Welcome To 2020… Lets Talk Safety… And Prostate Exams?

Welcome To 2020… Lets Talk Safety… And Prostate Exams?

Don’t get squeamish yet, I won’t start there

Monday was my first morning gym session after a couple months of sporadic workouts after work. Most of my inconsistency was due to my own lack of motivation but kicked into high gear when my workout partner, Kevin (first mentioned in THIS POST), transitioned to night shift. As a result, both of us went on a bit of a hiatus. That isn’t really that big of a deal for a couple of guys who’ve both lifted for over 20 years. But lack of discipline will catch up to anyone eventually.

Since neither of us are under the illusion that we’re still in our 20’s, we took things easy that morning. Not everyone in the gym is as wise (or old) as us, though. So, as we set up for some light squats I glanced over at the three guys in the rack next to us. They probably weighed 180 lbs combined, yet had their loaded bar with 405 lbs. I watched as the first of them got under the bar and unracked it. Then he staggered backward to a box behind him to risk his life for some box squats. I’m sure I was frowning at him the whole time (or as my wife says, using Resting A$$hole Face). My disapproval turned out to be warranted, though, because when he sat down on the box he COULD NOT stand up again. Nor could he figure out how to get his arms off the bar behind him in order to dump it without dislocating something. The trio hadn’t set their safety bars high enough either, so any attempt to fall forward or backward would have been disastrous.

For a few tense moments, he and his “bros” wrestled it back to the rack just before (I assume) his spine collapsed or he soiled himself. It was scary and cringe-worthy. But… he didn’t die.

Everyone needs an exit strategy

People in gyms are easy to pick on. I typically don’t because I realize very few aspire to be elite athletes (and I’m not a complete d!@#). Good on anyone who pursues better health and wellness. I can’t look down on that. But, I’ve observed that very few enter a gym with a for plan their exit. And, by exit, I don’t mean returning to your car after frolicking on the treadmill for 30 minutes. I mean figuring out what to do when things go wrong before they do. How will you dump that bar that outweighs you three times over? How will you drop the weights that are forcing your shoulder out of it’s socket?

Safety is uncannily similar. We’re often so focused on what has already gone wrong that we’re blinded to the failures of the future. Thus we fail to plan our exit. But that’s where the money is.

What part of your process could create real chaos?

How much of that chaos can you control before it gets out of hand?

The answer may surprise you (and no, you can’t control everything).

How misguided are you?

I’ve told the story of my ill-fated hospital visit in 2016 before (see THIS POST if you missed it), so I won’t rehash all of it now. But the most memorable point of that 36-hour ordeal was laying in the ER bed shortly after being told I would be admitted to the hospital for Atrial Fibrillation (a heart condition). While waiting for my new room, a doctor walked in and asked me if I was ready for my prostate exam. Since I consider the heart and the prostate to be two distinctly different issues, I thought he was joking.

HE. WAS. NOT.

In the years since that event I’ve reflected quite a bit. It occurred to me somewhere along the way (ahem… IMMEDIATELY) that getting a prostate exam for a heart condition was a bit… misguided. I realize I’m not a doctor, but nothing in my WebMD searches has led me to the conclusion that I needed that particular “probe” at that moment in time.

You might not be making the same connection I am, and I fully understand that. I didn’t reach this conclusion through the use of any logic. It simply occurred to me while watching the gym bros that I never want to go to the hospital again and get an unexpected cavity search. So, being twisted as I am, I related all of that back to safety. That got me thinking about all the plans we make (or don’t make).

Reactions only get you so far

In the gym I plot out my activities. There’s a plan for execution, a mental thought process before executing, and a contingency for when things go wrong. Safety should be the same, yet too often we get stuck analyzing incident rates and trying to identify root causes for sprained ankles. Those things deserve some attention, but I would submit to you that your time is better spent planning work.

If we’re good at our jobs it seems to me that good planning, and a clear exit strategy should result in less need to analyze those rates we all seem to love.

Lastly…

My final point is this: Don’t give your safety program a prostate exam (figuratively speaking), when it has a heart issue. Practically speaking all that really means is focus on the real issues that are causing big problems (or have the potential to). Most likely those big problems aren’t bumps and scratches. Take care of those by all means, but look deeper.

What is out on your site that could kill someone today? If you don’t know, find out. Then do something about it.

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Safety Is Uncertain

Everything is actually

In late 2016 I had just passed all of the lab work required to obtain a new life insurance policy. My numbers were perfect and I was in great shape. I was less than a year past my unsatisfying attempt at competitive bodybuilding. And while I had given up on that dream, I hadn’t given up on the training and discipline of the craft.

On November 16th, I woke up early feeling queasy. It wasn’t terrible, but I wasn’t able to go back to sleep. So I went to work. By 9 AM my stomach was cramping so bad I knew something was wrong, so I told my boss I was heading to the doctor. On the way I called my wife and told her I thought I had a kidney stone (not that I know what that’s like, I still haven’t had one). She suggested that I go to an ER just in case I needed some kind of test a quick-care couldn’t offer.

The next 36 hours made me seriously question the cost of medical school

When I got to the ER, the triage nurse took my blood pressure and it was sky high. She set off all the alarms and immediately called in the doctor (by immediately, I mean an hour or so later). When he walked in I was curled into a ball trying to hold my insides in.

“Alright, Mr. Maldonado, lets get this prostate exam done,” he stretched a pair of exam gloves on as he completed that statement nonchalantly.

“What?” I rolled over and glared at him.

“Need to rule everything out,” he replied.

“Seriously? For stomach pain?” He didn’t flinch. “Are you joking?” He wasn’t…

This is a long story, so I’ll just hit the high notes

After that first unsuccessful “exam,” they hooked me up to an EKG (also not a freaking stomach test!). If you were in that room at the time, you would have thought the world was imploding. Apparently I was in what’s called Atrial Fibrillation (or AFib).

“We’re going to have to admit you, Mr. Maldonado,” my nurse explained. “If you’re in AFib longer than 24 hours, you’ll be at extreme risk for a stroke.”

I’ll skip the witty banter that occurred after that statement, but the long and short of it was that they could “shock” my heart back into normal rhythm. The only problem was that the ER (it was a standalone facility) didn’t have the equipment to do it.

So I got a super-fun $50k ride in an ambulance

When I arrived, the stomach cramps hadn’t subsided at all. The staff at the hospital hadn’t even gotten the message that I had come in for that. When I told my intake nurse, I was informed that they couldn’t give me anything for that pain because the cardiologist needed to evaluate my AFib first. As it turned out, I had a quite a while to ponder my situation and realized I had felt this way a handful of times before.

At 7 PM (almost twelve hours since I’d begun feeling off), I was finally visited by the first cardiologist. My wife and kids had arrived shortly before that and I was doing my best not to alarm the tiny humans. The pain was making it difficult, though, and I didn’t need to tell my wife out-loud that I was agitated. The doctor did not help. She had a thick Eastern-European accent and zero bedside manner.

“You’re a very big boy,” she said without introducing herself. “You’re not doing anything silly like creatine, are you?” I glared at her without answering that ridiculous question so she continued. “What’s wrong with you, then?”

I explained the whole sequence of events and then told her about my revelation that I had felt this way before.

“It’s happened a few times. I didn’t know what it was, but every time it’s happened I went to sleep and woke up the next morning feeling normal,” I explained.

“That’s not possible,” she dismissed my evaluation and then dismissed me, looking up at my wife. “Is there anything you would like to tell me? Sometimes they forget.” The doctor pointed at me as she made that statement.

Umm… Nurse, that’s “normal,” isn’t it?

For the next seven hours I battled back and forth with the hospital staff about my condition. I insisted that it was going to go away on it’s own, they insisted that it wouldn’t. From there the argument transitioned into my endless requests to fix the AFib and their insistence that they needed to “run some tests first.”

Around 3 AM I finally got some medicine for the stomach pain and drifted off into sorta-sleep. Then I felt the snap. At 4 AM on the nose I was jolted awake by a new feeling. I was exhausted, still a bit queasy, but… better. I looked up at my heart monitor and I could no longer feel the palpitations. As I squinted through the medication haze I squeezed the call button. A few seconds later the nurse walked in.

“That’s normal, isn’t it?” I asked as she walked up to my bed. “I guess you can’t do your tests now.”

They never figured it out

I was stuck in that bed for another 24 hours before I was released. And only then because I threatened to sue them for malpractice if they didn’t let me out. It felt like prison. But I can understand why they didn’t want to let me out. No one likes not knowing.

There was no medical reason for my being there. None of the numerous tests (there was a CT and many other in addition to the prostate exam) showed anything abnormal. Other than the fact that I felt like I was dying, I was normal.

As much as I despised the staff who “treated” me (still do actually) over those 36 hours, I understand their frustration. It’s one shared by every safety professional out there.

We’re not the gods we wish we were

We can’t control everything because we don’t understand everything. That’s a sobering reality. And it’s especially hard to cope with when something bad happens. But it doesn’t mean we stop trying. It just means we have to accept that all risk cannot be removed. The best we can work toward is creating a system that reduces those risk’s impact on people rather than believing the false dogma that we somehow have the power to eliminate all accidents. Anyone who believes that is possible is lying to themselves or (even worse) to everyone else.

As I was thinking about that event yesterday, it occurred to me that it changed my whole perspective. Prior to that day life seemed like a foregone conclusion. Now I don’t see a future. Don’t get me wrong, I’m not making a veiled cry for help with that statement. I just realize that there’s no grantee I’ll grow old and get to see my kids experience life. No one else get’s that certainty either. With that realization, it becomes all the more important to manage the risks we deal with on a daily basis. When you do, though, just remember you’re human. You’re not going to manage (or even see) them all.

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