I was recently at a conference of stroke physicians and emergency room physicians. We were talking about the grim reality of emergency medicine and the calluses covering our personalities after years of being on the job. As is often the case in such circumstances we told war stories. I literally heard a story that I could have told. An ER employee was talking about a patient who was an indigent patient living on the street. As the story goes the patient was septic with no obvious cause of the infection. The physician ordered the patient’s shoes to be removed and feet cleaned and examined for the source of the infection. An overwhelming majority of emergency personnel know that this is a big and unpopular job. If this blog were a story within “My Ambulance Education” I would likely use some emotive characterization of the smell of the feet being a cross between rotten cheese and road kill, but I think that is not necessary here. The story that I heard is that the three people who would normally be tasked with doing this did Rock – Paper – Scissors to decide the loser who would be cleaning the feet of this patient. I laughed hysterically because I had been in the exact same situation and in my case we flipped a coin and loser got the job. These two stories occurred over a thousand miles apart with 20 years having passed between them, but some parts of medicine have not changed.