Prairie View

Wednesday, October 14, 2015

Stories From Class Day

At last week's Master Gardener class, during lunch in a restaurant, I sat with people from the class who reside in neighboring counties.  In the process of getting acquainted, I learned that the lady beside me was an inspector for the health department, and the man across from me was a physician.  Both are recently retired, I believe.

The inspector beside me asked the doctor across from me if he had been involved in any way in an Ebola episode.  That was the opening to the following story, set in a veteran's hospital emergency room in Wichita.

Someone showed up who had just arrived by air from overseas.  He was diabetic and had developed gangrene in his foot.  It needed to be amputated.  He was from Africa, and had recently been in areas where Ebola was present.  Upon arrival in Wichita, because he had a fever and was nauseous, his presence triggered all kinds of Ebola-evasive action.  That's apparently why he promptly showed up at the emergency room.  Complicated quarantine measures followed.

The patient's route to Kansas, however, was very circuitous, and why he came to Wichita is still a little mystifying--except for one little clue that eventually surfaced.  Maybe there was a good reason for seeking out a location in the middle of "nowhere."  He worked for an oil company in Saudi Arabia.  When he became ill, the company bought a ticket for him to be treated in America.  He had arrived in Wichita from Saudi Arabia after stops in London and Chicago, and perhaps other places.

Fortunately, he was not found to have Ebola.  His symptoms were caused by the massive infection in his foot. That was the good surprise.  The bad surprise came when he needed to clarify the nature of his job with the oil company:  Assassin.

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The doctor also recounted how he had come to want to specialize in trauma and injury cases, consequently spending most of his medical career as an emergency room physician.

"I was the only one in my class of 160 at medical school that was paying my own way, so I decided I'd better get as much as I can out of my training.  That's why I asked if I could observe surgeries.  The first time I did that--I hadn't even started med school--things started going bad in the surgery room and the doctor asked me to help.  I protested and said I didn't know anything about this yet."

"You grew up on a farm, didn't you?  You've seen worse than this.  Get over here."

He ended up helping then and helped regularly from then on.

That's one perk of growing up on a farm that I never thought of--having a foot in the door during medical training.  

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The doctor also recounted what happened at the hospital when someone sprinkled white powder in the area and called out "anthrax! "  An immediate lockdown occurred, and a phone call went to alert a designated person at a state agency.

After several hours of cleanup and testing, during which time no doctors, visitors, or patients could leave or enter the facility--creating havoc with the normal functions of the facility, the powder was found to be coffee creamer from the cafeteria.

A similar scenario occurred twice more in rapid succession.  Finally, the state official who was notified each time became a trifle irate.  "Why do you keep calling me?" he asked the doctor who was telling the story.

"Because that's the protocol we're ordered to follow," he answered.  "We know what to do, and if you'll let us, we'll just do it without bothering you."

"Go ahead," he said.  "You're the first person who's ever called me with this problem, and I'm sure you're not the first person this has happened to. And please hide your coffee creamer."

So much for state regulations and official disaster protocols and doctors following orders.

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I asked the state inspector lady if my information was right about what was required in order to make a church kitchen "inspectable" as a site for preparing food to be sold (or, technically, to be served to the public).  She told me that my information was basically correct, but added a few bits of information.  She wasn't quite sure that having an automatic dishwasher negated the need for a three-compartment sink.  She also said that the dishwasher must reach a certain approved temperature in order to qualify as a sanitizer.

Another detail that I had never paid attention to is the requirement that food be kept at a safe serving (or storage) temperature, or consumed within four hours from the beginning of preparation time.  Any leftover food must be refrigerated within two hours of completion.   Serving from a steam table would presumably keep it at a safe serving temperature for a prolonged period of time. Not so for food set out on a serving table or counter.

The outside entrance to a kitchen that I had heard was a requirement was not clear to her as a requirement.  Maybe this applies primarily to cases when it's located on the site of a family home.

She also asked me if our kitchen would be used for canning.  I said I didn't know.  She hastened to add that "it can't be, unless you have retort equipment."*  Relying on my own research and memory from hearing this addressed in a workshop by someone from K-State--and on research Leroy H.  had done on this matter earlier, I said that  my understanding was that retort equipment was required only when canning non-acid foods that required processing under pressure.  (A second requirement for us is attendance at the Better Processing workshop at Nebraska State University) She acknowledged then that she didn't know for sure, and gave me names and phone numbers I could call for more information.

I gained several impressions from this encounter. One, even inspectors don't know everything.  Two, some inspectors are very distrustful of uninspected facilities.   This one said, "I'd trust something from your kitchen [it's possible that this is misplaced trust, although I certainly don't have cats walking around on my counters--as one circumstance she cited], but I never eat anything from farmer's markets or any place selling food I think might have been prepared in a home kitchen."

*Think of retort equipment as "reporting" equipment.  In this application, it keeps a running record of temperature changes at specific times during the canning process.

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