“I slipped and fell in the shower.” It was 3ish a.m. in the morning. The fluorescent light of the triage area was losing power or something because the light kept going intermittently dimmer. I realized it wasn’t the light, I was falling asleep. For those of you that don’t know the soul crushing atmosphere of an emergency room triage area, just imagine dying and being sent to hell. And everyday, damned people will come up to you and relive the worst days of their lives. Constantly feeding you with every complaint, every pain, every problem and your head is in a vice-lock so you can’t look away. Your eyes are held open by those creepy metal claw things in science fiction movies where a needle drill comes slowly within a millimeter of your eye. It’s kind of like that. But we do it because we care. And we also don’t want to get sued by the patient or shamed by our peers and the administration for missing an emergent medical condition. So yes, my eyes focus back on this patient that fell in the shower. Initially I assumed some kind of head trauma so I asked them the annoying pain questions, “On a scale of 1 to 10, how bad is your pain?” I glance back at my computer screen to start documenting as they answer, “10”. Yeah… right… For you non-medical people, a 10 is THE WORST PAIN IMAGINABLE. So unless you have the imagination of a pet rock and you’re not coming via ambulance with tourniquets in place, you can see why nurses have a completely different perception of 10 than you. It’s nothing personal. Our experience in an emergency department that treats car accidents, gunshots and meat grinder incidences, is probably a bit more than what you would experience in the suburbs. Next question, “Where is your pain?”, the hesitation and awkward inflection in their voice suggested they were about disclose something I definitely wanted to hear. Sure enough as I opened the chart to document, I see the chief complaint “Rectal FB”. The sleepiness instantly dissipated as the only entertainment available in this hell comes from moments like this. ‘FB’ is shorthand for “foreign body”. Putting two and two together, my interest in this patient was suddenly piqued. At this point, the questions are irrelevant but wanting to know more, I continued to ask, “What did you fall on?” Either way, we’d be able decipher the object in an x-ray shortly. The x-ray results always draw a crowd of medical professionals around the screen attempting to decipher the meaning this mysterious hieroglyphic. The winner of this competition would be the one whom guessed correctly once the treasure was excavated. After the bringing the patient to the room as they waddled awkwardly in slow motion, it drew a slight curiosity of the staff and I couldn’t wait to give report to the nursing station. Seeing their glazed eyes and tortured spirits, I make every effort to help them cope through humor that some may consider dark. “I brought you guys a special anniversary into room 12.” Like snapping a person out of hypnosis, everyone pauses and turns their heads just itching to know what this unfamiliar term means. “Special anniversary? What’s that?” To ensure I achieve the full effect, I maintain my flat affect and monotone voice in a ‘oh, you didn’t know?’ seasoned nurse type of attitude. “It’s when your marriage gets kind of dull so you decide to experiment to spicen things up.” After a short pause to let the idea simmer, I drop the hammer back for the punch line, “It’s a rectal foreign body.” Ohhhhhhhh… then separate childish conversations erupt in unison filled with giggles and sheepish grins. Seeing the life come back into their eyes, my work here is done. I walk back to triage with a renewed spirit so I can tackle the next 87 patients only to put them in a waiting room where they will wait over 24 hours to see a doctor. My only salvation is the thought of a coworker filling me in on all the glorious details about the special anniversary at the end of our shift.
Wait, why am I telling you this story? I was an overworked, burnt out E.R. nurse that worked nightshift. After years of being an emotional punching bag, second-class healthcare worker and patient slave, I have had enough. It was time to leave the security of employment, health insurance, pensions and 401k’s. After seeing what rock bottom looks like in the E.R. and despite not being the brightest crayon in the box, I decided I was definitely smarter than those patients. I assured myself I would never let it get that bad. Boy was I wrong about that. Before you decide to read further, I want to be clear that I am not bashing the nursing profession. I believe that nursing is genuinely a profession of the heart and suffers from academic ridicule because emotions cannot be quantified or measured. This is what made reading nursing textbooks an arduous process and I understood why other professions mocked their doctorate work as a joke. It is more of an art than a science and if you are a nurse that loves your job, it was your dream as child, and patient care brings you fulfillment, then this post probably isn’t for you. Don’t get me wrong, my coworkers and mentors have taught me how to care for someone when no one else will and the meaning of that act. After almost a decade into my career, I recognized the people I wanted to help most were my coworkers. It was painful to watch them become a victim of the environment they spend most of their waking lives in. I believe I can help them by choosing to walk the path less traveled and writing about those experiences for those of us that got into nursing for different reasons than helping the public. If you are one of those people, do not be ashamed. The silver lining that I noticed is that the nursing field suddenly got an injection of bright and capable people that have the potential to be the best in other fields. We need to find where their gifts can best be utilized. This is a time for new ideas, new nursing theories, and learning from highly controversial topics that we are facing in the Information Age. Case in point, how I leveraged my medical knowledge to find a product I could sell on Amazon. The entire process both shocked and depressed me because I approached it the same way people learn new languages, with all the bad words first.
My coworker and I get breakfast as both the only meal we were able to eat that shift and as a decompression session for mental health reasons. “So… what happened?” anxious to get started after ordering my pancakes, sausage and eggs over easy. With wheat toast. Their expression lights up and you always have to prepare when a nurse is about to tell you a story because we are kind of immune to the grotesque nature of our work. We relive the moment to the extent we completely disregard our present surroundings and those eating around us. Shortly after I had given report, they prepared the room for extraction. This process usually includes a full team of: residents, attending, respiratory therapist, pharmacist, nurses and support staff preparing for a conscious sedation. You may be wondering why the hell are there more people present in a procedure where a patient is awake than in an actual surgery. One reason, Michael Jackson. Propofol is a medication commonly used in these procedures. Once the public realized people can abuse and die from it, the people that pay the price are the ones who were doing correctly in the first place. Anyway, just a gripe of the administrative hoops we must jump through just to save this patient from “a hairspray bottle!?” The x-rays confirmed an aerosol container completely inside the rectum past the full length of the sphincter we call “the point of no return.” I’m not sure how much experience you have with anuses, but after a few digital disimpactions for constipated patients, I’ve deduced that distance to be approximately two-thirds of a finger. A distance where it is possible to retrieve an object if it does not possess a safety string or other leash of that nature. “What did they end up using?” inquiring about the medication decision. To my surprise they used a new machine the hospital just purchased that dispenses nitrous oxide, also known as laughing gas. What a perfect medication for this story. My experience with nitrous oxide had been with one sucking on whipped cream bottles in the store as a deviant youth for about 15 seconds of lightheadedness wondering what the fuss is about. Later in life, that practice graduated to purchasing the whipped cream chargers themselves and filling balloons at parties of questionable integrity. The goal was to inhale the gas and hold your breath while attempting to play a game requiring some level of hand-eye coordination with the round ending when you exhaled and become overcome with a brief but intense euphoria and laughter. Sheltered people don’t typically have experiences like mine. Residents generally meet this criteria because they spent the first quarter of their lives focusing on becoming a doctor. There was no time for tomfoolery. Like most doctors that are in residency, they had no idea what they were doing but the concept using nitrous oxide in the procedure was exciting and novel. They also don’t mind learning on patients with medi-cal. Thus, the procedure commenced. The difference between the recreational use and medical use of nitrous oxide lies in the oxygen content. In medical, we typically mix the nitrous oxide with oxygen so we don’t suffocate them to death. They had the patient assume a doggy-style position on the gurney which I imagined to be a hilarious scene to see. A room full of medical professionals, a patient bare-assed on all fours in the gurney, while inhaling a gas that makes them giggle uncontrollably. I was told the patient became aroused during the procedure. TMI. After several failed attempts with an odd collection of surgical tools, the can was just too large in diameter to force back through the point of no return. “Oh I forgot to mention, the spray bottle… had no cap.” My face contorted at that visualization and failed to see the pleasure from that kind of sensation. Oh my virgin ears. Long story short, the patient had to go to the operating room to have it surgically removed only to come back to the E.R. years later with the same complaint, different object. These patients never learn.
Fast forward about 5 years later and I just attended a free seminar on how to sell things on Amazon using their (F)ulfillment (B)y (A)mazon service. I’ve sold things on eBay in high school so how difficult can it be? After being shilled a collection of info products, a book, and software program, I decided to save my money and learn things the hard way. It was too hard so I spent a ton of money on info products, books, and software programs I didn’t need. In order to cope with initial failures, I recalled that special anniversary to cheer me up. Bingo! It hit me like the enormous bowel movement that must have occurred after that surgical extraction. A quick search on Amazon and using one of my many sales statistic softwares, I finally found a product to sell: whipped cream chargers. In case you forgot, whipped cream chargers are filled with nitrous oxide. It was perfect because it was cheap, consumable, addicting, with high profit margins. This is probably the same line of thinking that tobacco companies had. All I saw were dollar signs so I went to work. It turns out that the existing listings at the time failed to have that magic badge, the “Prime” badge of consumer trust. Because nobody buys things that aren’t Prime, unless you’re my partner who just buys everything with no regard to the country of origin. So I had my business plan, had my sales projections, profit margins, and I just had to figure out the other details like where do I buy it? How can I get the prime badge? I was motivated. I had no idea what my mind was capable of until I started this process. Every step was an obstacle that appeared before me that was larger than life. Stop signs everywhere I went so I changed my thinking. With every obstacle I clear, I gain a distinct unfair advantage over all the other normies that had the same idea but gave up along the way. I pushed forward. After several listing rejections I had to stop and rethink my strategy again. Amazon does a good job of not telling me why they rejected my listing citing vague violations of policy. It was then that I started to visualize Amazon as this mystical creature. Each part of this creature served a different purpose to the whole and it was here that I exposed the greatest weaknesses of a company that is in my opinion, too large. When you have a vertical chain-of-command organizational hierarchy like in big business, it’s the responsibility of the grunts and middle management to filter all the BS that tries to go through their system. It’s a system with flaws. I know this because there was at least one listing for whipped cream chargers that had the Prime badge. This was that Bannister barrier phenomenon working its magic, it can be done. I just had to believe.
The biggest challenge I faced was with the MSDS requirement or material safety data sheet. This is like a fifteen-plus page document with all the legal chemical mumbo jumbo for storage and transportation. Apparently, I discovered after rejection #4 that their concern was with the fact that: (1) they don’t like the name ‘nitrous oxide’, (2) they don’t like things that can explode, and (3) they measure the flammability of a product by the oxygen concentration. I had no idea what terms or numbers I needed to use so I figured the contents were reasonably close to normal air which I googled at 78% nitrogen and 21% oxygen. Presto! Using the term compressed air, making it non-flammable, and giving the approximate contents expressed in air percentages, my listing was approved for FBA. I’m not a freaking scientist nor do I have tools to measure percentages of gases in the air, but I wet my finger, pointed to the sky and gave it my best guess. Apparently it was good enough, ethics aside. Now the tricky part, where the hell do I get whipped cream chargers to sell? I know what the retail prices were going for but I needed wholesale prices. So I emailed a few sites asking about distribution and I received a favorable response that had very loose definitions for their resale requirements. They said they can sell it to companies that produce medical equipment, which at the time I was technically working on in my mind. So I figured I met this requirement after sketching a few ideas on my notepad to ease my conscience. The thing I realized about business is that it’s all up to interpretation. We live in a country that is defined by private and public contracts. When you enter into one of these contracts and convince someone that your paperwork is legit then it’s fair game. I purchased 10 cases delivered to my residence for about $1600. This was about 250 units that I was planning to sell at $25 each for a total revenue of $6250. Amazon FBA takes a third in fees (you need to able to sell something at triple your cost to be profitable) so I’m left with a sweet $4125. That’s a 250% return on my money. After working some UPS magic with the size and weight of the boxes, I was able to get freight pricing for small parcel delivery (SPD) sized shipments directly to Amazon’s warehouse. This magic greatly decreased the cost of goods sold and increasing my profit margin. After slapping Dymo FBA stickers on all the products, they had me ship the items to some “hazmat” capable facility where it sold out in less than a month. Coming off the high of my business genius I got greedy. I did some mental math and bought an entire pallet containing 65 cases with a wholesale discount pricing in at about $6,800. Using money I took out of retirement and borrowing from my dad, I was delivered about 1600 units in my garage. Quick math at $25 a piece adds up to a grand total $40,000. After Amazon’s cut, I’m left with $26,400 giving me a sweet 400% return on investment! I thought to myself, this is how they do it, this is how people get rich. I was ready to quit my job and travel across the world. I was imagining my new Tesla and house like I had already won the lottery and just waiting for my lump sum payment. For a couple more months the sales were through the roof! Reviews were going up giving fuel to the sales and I was slanging this gas like it was the cure for cancer. The money just started to pour in and when a quarter of my stock had sold, I checked my Amazon seller app to find my listing had a red warning symbol on it with the word “Suppressed” next to the status. This means my listing was flagged by Amazon and taken down. My first taste into the possibility of infinite profits had turned into that second taste of tequila vomit after a night of drinking.
I was stuck with 45ish cases of stuff I cannot possibly sell for a profit. My only unfair advantage was the prime badge which allowed me to sell my product for a premium due to Amazon’s brand name and customer trust. This is the power of a brand. Once I lost it, the product can only be sold for about $12 but it’s the shipping that eats into all the profits and puts me in the red. My break even price was $15 and even at $10 a box it was difficult to move. There was too much competition. My payceck-to-paycheck life’s savings and loan were all wrapped in this now useless product. The market I had cornered was rug pulled from me and I was stuck fighting for every dollar back. The lesson I learned is that there’s always someone willing to sell it cheaper. I started to feel like this was a karmic debt that I had to pay in exchange for the brain cells I killed by making this high potential for abuse product accessible to anyone with an Amazon account. I went into a very dark place physically, mentally and spiritually. My life was in shambles and things starting falling apart one after the other. I blamed myself for going down the dark path of greed at the expense of other people’s lives. The strangeness of that experience was that I believed I deserved it. I believed this experience made me no better than big pharma or tobacco. I was overcome with tremendous guilt as if I had betrayed my own soul. At the end, the pandemic hit and I was locked down. Coping in the worst ways possible, I concluded this journey with a $25,000 hospital bill, no job, no insurance, no money, and attempting to bounce back with a mind that was still healing. This was it, I hit rock bottom just like those patients I took care of in the E.R. and I’ve been climbing out ever since. I kept climbing and climbing thinking it would never end until I found myself in a higher place than I ever was. I suddenly had a greater perspective and broke through another limiting belief about what the mind is capable of achieving. Feeling nostalgic, I did a quick search on Amazon for this product that destroyed my life and I saw a myriad of sellers that were able to accomplish the same feat as I. I only wish I can warn them that this is not the path to follow. I decided to let this experience be a valuable lesson to my entrepreneurial spirit moving forward. I recognized that my ingenuity toward this process can best be used to serve others, the way God intended for us to use our gifts. The mind is a powerful ally and an unforgiving enemy. Be sure to direct it toward the correct motives and improving the lives of others before concerning yourself with profits. Because at the end of the day, you still have people wasting their mind’s potential by contemplating: What else can I fall on in the shower?