell you that it's going to be easier to communicate, because things just seem to clear in than they do out. But welcome to the other side.
Speaker 2:Thank you I'll say it's a different color green, right Way blue.
Speaker 3:It's just a different color.
Speaker 2:It's a whole different mosaic.
Speaker 3:There's a lot of. There's a different language over here and sometimes it's not real clear on the outside. I don't know why, but it's not crystal clear.
Speaker 2:Yeah, I have to agree with that. There's a different, there's good and there's bad. When I got out it was a little more. I got to breathe. I decided I never wanted a boss again, so I don't. But there are other parts of it that I'm like what the fuck? Why are you not answering me? Why are we not getting this done like yesterday? I'm missing some of that structure and yeah, yeah, but I said good and bad with everything. So welcome to our dark side of the world.
Speaker 3:Yay, so thrilled to be here. Like I said, I can't wait to open up this conversation because there's a lot for us to talk about there is.
Speaker 1:So, for anyone who hasn't participated in, maybe, a cadaver lab, like I said earlier, the idea is learning for the unit. We were knocking out CEUs and just figuring out how can we hone in on those skills and master our craft a little bit better so that we're better equipped, more prepared when we do respond to crisis. So that's that's what we were doing out there, I think, to get us started. I'd like to ask Goddy how did, how did you even wind up at this center, because I'm sure that wasn't part of the original plan. I'm guessing you, probably as a 20 year old, then wake up one morning saying you know what? I think? I'm going to cut dead bodies. Yeah, I'm going to teach cut downs and have my world look like this. How did that even begin for you? How did you get started? What did that look like?
Speaker 3:Well, it's kind of funny and I'm sure it's a very similar path to a lot of the people who are listening to your podcast. I was a below average high school student with an above average desire to be out on the ocean and in the water, and I just happened I graduated from the university in Meisha, specifically in Jakarta and so, but I grew up overseas. I worked for a Dutch merchant marine and when I got back to the US I didn't. I had promised my dad I would come back and go to college, which I did, and I was floundering in college. But I started working on a sport fishing boat and hated it, and so I saw a thing that said hydrotherapy cleaning or a person needed in the hydrotherapy room, and I went water. I do water, this seems easy, and I wasn't grossed out by fish or rotting fish or anything else, so human tissue didn't bother me.
Speaker 3:I'd already was an EMT because of the requirement for our insurance group. So I went into the hospital, spawn hospital and corpus and started scrubbing Humber tanks and cut through the ER. One night, when I cut through the ER, I saw some paramedics and wondered what they were, and one thing led to another and all those people became friends and I started taking night classes. I loved it. From there I went to the Rio Grande Valley and I started recognizing that people didn't teach completely and thoroughly. So I started a program in the Rio Grande Valley and then we were working on mannequins and they were terrible. So I ran into Larry Miller and we started a device company, and when that company was sold I had started another place where we could do research and development and teach the way we're supposed to teach. So that's how I wound up here. I was a boat guy with the ability to put a period at the end of the sentence, I guess. So that's how it can happen.
Speaker 2:That's a validation, though, about finding your vibe right. It is Like I know kids that went to high school with that were just screw-offs. You know, and you talk to them now and they're very successful and they're just like it wasn't challenged, it wasn't motivated Very intelligent people that just a school system couldn't match their brain power.
Speaker 3:I've got some friends that I graduated with. One retired out as an Air Force Colonel was an F-15 driver. I've got another one. I'll say your name. Some of your participants will not like her because her politics are so far left. She makes Hillary Clinton look right. Vermila Jayapovla was the vice president of our class. I've got some really good friends who teach at MIT now, but we were all just scatterbrained and didn't find our passion, didn't find the thing we love. I think out of 124 in the senior class, I think I was like 123, 124, you know I was at the very end of it, but hey, I was still a class president, so I was still having fun. I just happened to love diving and water.
Speaker 2:You didn't go into politics. That sounds like a total charismatic, but just not. No, I believe in.
Speaker 3:Frank Trude. I wouldn't be exactly where to get off the fucking bus Like right now, so I don't think politics were in it for me so at all. But I do have friends who did go that direction. While I wouldn't vote for her if she was my congressman, I still applaud her for stepping up and doing it.
Speaker 2:Yeah, yeah, there is some acknowledgement there. So little birdie told me, if I am not mistaken, you speak more than two languages. Right, You're fluent.
Speaker 3:No, just, I still am fluent in Indonesian. In fact, my number three son, who swam for the University of Texas A&M and was just a phenomenal swimmer he had no idea. He graduated from college and we were down at the coast and the restaurant opened with some Indonesian guys running it Taiyo Sushi, which is phenomenal. But the Indonesian guys were running it and I started speaking to them and he was just sitting there with his mouth wide open. He had no idea that I spoke another language and I really hadn't spoken Indonesian a lot for almost 30 years, 35, 40 even.
Speaker 3:Wow and now I just all came flooded back so I see them all the time. Now I really know my Spanish is just medical Spanish, but Malaysian and Indonesian are pretty close so I was on the language for the hospital Baptist for the longest time I was on the language committee there the help group and only ever used it one time for one injured kid.
Speaker 2:That was it? When I was in, when I was at Andrews, we had I remember this the years ago, I was the second lieutenant and they had somebody that was spoke Creole. That's not not Creole. Yeah, maybe it was. It was a combination of French and Spanish, is that?
Speaker 3:Yeah, and French, french and English is Creole.
Speaker 2:Frenchening. No, this was. It wasn't Creole. God, I can't remember the dialect, it wasn't. Anyways, they were like does anybody speak French or Spanish? I'm like my dad was French. I know some French words and I took Spanish in high school. They're like, close enough. I knew like Caliente and like I knew about like five words in each language. It was no help at all.
Speaker 1:Pretty fluent in French myself, but it usually gets me kicked out of places.
Speaker 2:That's the one. You got to start somewhere.
Speaker 3:You can say a couple of good words in about nine languages. I think you're good, so you know those. Like you know, I worked for a Dutch guy and everybody thought I had long white hair and everybody thought that I was a Dutch kid. So for me I could, you know, half a garment in two sets I could cuss like a Dutchman. So those things always really helped, so that you know nine or 10 languages that you can cuss in.
Speaker 2:Those are always you know it's funny at Morocco. I was in Morocco and you know how. You just that big open area in Morocco before you go into the suks, right? So, yeah, so you know, you, I didn't. So we're there and we're looking around and we're trying to figure out what we want to do, because when you go into the suit you may not come back out unless you have a guide, right, because they're very windy and stuff. So you really have to have a guide with you.
Speaker 2:I was watching these guides and what they would say. They would say, like, hello, do you need a guide? Five languages. And then what they would do is they would watch people and when somebody recognized then they'd come over and speak to them in that language. And it was English, french, because Morocco's French language English French, spanish, German and something else I don't remember what it was, maybe Arabic or something, I don't remember, but five. And I'm like holy cow, and they could. They had enough behind them. It was. It sounds this is gonna sound horrible when I say it, but you associate somebody knowing a lot of languages with higher stature, if that makes any sense.
Speaker 3:You know what I mean Like intelligence when in fact, it's necessity, and some people are more. Yeah, speaks fluent Austrian, of course, german, he speaks French, he speaks Spanish and he speaks English. We graduated from high school together and it was just necessity. Anxiety yeah, interesting. We're the only ones we're very, very isolated as Americans, and we generally don't, which is unfortunate, but we do the same thing when we teach. I'll look and tell my point resonates and I'll find the person that it resonates, because generally, once they start bobbing their head, I can get the rest of the group to start bobbing their head. So, resonation, resonation is really important. And those guys in the market that's a great thing to remember because they were really getting it across. Yeah, that's phenomenal. A lot of people can't see that.
Speaker 2:There you go in the Malcolm world. I kind of had a moment.
Speaker 1:Learn some languages, similar to what you're describing, scotty. At the center I had gone through the 4N pipeline, came out, did OJT, got CDCs knocked out, you know, did the little bit of clinicals, wrote on a rig for a bet but at that point understood concepts. But what you can learn, pardon me from a book is so much different than what you get from that hands-on application. And coming in those doors for the first time was still very, very much shaky and unsure of how to do this right. So I remember middle of lab, I think you were teaching easy IOs and I hadn't ever done one, we just did regular IVs and I was trying to work out like, okay, this is a deceased person, how are we going to? It's just not clicking.
Speaker 1:And I started doing what I do best, which is overthinking, overanalyzing and getting you know spun up in my own head, and my buddy at the time was still is to this day Ruben, hey, man, if you're listening to this, what's up?
Speaker 1:You had called him up and he was inserting an easy IO for moral. And the way you explain things, scotty, just kind of bit by bit dissipated all of that confusion and doubt. And I think that's so important in a training center too, because, especially on the military side I can't speak for the civilian side, but we're used to getting yelled at a lot and if you screw something up you're definitely going to get yelled at and I was like man. I wonder if this is going to be another one of those situations. And I don't really know what I'm doing. And it never went down that route went down that route. So learning how to do new things with somebody who takes the time to thoroughly explain and isn't going to let you leave until you do not, in a scary you're you can't screw this up kind of way, but knowing that you want your students to walk out the door, owning that skill was pivotal, we see we see so many.
Speaker 3:We see FSTs, I see surgeons in asset, I see I see Saust and Ghost and three letter groups from all over. I see deltas, I see PJs, I see all of the civilian equivalents and non equivalents all across the board. And one thing I'm absolutely certain and this comes from a really easy story is there is a young man, this young and, by the way, that's also nurses, paramedics, firefighters, police officers, practical police officers, doctors, nurses, npas, pas, mps, dos everybody yeah Right. So this young man is decided he was going to work for a fire department, joins the fire department. The first thing they do is tell them to go outside and cut the grass. Well, his chief comes in all mad because the kid can't cut the grass. Well, that chief's boss says you know what? The kid grew up in an apartment with no alarm, in a city.
Speaker 3:So how in the hell do you expect somebody who's never seen it to do it? So you can't watch a video and you can't just see. I don't know. Somebody do it, you physically. And everybody learns differently. Some can hear it, some can see it, some can feel it, some need all three, some need a portion there and of.
Speaker 3:But when it comes to critical skills, and I'm talking about all of them, and there are many, many. You've got to put all of those things together. And then the other part that's missing for us. Not only can we break it down into this little itty-bitty task, little like first pick it up how's it feel in your left hand? And I speak right hand, so my language is right-handed, but if I, if you, speak left-handed, I have to be able to show you how to hold it in your left hand. This includes Ivy Capital or other ones. Well, this then distills down into anatomy. There are a lot of people in it. It's not just even physicians, even a physician who graduated from a traditional medical school. Their anatomy is gray over brown when they first start in an embalmed specimen that they spend anywhere from six months to a year on. Well, that brown over gray specimen turned yellow over bloody really fast, and they made that transition over a three-year period, the average medic, average nurse.
Speaker 2:Scott, when you say brown over gray and yellow over red, you're talking about a dead versus.
Speaker 3:I'm talking about embalm. Embalm Embalm specimen is brown over gray Right. So thanks for the clarification.
Speaker 2:So just because there's sometimes there's civilian audiences that they're listening.
Speaker 3:So a physician will work on an embalm specimen first and then go from the embalm specimen into the hospital and then transition their informed understanding, or their understanding of anatomy Looks different.
Speaker 3:The average medic, the average nurse, even the average PA, definitely the average MP. They don't have that anatomy. They don't do it the same way. So if you give them a skill and say like in, we'll use in your case the IO, you want to put it into the bone and it's supposed to magically get into the veins, like the fluid is magically going to get there. But if you didn't understand the connection between the bone and the vasculature, how would you need that connection there? Always a good example thoracic injuries.
Speaker 3:My favorite with thoracic injuries and there are many in your group that will get this the Department of Defense specifically, the Army specifically, fort Sam Houston specifically I could get down to the schoolhouse was teaching bury the needle in the chest. Take a needle, push it all the way as far as you can. It doesn't matter if it's a 3.25, we'll call back the standard. Just bury it in the chest. It is galactically wrong. If I buried a needle in either of your two chests, if I did them on the left lateral side, I will hit your heart. No question about it. Now, there are a lot of people who were teaching that. But we knew in placing chest tubes that you didn't want to stick your kelly's or your roach peens all the way into the chest Things all the way in chest.
Speaker 3:In fact, I don't know. There's this dude named Socrates. Most people have heard about him. Socrates said don't put more than your fingernail into the chest. Yet the Army thought it was an awesome idea to bury the needle. Now there's some wonderful people. Dr Jennifer Gurney is a good example. Colonel Gurney now I just had dinner with her last month. She has been on a worldwide tour saying stop burying the needle. I've only been on that tour for eight years now, so I don't even understand why people still do it. But if I go backwards, how did we get there? We got there because somebody forgot the anatomy. It was really funny In 2017, I got a call from and I can tell his name.
Speaker 3:His name is Colonel Ford Cunningham, a distinguished officer, a phenomenal physician, a ranger, just the nicest guy in the world. So cord calls me on the phone. He goes hey, scotty, do you know how close the heart is to the left side of the chest? And I went fuck, I do. Do you people in the Army know how close it is? Tell everybody to bury the needle. So this conversation has been going on for a long time, but it comes back to anatomy.
Speaker 3:So in our facility and thank you for the gracious acknowledgement. But in our facility we teach anatomy as it relates to the procedure. We do it on a bone specimen and then we do it on specimen that are fresh. They have never been touched, they've never been embalmed, they only recently died and their tissue is exactly the same as yours or mine. So any research that comes out of here and we do a lot and it gets published a lot so all of the data that comes out of here is exactly the same as if I were doing it on somebody who just recently died. So then we have many projects that sort, that and this excuse me, this of course includes all of the orthopedic work we do, the general surgery or the trauma surgery, the urology. All the work we do here at the center always involves fresh human specimen.
Speaker 3:You know I but I have to take them back to general anatomy first.
Speaker 1:It's funny, you, you bring up the ortho surgeries. The last time I was at the center, there was a group of I think there were, yeah VA docs that were doing hip replacements, and that's standard, that's an everyday thing. We had a little bit of break for our class. I was right after lunch and I'm ripped and ready to go, and they're like hey, do you want to come on in? I'm like, yeah, sure, so I'm in there watching learning, have a profound appreciation for the ortho surgeons.
Speaker 1:I didn't know you had to beat the hell out of something to do what they do. It's seriously. It looked like something out of saw. It was amazing, though, and, you know, took that experience, filed it back here and went on about my day fast forward. Several months later, I'm at the VA with my husband, who's getting ready to have a total hip replacement, and it was this one of the same docs that was at the center, and he's like you look so familiar to me. I'm like, yeah, you know you do too, and come to find out that that's where we met one another. He ended up having a surgery.
Speaker 2:Everything went well, but and you were happy that he had training over there.
Speaker 1:Yes, I was thinking I was like man. Thank God I know you went to the right place.
Speaker 3:I think that's. It's kind of like that first minute black, when Tommy Lee Jones leaned over and was asked the question. You know kind of actually was talking to Will Smith and he said you know, five minutes or an hour ago you thought the world was rounded. Five minutes ago you thought you were the only one here. And the quote continues on, or how he says it. But most people just think that surgeons magically learn how to do this hip, for instance, or a knee or shoulder, or somebody learns their first thoracic surgery. They just learn it right there on the human while they're doing it. And it is not that way.
Speaker 3:No it's got a practice beforehand and it's the evolution. So there are new hips, new shoulders, new knees, there's new procedures to get it done. We went from lateral to anterior to anterior, lateral. We have all these different approaches and all of these surgeons. They don't just find one way, they find the right way for the specific patient. So we spend, and it's because of that, because we have ortho as an example, here we cross, pollinate. So you'd be surprised, I teach people how to hammer an IO in orthopedics hammers, orthopedic drills, and orthopedic doesn't manual. So there is a parallel in everything we do, for instance, just in that skill, enterosis. This is one example between orthopedics and emergency medicine. But if you ask the emergency medicine, the average EM physician or nurse, you ask the average paramedic or medic, can you hammer an IO in? And they'll tell you, no, there's no way you could hammer one in. And I'll say, well, I could give you a spring loaded one. That's a hammer.
Speaker 2:So, it's.
Speaker 3:The cross pollination here is critical, especially when it comes to training. So we add up all those fundamental anatomy steps, then we break the skill down in the task, then you fucking do it, and you do it over and over and over, and we do it every day of the week and getting flashbacks to Scotty teaching me okay, hold it right here.
Speaker 1:And he literally. Now we're going to sing a little song like an okay, and I'm just gonna do it manually.
Speaker 2:So question I'm just sitting here listening and I'm kind of smirking because I'm going to date myself pretty bad right now. So way back, I was one of the first nurses to actually take the computer test. When it came out a long time ago, like the NCLEX, yep, yeah, the first. They used to be a two day handwritten torturous. Yeah, I was horrible and it turned into. We were the first, we were like the test run for the computer testing. So I was very thankful.
Speaker 2:But I'm thinking back to our training. You said something that was a little profound was how do we learn this stuff? How do we learn all of it right? And to show you how far we progressed, when I was in nursing school it was actually a liability for us to start an IV on an actual patient. That's, we didn't have a license. If we introduced infection, bad technique, something like that, there would be huge liabilities and hospitals are like, yeah, no, that ain't happening. So your options were we tried on each other or we tried on mannequins and, as you two both know, they suck. They stuck for shots, they suck, sorry, they suck for all of that.
Speaker 2:So when I got out on my own, my first IV I ever did on a person was my first IV I ever did on a person, my first shot. I mean patient, you know my first shot. You know nobody can tell you that a shot on one person is gonna go in differently than a shot on another person, depending on their skin turgor, you know. Are they 85 years old and have that very crap, it is paper? Or are they a young, really fit 25 year old black guy? And I say that because their skin's different than a white person? Right, how you hit that? I've bounced needles off people going what the hell happened, right? So what you're doing is gonna lower a lot of people's stress levels the students, the patients, you know.
Speaker 3:So I ask you and we do it with all the different, all the different densities of tissue you learn how to hold a scalpel the first time that you do a surgical airway as an example, the first time you do one shouldn't be on your best friend.
Speaker 2:Right.
Speaker 3:It shouldn't, and so for us there's great research that specifically points out how flawed mannequins are. It's a nice surrogate and I'm making a little, you know, back and forth motion with my finger here. But it's a nice surrogate to get the skills order down. It doesn't replace actually doing it, because I think working on a human is better. But men are not pigs. As much fun as everybody likes to think that men are pigs, you do something on a pig, it's not.
Speaker 2:Pun intended.
Speaker 3:Yeah, so but doing an animal lab, for instance and I can make a human specimen profused and bleed I can do exactly the same things. Now, I can't reanimate or make the human specimen alive. I can get pretty close. So is there a corollary between working on a human and working on a human? Yes, they're exactly the same. Is there one between a human and a mannequin? Well, no, veins aren't plastic and they're not round. Vains are flat, especially when you're sick, and so we spend a great deal of time de-teaching some of those mannequin skills which are rough, and you have to refine that skill. You need all of it, but when it comes to the lab, you've got to do some real refining.
Speaker 2:And it's order of operation right. Like doing an order of operation, like meaning starting an IV or suturing or putting in a Foley catheter, I think of a thousand things. Right, there's an order of operation. So it doesn't matter what you do that on to learn the order of operation to get that. So, mannequin, yeah, just get the actual, like this first, then this, and make sure your still technique's good and all that. It does not matter what you're doing on the act when the act happens. That's where it matters. I mean, it's really.
Speaker 3:So is there something more telling than that refined skill? So, as an example, if you're trying to anastomose two vessels together, so when you watch a surgeon who's getting a clot out of a vessel and then putting two vessels together, you can't do that on a mannequin.
Speaker 2:No.
Speaker 3:You've got to do that on a human. So all of the asset courses, all of the COTS classes combative epithet, trauma, or any of the surgical classes that we teach all of them are very, very real, which the combination, as I said, just bringing multiple disciplines together. So there's this cross-pollination. Everybody gets to see what the other is doing. That makes a big difference. But I wasn't going to fake it anymore and I flew for 20 years and I can tell you, in big aircraft we had four patients in six crew. I mean, our aircraft was the same as a Heracoy or a Huey.
Speaker 3:What'd you fly on Bell 412s? So, our aircraft were the same as your and I flew in a 60 as well, but the 60,. When they first came out, the Hue model we were the first ones to say that, the little rotisserie chicken thing in the back needed to come out and get thrown away.
Speaker 2:Oh, amen.
Speaker 3:It was an air methods airplane but our Bell 412s were a large aircraft. But I recognized that the skills we had in the aircraft were better than the skills on the ground. And it wasn't because we were some sort of gifted clinical individual, it's because we were exposed to more. I'd be in the ICU or in the OR. I would be downstairs in the lab and then I would get on the aircraft and I would fly to take care of your patient. I'd come back to a big center, either Baptist or University Hospital.
Speaker 3:We were always in some place very, very busy, whereas if you work in I don't know, pick a place, if you work in Jardinton, wilson County, for instance, all of their medics come here now, so they get the very same exposure. So if I wander down the hallway here and this is with Boberti Spring Branch, ems or Canyon Lake as an example if I wander down the hallway here, they have sedatives, aerolytics, ventilators, swanj pumps, they have antibiotics, they carry whole blood. So everything that you fought for in your military career. These men and women have it here. Sorry about that, they have it here, but they have it because they can also walk down the hallway, walk into the lab and they can do their skill and walk right back out.
Speaker 3:Their first past success rate for placing a tube in the trachea is 96% and they had no failures. And I believe they had one surgical airway last year and that surgical airway was a gentleman that there was no way that his airway would. They didn't even try to intubate him because it wasn't going to happen. And so it's a matter of repetition and refined skill. So they are and it's critical, so we built it for that.
Speaker 2:So a couple of things that come to my head. So I was a flight nurse when I was in the military and I appreciate exactly what you're doing, because we were fighting for us to go back into the hospitals to work in the ICU's and the ER's like that, and then go back and forth. But they weren't doing that, but we didn't have that ability. So if we had anything critical, we had to bring a CCAT team with us. So the CCATs were in the hospital and then we were mission managing and anything less than a ventilator we were handling, which was fine. I don't want people to freak out and say, oh my god, they weren't skilled and they were doing stuff. Well, no, we were all very skilled and we were out there taking care of people all the time, but we just weren't at that ICU level that we needed when we needed it. So I'd have to have a NICU team, I'd have to have a critical care team or whatever. So I appreciate that.
Speaker 3:Well, there's a fix for that. We hired ICU nurses and experienced pre-hospital paramedics, right? But a good example and a parallel for your audience. I got a call from he was at the time, he was a light colonel, but Bob Mayberry called me and said hey, could you come to Fort Sam? We got this meeting and we're trying to make a flight paramedic. I said, well, gee, bob, I'd love to, but I'm on duty tonight. He goes no, just come in the morning, it'll be just fine. I said OK, but I mean I'm flying all night long. But yes, sir, I'll be there. So on to Fort Sam. I came, I walked into the meeting, a lot of people in that meeting, and I'll leave all those things off, but there was a lot of rank in there.
Speaker 3:And just the very same second he puts a thing up on the screen and there's a picture of a guy that's in trouble, but at the same time there's the values up there and he turns to the medic who smells like shit and he goes young man, what do you got here? And the kid goes I have no idea what I'm looking at, I don't know, somebody wrapped up in a blanket and I don't know. He seems pretty sick. Ok, well, how are you going to manage him when you fly? He goes I don't know, I'm going to throw him in the aircraft, I'm going to fly him.
Speaker 3:And so Bob goes all right, I'm going to ask Scottie Ballard, to ask, scottie, what do you got? And I said, are those that guy's values? And he goes yep, I said I have a hypotensive hypothermic acidotic patient, the ventilator. I'm going to adjust the ventilator, I'm going to give him blood. This kid's in a lot of trouble here. And I started going through the whole entire list of all the things I needed to do. So then Bob turns to the rest of the group. He goes these are two flight paramedics. You have a flight paramedic that's civilian, you got one that's military.
Speaker 2:We have a problem.
Speaker 3:So that's how the FM. That was some of the genesis behind developing the flight paramedic program.
Speaker 3:But, we also identified the very same thing in the Air Force and we identified the very same thing in other places. A medic isn't a medic, Isn't a medic. And a nurse isn't a nurse, Isn't a nurse Correct. But you can train all of them to do those things and I flew with some. Wendy Bias, as an example, was a phenomenal. She was a 10th cash nurse. Gwynne came back from being overseas and easily jumped right on the aircraft. She was in a really busy cash unit and had no trouble. As an example, I could show you a ton of those examples where either civilian or military nurse walked right in the aircraft sedatives, paralytics, ventilators, syringe pumps, no troubles managing the patient completely. But I can also show you people that are nurses or that are paramedics that cannot walk into that environment, can't pick up a balloon pump, can't augment those pressures or transduce an art line. Those are important things. We teach those things here because they have to be taught.
Speaker 3:Yeah, but there's an evolution. But it all comes right back to me. It came back to. I'm not bullshitting this anymore. You've got to teach this correctly.
Speaker 2:Right, and so it's a very good point that I've said this before nurses and nurses and nurses, that people found that out with COVID. A lot of people I've talked about this in the past. They don't realize that a lot of people were getting furloughed and let go as nurses because they couldn't utilize them right. They needed those finite skills. And this isn't digging on any medics, nurses, visit providers, whatever. It is right.
Speaker 2:If you are living in a remote area and you're going to see other things than you see in the city, you know that kind of stuff. It is what it is. All we're talking about is matching the skillset to the environment that you're going to go into. And when we flew, you know we could get in some pickles if we didn't have the right people. We were lucky. But right after I left flying, then that's when everything really broke out O-I-F-O-E-F. I was there during Bosnia, kosovo, but when the real heavy stuff broke out, I had left flying and that was a whole different skill set that was needed. But I want to turn this just a little bit.
Speaker 3:Before you do that. You're gracious and kind the way that you said that, but I won't be so. There are a lot of systems now where they don't have the exposure that they need to have.
Speaker 3:Yes, I don't disagree, take a helicopter crew and you put them in the middle of nowhere Texas or nowhere America. You expect them to be boiled and capable of doing a skill instead of working in a busy or at least rotating through a busy hospital where they're constantly doing the skill and then rotate back out. You don't get. Skills are very, very perishable. So I can tell you for sure, if you're doing critical care and you don't do it as a matter of routine, you will you will, you're right.
Speaker 3:You got to either walk into a lab or walk into a combination of lab and otherwise. It's not a once a year thing We've definitely had. We've done two research projects. But one specific thing I can think of where you could do a skill for about six months. If you've never done it, you could do it for about six months. But then after six months you can sort of do the skill but you can't really remember why and all sorts of little things start to fall off. But I wouldn't go more than a year without having done that skill as a matter of routine. And that's a in a year is a long time. A critical care environment.
Speaker 2:Well, and it's critical to. I mean, I've worked in teeny tiny hospitals and I don't disagree with you at all and I remember brand new nurse, brand new nurse, and, and the long and short of it is, the lady walked in the door and delivered her baby in her pants, like literally in the wheelchair. The baby's coming out, we're pulling this baby out and we're in this podunk hospital. I am literally a nurse of about a month. My eyeballs are enormous. I am like holy shit, like nobody put this in any of the books right. And they got the baby stabilized and there was a nurse, michelle. This woman to this day was my. She was a rock star. We got the baby in the in the ICU and, putting quotes around, that was like one room. They made a makeshift warmer, got the baby in there and they needed to put A-lines in. They had to.
Speaker 2:Now, as a nurse that was an OB nurse for years, I'm like God dang, you gotta drop an A-line. You got to get this. You got it. You know like in my head Now I know, but at the time I was like holy crap, that's a really tiny baby. What the shit are we doing? Holy shit, I hope somebody here knows what they're doing. And I will tell you it was that nurse, the physician. They were on the phone with a big hospital, dartmouth or something, and they're telling me to drop an A-line telling them how to go through the procedure and the doctor stepped back would was afraid to do it. The nurse stepped up and dropped the line and I was like she was a badass.
Speaker 3:Even something like a UVC or even something along those lines like what we're talking about here. If for us here experience, combining experience and history, you've got to put those two things together. But you can't have. You know, a brand new medic and a brand new nurse and neither one of them have ever cut anybody's neck apart and nobody's ever cut open a chest. Nobody's ever done a thoracostomy thoracotomy interosseous lying. Nobody's ever done a cut down, Nobody's there's always a first If between the two.
Speaker 3:You've never done it. Have all in a human. There's a problem.
Speaker 1:You're leading the blind.
Speaker 3:This is something that we can fix nationwide.
Speaker 2:Let me ask this question, Let me turn this, because this is what kind I want our audience to get at is. I'm sure listening. They're just like, oh my God, like it makes you a little anxious, right, Like we're. We have to learn all this stuff. What do you see?
Speaker 2:The patients not the patients get that medical mindset here. What do you see, as the students that you have and when we say students, folks, we're talking people that are already licensed all the way down to brand spanking new suit, Like he was talking about. Like doctors are coming in learning new hip procedures. They'll come in and work there. They're already physicians, are already orthos. We're trying to learn a new way to do it. We're going to come practice here. When you see all these people come in, how do they respond? How do you see their reaction? Like what is that? That's really the whole point of bullets and blood pans. Like what is it about them? How are they responding? How are they dealing with it? Well, I'm glad you brought this up, so I'm going to give you two stories, and both of them involve military individuals, and I'll tell you neither name.
Speaker 3:So the first one involved a physician who came through the door and was going to do some work on surgical airways and in this particular case he was aligning himself up in exactly the wrong spot. Now you would think brycoid ring, thyroid cartilage in between the two bryco thyroid membrane, no problem, this is a surgeon active duty, lining up in the wrong spot, which my partner, jennifer Akai, who is a gifted anatomist, said you know, in a very soft voice, said you know, you're kind of in the wrong spot. And he said, and I quote I teach thousands of paramedics a year how to do surgical airway. I know where I'm going to cut. To which I said you know that may be true, but you're in the wrong spot there. He goes Well, there could be some anatomical variants. I said no, you're just wrong.
Speaker 3:To which then he lines up in the right place and he goes Well, I'll do it here, but you two are wrong. He cuts in and he winds up on the cry. I remember in places Now in my brain I'm thinking you are a complete dick. Do which. Then he turns around after we're all done with it and he goes to walk out. He turns around and says that is the most humbling thing that has happened to me since medical school.
Speaker 3:Because your stock just went up in my book. So it can happen to anybody. I've had an in Ted Redmond. Colonel Redmond is a story ranger, also recently retired. Ted Ted will not disavow this story.
Speaker 3:Ted identified the saphenous fame as an artery one time and it's okay. But it can happen to you. But now here's the other side of how this affects a student. So you can have a humbling experience that'll affect you as a student and that happens frequently because you think you know something. Then you realize maybe I was wrong.
Speaker 3:Jennifer was teaching something that we do with IV catheters. She was teaching a specific part of IV just following. It was just how to roll the IV bevel over to to keep from lacerating the posterior aspect of a flat vein. But anyway, she's showing this, this young medic, over and over how to do it and the medic is just looking down and then and this is so telling Suddenly this medic who's looking down there's water dripping from her eyes and she goes does that ever happen to you? And I remember I was watching the whole thing and Jennifer looks at her and goes what she goes. Does anybody, when you teach something, does anybody ever have this kind of response to it? And Jennifer was puzzled and I recognized what was happening and I said, yeah, it happens every once in a while she goes. If I would have known this four weeks ago, I got that line on that guy, and so it was such an emotional turn for her that she was crying over the skill, because she was finally figuring out what was fucked up in her head, which is, which is, another one of those moments.
Speaker 3:So you can, you have to have the book, but you also have to have the skill. But combining those two things over a human specimen, you can have those who know everything, and I can give you name after name after name after name of people who've walked through. They know everything. And I begin my class with I probably can't teach this motherfucker a thing To. Then we get toward the end and they're like I just wish I'd had this class earlier in my career. And then you have the people who come in as a wide open book and they're like show me how I can help others. So, either way, we still wind up at the end of the class we had in it. If I'm talking about in a medic or a nurse or a physician's emergency medicine class, we still wind up at the same place, which is oh my god, I can still learn, and that's the big one. It's really hard for people to lighten up enough to believe that they can learn.
Speaker 1:Well, that's kind of in line with what I was I was thinking earlier is you've got the skill, you can understand the task, the algorithm, what do I do, how do I do it. But until you have that confidence and have done it enough times to have you know the self awareness to know I fucking have this, I know what I'm doing, step out of the way, let me do, let me do it, I've got this. That's really, I think, where the magic happens.
Speaker 2:And just I'm gonna add on that, though Let me sorry, scotty, I want to add this onto it because I forget if I don't say it. I have an old brain, but just like you need that point and you've got it. But we're not infallible. We still can make mistakes for a thousand reasons. And I will tell you this happened years ago again.
Speaker 2:Brand new nurse I'm probably like first lieutenant and working at a small hospital and they're going back for a C section. It wasn't my patient, it was somebody else's. I'm in the front doing my thing and the doctor, they come out. No, the tech comes out and says we need a urologist. Stat what we're in a section like whoa, what's going on. So you know you're not asking questions at times, you're just doing yep, got it called urologist, you're all just goes back. I hear nothing for like I don't know an hour or so. The OB doc they get done, ob doc comes out. This is a black gentleman, he was white as a ghost. He sits down and he looks at me and he's like who? That was a close call and I was like what the long and short of it?
Speaker 2:When they had gone in, this woman had had previous surgery on her ureters, typically, as you know where the ureters are. Usually, since the uterus is small, it kind of resides behind and then the uterus grows and then the uterus are back there. Well, these were like suspenders because she had had surgery, had come forward and very rare anatomy, and I remember seeing that like back's rare where they did. I mean it looked like suspenders right, they cut the ureter right. Okay, so that that's bad enough, right, but fixable. Nobody's, nobody's dying. You got to clean it up, antibiotics, we can go right. I mean, you're in sterile, so we're okay. That wasn't the bad part.
Speaker 2:The bad part was when they brought the urologist in and and they had to she did not want to run a stent down to make sure she had the right, the ureter right. She's like no, I got this. She pulled up this vessel, I got it. And and I I'm trying to visualize this I was having a hard time understanding how she thought she only had a piece, not the whole thing. So she says I got it. And the two OB docs are like let's run a stent down through to make sure you've got it. And she at first was like no, no, no, I got this. And so they did?
Speaker 2:She actually had grabbed and I still don't know how this happened, but she apparently grabbed, like the word, like she grabbed the wrong vessel, and of course she was like, yeah, iliac, she grabbed another vessel and it was probably like Iliac, because I'm like E order in my head doesn't make sense, but it was but grabbed another large vessel that if she would have done the procedure, which would have been to cut the end off right to reanastomize, she would have cut that and then that woman would have bled out. We would have been in a whole different scenario, right. So he was just like holy crap, you know and I say that because I'm not saying my God, that doctor sucked. Now that doctor hopefully went back and got humbled a little and said take a breath and slow the fuck down.
Speaker 2:You know, we are human beings and I'll tell you that is the point of this whole podcast. As much as we swear and joke around and act silly and make funny jokes, we do all that to diffuse and to relax people, but we want them to understand. We are bringing people on because we want to talk to them as the humans that are taking care of you. We are human beings. We are not perfect. We make mistakes. We get in our heads sometimes maybe things are going on that led us you know the Swiss cheese effect right down the wrong hole and someplace. So yeah, that that is really what I want people to understand. So when you have these students and I say students as in full practicing physicians and nurses and paramedics and nurse practitioners and PAs, and all of that that right there you are teaching, still they're not coming in to tell you how it happens.
Speaker 3:They come through the door here and, like I said, they usually fall into two groups know everything or ready to learn anything, but we always wind up at the same, at the same point out the end, which is an which, first of all, is incredible appreciation for just how awesome the human body is and how much more it is both resilient and fragile at the very same time. But how much more aggressive, for instance, you could be with a vein than you think. Or, conversely, in the very same sense, that IV blowing when you were starting. It wasn't because the vein was fragile, but it was because you sucked and started an IV was under too much pressure.
Speaker 3:Yeah, you actually can pick up the vessel, either through cut down or otherwise, doesn't matter if you're doing it or not. But if you actually see a vessel, feel it and see your IV needle and your catheter inside that vessel, well then you can appreciate something. It's the same thing airway management, same thing with chest injuries, same thing with lactic or access, same thing with suturing. The minute that you feel the tissues and there are multiple different types with the minute you feel them in your hand or on your fingertips, then you see it differently. And I just said that in a weird way. I said you have it in your hand and you're feeling it, but your brain sees it differently. So we allow everybody to get both sides of that equation when they're working with us, and some of the classes are relatively short, some of them are longer, but what the fun part about it is that that we're not faking it. So I'm not faking it at all and I don't agree with and we have people coming from all over the world. I don't agree with us faking it anymore and I this these classes. We taught them in Washington, we taught them on the East Coast, west Coast, north it doesn't have to be me and we give away 30 gigs worth of all of our gigs. So this is like a long download for most people. We give away all of our information so that people can get their PowerPoints and the materials, so they can realize, hey, there's a better way not only to teach it but also to learn it, but also to do it so and it doesn't have to be shrouded in mystery anymore, it's just here, it is. Let's just do this. But I want folks to run these labs for themselves.
Speaker 3:Colonel Redmond was he took his. The 160th, for instance, is flying specimen in their aircraft. I still see a lot of the. I see all of the 160th here as an example. And Rachel Birdwell was just here recently in the lab and she is. You'll find her in the back of a of an aircraft at the very same time and she's a night stalker. You'll find her in the back of an aircraft, but she'll also walk into lab. You'll find Joe Alder ready. Colonel Alder ready just got done with his military services over at University Hospital now. But Joe Alder ready was one of the very good example of a guy who totally didn't need a cadaver lab. But we're coming here and practice before surgery, so it is. It is one of those. We got to do this, and you're asking about what a student thinks. Well, those are my two good examples, but I have thousands.
Speaker 1:Yeah, yeah, it's a good look, I'm sorry, I was just thinking as a student multiple times. The first time there was a lot of fear attached to even just showing up. Man, I don't want to screw this up. I don't want to look stupid Mm-hmm, I don't want to let anybody down.
Speaker 3:I don't eat all this negative self-talk about which is, which is what gets in the way? Yeah, that is the thing that gets in the way. So for us, for me specifically, we all learn differently, but first of all, it's gotta be. You gotta walk through the door and know that it's okay, because I'm a hundred percent sure you're gonna fuck this up and I'm gonna.
Speaker 3:Yeah you might have to stand up in front of your group while you're doing a skill, but you're gonna unscrew it in your own brain, but we're gonna laugh, we're gonna enjoy it. But you also don't have to have the fear of Arming someone.
Speaker 1:Yes, especially, that's exactly where I was going.
Speaker 3:Yeah, with some of these skills. So we do them over and over and over again. And the human specimens that we have here? They will return it cremated and go back to their families and they donated their body and they are respected.
Speaker 3:They yes if it's a field of amputation, they're gonna get sewn back together, but they're treated like family. But they donated their body so that we won't have those mistakes. I I can't remember, and I've been doing this more than 40 years. I cannot remember my very best call, not even a bit. But I can remember every single moment, smell. I can remember the sounds and the voices of every fuck up ever. So I remember those clearly, mm-hmm. So my job here is to prevent scars, and I'm not talking about the ones that I'm going to put on a human. You're getting my scar. I have met people that I have scarred. There you go. But my job is to prevent scars in young medics, young nurses, young physicians World ones. My job is to prevent scars. This place was built for that.
Speaker 2:That's awesome. All right, I okay, I gotta, I gotta ask this question. You're in a, in a place with a lot, of, a lot of dead bodies, so what's the creepiest or weirdest or thing that that you've witnessed? Like you know, odd.
Speaker 3:Unexpected there's to. The creepiest thing, though, for me is that when we don't utilize a specimen To its fullest extent, like spine, work doesn't get done. You know, hips, knees, shoulders, when everything doesn't get done, that's probably the worst. You guys are fine. That's probably the worst thing for me, but oddly enough, spassman get goosebumps, so as weird as it is.
Speaker 3:I didn't know really you can be working on something and then tissue changes so and you can also produce a specimen and it can go from kind of a paler or even if they're darker skin you can be doing compressions, even automated compressions, or or you can get a blood pressure and you know things can change. So it is a little bit weird to see tissue change in front of you. It's a little bit weird to see, it's a little bit weird to feel a pulse, or a little weird to see somebody go from Sort of a kind of a pale to sort of a perfused look. So those things are a little bit weird. But I mean, I've been doing this a really, really long time but I never underestimate how uncomfortable that can make somebody else.
Speaker 3:Oh yeah, we start really, really slowly as we warm everybody the up. You know specimen are covered. You know there's no here all day myself. There's no Quincy. You know we don't walk through the door, take the sheet off the bed and cut into the head. There's none of that. So everything.
Speaker 2:Quincy was a, a guy who was a law enforcement right, I remember I was a little kid, but that's way before em Z's time like yeah, it was Quincy.
Speaker 3:Everybody warms up. We still have some folks to get a little uncomfortable, but it's very, very, very rare and Usually if they sit down for a moment they're back up and running. And I can tell you there are physicians who who have passed out in their cadaver lab and I know a neuro pathologist who passed out in the lab into a specimen. So I can tell you, oh yeah, it happens to everybody and it doesn't mean male or female, or Experienced or not, it's just your name.
Speaker 2:Yeah, maybe you need that day. Oh yeah, you could have be sick, not eat that day. I mean, I mean, I'm locked in memory.
Speaker 3:If we're doing field amputations and you did a lot of IED work Well, it can be bad. Yeah, it can remind you of things that you don't want to remember. So we're, we're very, very, very careful with that. And now, when I say I, you think I'm talking specifically about About military experience, and I'm not. You know, we've had some folks from Boston here. We've had, you know, we've got, of course, all of San Antonio bomb as well as the EOD from the military. There's a ton of them that come here. So they've all seen it, both in civilian and the military. So we're cognizant of what what people have experienced beforehand and what that might do to you.
Speaker 2:But again, we're here to prevent those really bad memories by giving you some great exposure before you walk out the street. No, no spiritual hauntings. No, my books flying across the route. It's.
Speaker 3:We haven't had anything like that at all and we see about 400 specimen a year. Dang pretty sure that if it was gonna happen, I don't even know go.
Speaker 2:He's like check your spirit at the door. I just want your body getting.
Speaker 3:You know, I think we're all pretty, we're all pretty spiritual here. I mean, I definitely believe, yeah, no doubt about it, but at the very same time I I think that if your soul does something different, at least in my world, yeah, and you know whether, whether we're headed to Fahalla or whether you're headed, you know, to some, some spiritual land somewhere else, or whatever it is.
Speaker 3:Yeah, I'm good with all of that, but I just haven't. I think I Don't see things like that in a necessarily bad way, because I think there's so much respect here. I agree I have not had one person in 12 years do something stupid here, not just because of the law or not just because of guidelines or anything else, but people can react differently if they're uncomfortable. I haven't had even the least little bit thing that was disrespectful here at all.
Speaker 1:I wanted to touch on that. So your spot on, scotty, the level of respect it's I Don't even know how to explain it. I remember coming through and that expectation is made upfront very clearly. You know, we are lucky to have these specimens here. This was a choice and this is, you know, a no-nonsense kind of zone, not that anybody needed to hear it, but everybody was super respectful and I noticed that, especially with the, the pediatric specimens too, which Was kind of triggering for some, for some folks, especially some of the moms in the room. I was super duper pregnant with my daughter During one lab and that was the first time I kind of had to take a step back and think okay, this feels a little bit different this time, but even still, you know everybody's. Just I'm struggling to even put it in into words but incredibly, Honoring of the body yes.
Speaker 3:Yeah, that's a good way of putting it. Yeah, well, I Matters to it's. It's kind of like your serve, both of you, your service to our country. I think a lot of people forget how, what that took from you and what you bring now to the table and experience. And I think the same can be said for a civilian paramedic, a civilian physician, a civilian nurse doesn't make any difference, you know what does somebody bring to the table. So I've got that respect for them walking through the door. I wouldn't have any less respect for the specimen that donated their body. I mean, I have seen fire service specimen come through the door. I have seen what elders I've seen housewives, mothers, daughters, sisters, brothers, I've seen it all come through the door.
Speaker 3:I have a little. You can barely see it but it's actually. I'm kind of pointing at it on my screen. But I've got a little handprint from a little boy named Amalia and that little boy Um his. He was donated to us and I speak with his mother frequently, but he was donated to us and we were able to solve a medical problem because of his existence. His little handprint Point's at East. So when I see the sunrise it rises right by his little handprint. So so, so it's. It's just really important for us to be to be like that. If it wasn't like that, it wouldn't. I just couldn't work any other way. None of the staff that work here could work any other way.
Speaker 1:So much so that I actually I had to go through the process of having a will made. You know one of those last last-minute things with leaving the military and just adulting. Part of my will fun fact actually has Donation specifically to the center whenever it's my time to go, so hopefully it's not during your tenure. I'm trying to be around for a little while, scotty, but eventually you'll have students. I'll get to hang out with them again on on a different side, and that's only because of the way they were treated.
Speaker 3:I always make a joke about it, but I I just want to be laying there on the table someday and somebody looked down and go Dang. I can't believe each dad is he's such, he's so good looking. But he just, he just looks good. Look at his body. So I'm still working on my body so that when I leave it is gonna be.
Speaker 2:They're gonna be like dang piece of art. Can't cut through those abs, man.
Speaker 3:Damn, and we make all of those jokes every time about each other. But yeah, we have some. We have phenomenal specimen and phenomenal families that donate, and the research that gets done here couldn't get done without it. And and it's in every one of our papers not just the thank you to them and to the families, but also to the men and women who just put themselves Into harm's way, and it doesn't matter civilian or military. The minute you decide to step it up, your brain Is is in jeopardy, and so is your body, and and we teach that in a full circle when we're working here at the lab it's a big one. I hope everybody else pulls something like that in as they go through 2024 and beyond.
Speaker 2:Well, I think that's a excellent way to kind of wrap it down. I want to add this one thing, and I said I know Steve Stevenson and he does some volunteer work over there. Oh, yeah, yeah, I know Steve, he is hilarious. He is hilarious. We're going to get him on one day and onto one of the podcasts. Yeah, we're going to be working an hour for that. I know, right, yeah, it's always something.
Speaker 2:But he said something to me and so I'm putting this out to the medical community that if you, you know, especially the young ones, if you guys are thinking about the medical field or you're in process of it, or maybe you know your high school or trying to figure things out, I will tell you the level of training that you get there. And, scotty, please correct me if I'm off on any of this, but Steve had said that people that work at the lab, some of them have considered going on to med school. Some of them have gone on to med school and they actually anatomically and physiology and all that they were equal to probably close to a second year in there.
Speaker 3:Absolutely so. Rachel went last year. She's in medical school in Tennessee and almost skipped her anatomy class. She wound up becoming a professor's assistant in the anatomy class the second she walked out the door. Dr Burkett is a neuropathologist in Birmingham. There are seven now that have gone on to medical school who work here, but that pales in comparison to the high school students that came here that went on to to a medical sorry, that went on to college. Some of them went I am never, ever going to go into medicine at all because they forced me to come here. So that's one or four. I enjoyed this so very much. Now I know what I want to do with my life and I'm headed to medical school, and there have been many of those as well.
Speaker 1:But they know where they stand.
Speaker 3:Medics who've gone on to PA or gone on to medical school. There's two that are in Ushas now and I think they're phenomenal. There have been. There have been emergency medicine guys and girls that have come through the door and turned around and went. I am going to go do a different fellowship now. Yeah, I want to do something.
Speaker 1:And that's okay.
Speaker 3:A lab does, and Colonel Stevenson is correct, and he spends time and money here to make sure that both soldiers, airmen, sailors, have not only a really positive experience but also know that they are. They're fucking loved.
Speaker 3:They can come through the door and they can learn something, but that they have come home and that is a different place. So it is a very safe place here. Doesn't matter if you're law and Border Patrol carrying a gun, Texas DPS, it doesn't matter who you are when you walk through the door here, neutral ground and you're about to learn something.
Speaker 1:They had warm cookies for us. No Warm cookies.
Speaker 2:They're cookies, pizza, they're warming up for the dead bodies. Warm hug If you don't want a hug, you don't want a hug.
Speaker 1:That should be your motto here, we give you warm hugs and cold bodies, and cold beer I want to a lot of the guys.
Speaker 3:it doesn't matter to me, they'll come through the door and I can't specifically speak for necessarily anybody, but some will come in, take a right hand turn and the first thing they do is they'll get a nice cold beer and I'll sit there and have it with them.
Speaker 2:Yeah, they'll have a nice ice.
Speaker 3:I don't care what time it is, It'll be two o'clock in your morning.
Speaker 2:A little road SOTY. So I will say this that, scotty, although you have never been officially military, you definitely have the military mindset and you are setting up a place that I think you just said it they can come home to and learn. So well, thanks, I'll take that as the highest compliment I could get. I do. I think that's impressive. Now I could talk all day, because I'm really good at that. I actually told MZ this podcast. I was going to shut my mouth that I do Okay.
Speaker 1:Oh yeah, this was good conversation. Yeah, I shut up this time A little bit.
Speaker 2:I don't know if I should say too much. That's a big problem. So you got any last words there.
Speaker 1:Mz Scotty, thanks for hanging out with us today. This has been an awesome conversation. I know you're pretty busy over there at the center teaching folks and doing your thing, but we're absolutely grateful that you took some time to share with us.
Speaker 3:It was an honor and certainly a pleasure for me to be with you guys, and I look forward to our next conversation.
Speaker 1:Yes, sir.
Speaker 2:All right, everybody. Yeah, I heard it here. So we have Scali Bolt, scotty Listen to me Scotty Bulleter and he all. Right, name the name. I'm sitting there going as the center for emergency health sciences.
Speaker 2:Thank you there we go Center for emergency health sciences out in Bo Verde, spring Branch, texas. Y'all can look that up and he is the most personable guy and if you can get ahold of him he will talk to you, he will teach you. So if you guys are interested, get out there and check it out. All right, this is Bulls to Bed Pants. We're here, all right, bulls to Bed Pants everybody. Thank you, peace out Very much. And that's what she said. Peace out everybody.
Speaker 1:Thank you.