Category: You have to be kidding, right!?!

Our hero was north of 400 pounds. In the place where I learned my trade, we’d call that four Mississippi Units. He was a big boy but not the biggest I had seen … not by a long shot.

The man waddled into the emergency room under his own steam. At first brush, he honestly seemed unhurt. Then, he turned around and showed me his shirt. The right aspect of his back over his shoulder blade was soaked with blood. I got him to take his shirt off, put some pressure on the wound, and got about the business of figuring this all out. Along the way, he told me his story.

Just Minding My Own Business …

They all had the same tale or some variation thereon.

“There I was, sitting on the front porch reading the Bible to my blind grandmother when Some Dude jumped out of the bushes and busted a cap on me. He was wearing a hoodie, so I couldn’t see his face, but he was packing a GLOCK 9.”

Repeat as necessary.

If the cops could apprehend Mr. Dude, the crime rate in our little corner of hell would plummet precipitously.

In this case, the guy was supposedly just driving along when he pulled up to a stoplight and was accosted by a total stranger. Now, I was born at night, but not last night. Were I to hazard a bit of conjecture, I’d guess that he took part in a drug deal gone bad. That’s what got most of them.

Anyway, the two men exchanged words, and things escalated. Then, my new buddy hit the gas. He had enough sense not to hang around amidst such fulminant percolating drama. His roadside buddy decided to seal the deal with a single 9mm Parabellum ball round.

Shop Talk

Talking guns with shot-up thugs was actually one of the bright spots of my time in an urban ER. They were all rank amateurs, but they spoke the language to a degree. Hi-Points were ubiquitous, and GLOCKs marked the Thug of Distinction.

A GLOCK that had been credibly taken from a cop was enough to fill one’s dance ticket any place two or more criminals formally gathered. I only heard of that once. As this was in the early aughts, the criminals in my hood had not yet discovered the joys of the homebuilt AR-15 pistol or the Draco.

Long guns were mostly SKS carbines and illegal cut-down scatterguns. Interestingly, not one shot-up criminal who told me about the sawed-off shotgun they kept back in their crib knew anything about the barrel length restrictions imbedded within the National Firearms Act of 1934. To have even asked would have seemed insane. Methinks there might be a message buried away someplace in that, something deep and timeless, perhaps.

Once they secured their Gat, they had to feed it. Ammo was and is expensive. They didn’t much care about details so long as it went bang. That meant cheap FMJ ball. Think Winchester White Box or the imported Russian steel-cased stuff. Just blasting bullets to us.

Performance Anxiety

Never underestimate the penetration capability of 9mm hardball. There is a reason most tactical teams use rifle-caliber carbines rather than pistol-caliber subguns these days. Believe it or not, those zippy little 5.56mm rounds don’t generally punch as deep through drywall as do 9mm pistol rounds. That’s counterintuitive but nonetheless real. My new lumbering pal was a great example of physics in action.

This particular 115-grain Full Metal Jacket bullet penetrated the steel trunk of his ghetto sled, bored through the back seat, followed subsequently by the front, and finally found a forever home in his ample back fat. The man actually told me he didn’t realize he was shot until he got home, crawled out of his car and noticed all the blood. He claimed the wound was literally painless. How weird is that? He then got back into his hooptie and came to see me. By the time we met, he was starting to get a little bit sore.

The wound was superficial, though it likely would have been through and through for a skinny guy like me. His X-rays were fine, and the bullet had not reached anything important. If I remember correctly, he left with some antibiotics, a tetanus shot and an outpatient follow-up with the university surgeons. The guy was in and out in a couple of hours. Just another day in paradise …

“Doc, I have sinus,” says almost everybody. At that point, I typically smile and inquire about how long someone has felt bad and explore the sordid details. However, “I have sinus” is kind of a nonsensical thing to say if you really pick it apart.

Sinus is a Latin word. Literally translated, it just means cavity or empty space. All normal people have scads of sinuses. In the head in particular, you have eight — two pairs of four. These eight empty spaces accomplish some of the most amazing things.

Anatomical Details

Your head is really heavy. I’ve actually had the pleasure of hefting a detached example myself. By incorporating these eight empty spaces into the design of your head, God made things considerably easier on your neck.

Your sinuses act as crumple zones for your face, not unlike those of a modern car. When real people get hit in the face it is not much like the movies. The thin, brittle bones of the sinuses and face crunch in on themselves to protect sensitive stuff like your brain and eyes.

Your sinuses serve as antechambers to your lungs. The air that goes into your lungs needs to be clean and warm. Your sinuses take care of that for you. Were it not for this pretreatment, the sensitive tissues of your lungs that facilitate gas exchange would be forever infected and subject to thermal irritation.

That’s actually asking quite a lot. Room temperature air is typically 70 degrees Fahrenheit and 35% humidity. Four inches later, the air headed into your lungs is at 98.7 degrees Fahrenheit and 100% humidity. Your sinuses do that for you, and we don’t even think about it.

To accomplish that mission, your sinus linings are forever secreting mucus, the voluminous, slimy snot that is so delightful in a three-year-old with a head cold. In fact, to process some 20,000 liters of air each day, your sinuses produce roughly half a gallon of snot.

Once that slick, slimy stuff is corrupted with bacteria, fungi, sloughed-off dead skin and good old-fashioned dirt, you simply swallow it so your stomach acid can render everything digestible. Half a gallon. That sounds gross because it is. However, it’s also all pretty normal.

Now Things Get Weird

So, you actually have two separate noses — one on each side of the midline. Each is entirely independent from the other. One of the more frustrating aspects of a typical cold, flu or COVID-19 is nasal congestion. You won’t believe where that actually comes from.

When your head is stuffy, you’ll never actually blow that stuff out. The inside of the sinuses is lined with highly-vascular erectile tissue, not unlike that of the male penis. Don’t think too hard about that. It is this mechanical swelling, not excessive snot, that typically creates the head stuffiness.

The opposite sides of the nose actually become engorged and then relax rhythmically as part of normal everyday life. ENT doctors call this the nasal cycle. At any given time, one-half of your nasal passage is typically kind of sealed off and shut down. If we aren’t sick, we typically don’t notice. Nobody is really sure why this happens, but cats, pigs, rats, dogs and rabbits do it as well. If nothing else, it allows half of the nasal system to rest at a time.

Medical Manipulation

Many nasal decongestants don’t actually work. Steroids and Sudafed are fairly effective, but phenylephrine and menthol like Vicks Vapo-Rub … not so much. Menthol actually tricks your sinuses into believing the air they are passing is cold when it really isn’t. That lets you perceive that your stuffiness is better even though the bogginess of your sinus linings and the caliber of the air passages aren’t much different.

Afrin is topical epinephrine. That stuff works like a champ to decrease sinus engorgement and open stuffy sinus cavities. When I used to fly Chinook helicopters to the top of Mt. McKinley, Alaska, back when I was an Army pilot, we always flew with a bottle of Afrin in our helmet bags.

If you were coming down off the mountain at 20,000 feet and found that you couldn’t clear your ears and sinuses, Afrin would reliably do the trick. The same stuff works well if you have trouble with ear pain on commercial airplane flights as well. The problem always seems to be on descent, seldom while climbing.

However, Afrin is also profoundly addictive. It’s not heroin or fentanyl addictive. It is simply that after a couple of days of regular use you won’t be able to decongest without it. Another couple of days and you won’t be able to decongest with it.

Ruminations

So, why all this jabber about sinus problems in my weekly GunCrank column? I have long asserted that the best way to clear your sinuses is to stand alongside someone firing a Russian AK-74 on full auto or, even better, a Barret M-82A1 .50-caliber rifle.

The blast from those superb muzzle brakes angling out the sides will indeed reliably clear your sinuses. However, if you don’t have one of those awesome rifles handy, you might want to try a little Sudafed. While you’re at it, just take a moment and appreciate the amazing functions of the humble sinuses. Despite being slick, slimy, warm and gross, they’re also actually pretty cool.