Chapter 3 - City of 10,000 Guns (D.T.)

[jemmus]

Wow! The rules don't say how often a Medicine roll can be made for the same patient. Once per day sounds kind of reasonable. The doctor does the treatment, then checks on the patient's condition the next day to see how effective the treatment was. In this case, I don't think DT thinks there's much that could go seriously wrong. It's a local skin infection, not a gunshot or knife wound or a serious disease, that DT guesses will heal on its own in a few days..

Tom is a brave patient, as country folk tend to be. He eyes the jalapeno peppers, but doesn't say anything as they're applied and begin to sting. DT makes the incision a searches for a trace of the tick's jaws the boy mentioned, but doesn't find anything. If they're there, they would be very tiny things indeed, considering that a tick's whole body isn't more than 1/8th of an inch long. The little surgery done and the wound wrapped, Mr. Dwyer nods his understanding of the doctor's instructions. I thank you for yer help, Dr. Crockett. It ain't often that ya see a person who's not family helping another for free. Have a good evening. Tom says, Thank you, sir. DT can't tell if he means for the treatment, or for introducing the boy to his friends and acquaintances. He decides it's probably for both.

[Thumper]

He eyes the jalapeno peppers, but doesn't say anything as they're applied and begin to sting.
[/quote]

I know, right?
https://www.thecrimson.com/article/2007 ... ve%20cells.

Not a lot of natural anasthetics…willow bark and leaves (natural equivalent to aspirin), and oils from pressed herbs (Rosemary, Peppermint, etc) and cloves is all they had. Capsaicin from peppers can be used to make the others more effective.

[jemmus]

I had no idea. But I've cut up a lot of japalenos for cooking (chili, etc.) They have the double-hurt effect of being loaded with irritant oils and somehow making you want to rub your eyes. A bad combo.... But my daughter says we can't really taste the hotness, it's mild pain we feel. And brain releases adrenaline or something for energy and fight or flight reflex, because it thinks the body is signaling trouble. And the body needs pain suppression for the mind to be able to decide and act.

So to me it makes perfect sense that a hot pepper would be a strangely effective pain killer. The patient's system would be suppressing pain. But, they might have an adrenaline rush and fight or flee. Interesting....

[Thumper]

Capsaicin is gonna hurt!!

My Doctor family tells me capsaicins actually binds to the pain receptors. That’s why it’s so painful hot. But after it binds, it allows a follow on analgesic to enter directly into the nerve…increasing its affect.

[jemmus]

Hmm. That's so interesting. It's always seemed to me that coffee is both a caffeine stimulant and an analgesic at the same time(?)

[Thumper]

I have been corrected by family. While capsaicin/analgesic-analgesic combo is valid medical science, it is newer science (past 20 years). There is only circumstantial and inconclusive documentation of primitive use in some cultures.

[Rex]

So sort of my area of specialty as I am a pharmaceutical and analytical chemist. I have never seen any studies that showed either capsaicin or caffeine have analgesic properties of there own. There are some that show caffeine can amplify or accelerate pick up of an analgesic. It does this with several other pharmaceuticals and alcohol as well. This is theorized for capsaicin but hasn't been shown to my knowledge yet. I am sure their are some working on it, but drug interaction studies are pretty complicated and expensive to do right. Also, why use something that also causes pain (capsaicin) when you already have something that will do the same thing without causing pain (caffeine).

[jemmus]

Interesting. That sounds like pretty complex and challenging work. I remember a friend putting rum in coffee once. She quickly got drunk and a bad caffeine buzz at the same time. She didn't enjoy that at all.

[Rex]

Irish coffee

[Thumper]

Oh, cool! We have someone in the game that’s a true expert…and not relying on my 2nd hand info.

I think we have firmly established that use of peppers as a preparation for anesthetics/analgesics was not historical. 125 years ahead of science and was not a known historical folk-remedy. Though it would theoretically work as a non-clinical folk-remedy solution?

[Thumper]

Irish coffee

Red Bull and Vodka

Wasn’t there an energy drink/booze mix in a can that was outlawed in most states about 15 years ago?

I had to ban consumption of Four Loko in my squadron when I was a Commander in the AF. Guys went crazy with that and had some glove saves to keep people from driving home drunk or hurting themselves on property on Friday evenings.

[jemmus]

Black Russian.
I had to look up Four Loko. Internet says it was banned too. I'm glad that was something that came along after my time.

[Rex]

Oh, cool! We have someone in the game that’s a true expert…and not relying on my 2nd hand info.

I think we have firmly established that use of peppers as a preparation for anesthetics/analgesics was not historical. 125 years ahead of science and was not a known historical folk-remedy. Though it would theoretically work as a non-clinical folk-remedy solution?

Hot peppers of various sorts are used in Ayurveda. Not sure if you consider it folk medicine or not since over a billion people still practice it. I don't think they are used as a pain killer though. More to do with circulation.

I actually know someone who had a minor heart attack drinking red bull with vodka. Bad idea.

A little caffeine with a reasonable amount of alcohol is one thing push to much of both and you can have an issue.

Anacin is a mix of aspirin and caffeine if you ever want to try an over the counter to see how it works for you. If I need to get rid of a headache fast it is my choice.

[jemmus]

Jack Daniels and Coke
It's interesting that different plants produce caffeine (coffee, tea, cola). I wonder what it's biological benefits are for the plants.

[Rex]

No clue, botanist I am not. One of my sisters is though, if I get a chance/remember I will ask her.

[Thumper]

Before departing town for the rail camp for the evening, DT would make three stops.

1) He’ll stop at the Doctor and Dentist’s office, show his degree and Army training credentials, and ask if he can work there occasionally…since he’s an itinerant doctor using Austin as his base. Could he work there tomorrow, (Saturday)…perhaps giving the normal docs a day off?

2) He’ll stop at a store and buy 100 rds of ammo for both his pistol and carbine. He’ll practice shooting outside of the rail camp before sundown that evening. Also purchase a telescope. Deducted

3) post a letter along with a sharp crisp $10 bill enveloped in the page to and posted to the horse rancher in San Angelo from who he obtained his horse, Ajax. That settles his debt to the man.

[jemmus]

The doctor replies, We can always use qualified medical help. It would allow me to visit some infirm and bed-ridden patients in their homes more often. How much do you want per day? The office is closed on Saturdays, and patients wouldn't know to make a call. If you can give me more notice in the further, I can inform the public of the special hours.

Noted about 2 and 3. DT's stocked up on ammo and he's debt-free. The stamp for the letter costs 5 cents.

[Thumper]

It wouldn’t be right to take a flat salary then risk having a slow day. No sir, I believe in earning my way. I’m thinking a production arrangement would be better. Of course you’d have overhead expenses to my manning the office (the building and furnishings, supplies, etc.) ya have to cover plus it’s your shingle. How about we split the visit fees 50/50 up to the $3 minimum visit fee…above that, the particularly difficult cases, remaining fees are retained by me?

My comings and goings might be a bit unpredictable for a bit. But I’d do my best to read ya ahead. Alternatively, I could also do some of the home visits. I have a wonderful horse and would be happy to ride out of town to make ‘em. Not sure how you’d want to handle pay on those.

[jemmus]

That sounds fair enough, Mr. Crockett. Your havin recently mustered out of the Army, you might have more recent experience with gunshot wounds than I do. I have more experience with those than I care to think about, from the War and more recent times. But my patients are getting older, and I am too. I wouldn't mind leaving more of the orthopedic work to someone else and focus more on internal medicine. I have some theories on treatments that I'm testing. Safely and ethically, of course.

As for home visits, there's a horse rancher that I call on as often as I can. Which is not as often as I'd like, because it's a 10-mile ride to his place. Some years ago he was kicked in the head by a horse, and he hasn't regained consciousness since. He's confined to bed, and that causes all kinds of side complications. Muscle atrophy leading to curvature of the spine, bed sores, hemorrhoids, et cetera. And comatose people get influenza, common colds, pink eye, ring worm, et cetera the same as anyone else. The former two maladies can lead to pneumonia for a bed-ridden person. That good horse of yours might be a real boon for preserving the man's health.

[Thumper]

Ok, doc. It’s agreed then.

He reaches his hand to shake on it.

When in town, I’ll either work alongside ya here, spell ya here in the office, or conduct the out of town ranch and farm visits. I think it fair that I keep the fees for the out of town visits.

I’d be keen to learn your treatments should they prove efficacious.

Where is this comatose rancher? I’m heading west of town on Sunday for certain…possibly as soon as tomorrow. Be happy to see him on my way out and when I come back again. Other directions, depending on our plans, I might be able to visit tomorrow. I’m finishing some medical and horse treatment work out at the rail construction camp tonight. So, I won’t know for sure until tomorrow morning. I’ll let ya know then. How shall I contact you in the morning?

Does the medical office have a residence upstairs?

This Sounds like an effective way to “home base” out of Austin for as long as the story centers around here.

DT will try to refrain from referencing his ‘64-‘65 time in the Union Army. Instead, he’ll focus discussion to his time in the Indian Wars. That’ll be his public MO.