The writer's wanted her to fall so Pete could catch her.

And it wasn't just the sight of blood. That man had his foot partially chewed off. Yuck!

Hi Andrea!
The sight of a mangled limb/traumatic amputation can make anyone faint. And the sounds of that poor man's screams were worse.

I did get a kick out of Pete catching her though.

This is very true, anyone could definitely faint. But it's extra interesting that Joan--the arguably more feminine one--took control of the entire situation, while Peggy, who has often been described as Don's protégé, is the one who faints. I'd almost expect it to be the other way around :)

Hi again Andrea!

You're right! Joan seems so delicate in a way. She really proved herself, a steel magnolia.

I wrote on another thread that I believe Joan has some past history in a medical setting. She knew exactly what to do, and jumped in and did it.
And, I was thinking of the scene Joan had with Roger in Season 1. They were in a hotel room and he wanted to order room service, she said she didn't like to eat in a bedroom, it reminded her of a hospital.
Other Maddicts have noted this comment before. There are a few discussions in the archives about this. People were speculating about Joan's past. did she work in a hospital, spend time as a caregiver, or a patient?

Last weeks' episode convinced me she has had some sort of medical training, we just don't know it yet.

I am not sure being a go-getter professionally makes one immune to the sight of blood.

Do you think Joan served in Korea as a female medic or such? The age is about right...

I think you're right about the writers wanting Pete to catch Peggy--though there's hardly anything romantic about catching a fainting person falling right into you. I had a male classmate who went into an epileptic fit right next to me and I caught him (kind of, he was big--shall I say I broke his fall anyway). I don't think that means we're bonded for life.

Hi Betty Crocker!

Korea did cross my mind. Then I thought maybe she went through a First Aid course as the office manager.
But, that can't be the answer, what she did was so beyond that. She knew she needed to stop the bleeding.
She acted like a professional. First, she grabbed his leg and applied pressure with her hands and then asked for and applied a tourniquet in the right location to stop the bleeding. She did save his life.

I think the idea of a tourniquet in an office First Aid kit is a bit of a stretch.
If there hadn't been one it would have been interesting to me what she would have used. A stocking, belt, neck tie, scarf? Even a rubber band would have worked.

I agree with your comment about Pete and Peggy. It was just funny that Pete was right behind her.
I was thinking of all the times Peggy "saved" Pete, for once, the tables turned.

Your experience with your classmate must have been really frightening. I had the same thing happen to me with a friend at Girl Scout camp. I was probably 10 or 11 years old. The scariest thing was that afterward I kept thinking it would happen to me.
I'm so glad we have the technology today to help prevent seizures.

60'schild - I hadn't thought about it from the perspective of "saving," interesting! Prior to this episode I was wondering if the writers might set up a situation where Peggy develops feelings for Pete (he prevents her from defecting to Grey's or something maybe?). Maybe this moment is meant to foreshadow this in some way? Regardless, I thought it was cute!

Hi giantsfan21!

I'm probably way out with that theory, but that's the fun of MM.

Honestly, I thought Pete would be the one to faint before Peggy!
Jeez, I hope Peggy isn't pregnant again!

I was more puzzled by Peggy's behavior during the time leading up to her fainting. She was so obviously "brown-nosing" the Brits when they stopped by her office ("I was just writing some copy"). Then her brief scene with Don where she commented on how good the champagne was. It was as though she had drunk the "kool-aid", and was ready to fall right in line with the new status quo. Not the independent Peggy I am used to seeing.

Hi docmama!

I forgot about Peggy's lame attempt at sucking up to the Brits!! That was so stupid...I was just writing some copy?
I wonder if they were impressed?

Hi 60s!

Re Peggy...I thought she was being kind of "cute"--not sarcastic, really, but kind of funny. Like, duh, I'm writing copy...Almost like she feels competent and comfortable enough to make a joke. But also, she IS driven and these are the top dogs, so she's got to try to show she's a team player. I can't imagine she'd be so blase and "too cool for school" to play the game in her rather lowly position. She's got to try so much harder than the guys and show her eagerness.

And isn't a tourniquet an outdated first aid device--meaning, it's exactly what would have been in a 1963 first aid, but now we know that tourniquets are not helpful in comparison to the risk of limb loss, so they wouldn't be in there now. I thought now the first aid protocol was to apply constant pressure?

Last I saw, most first aid kits still come with a tourniquet like item. Usually a long piece of linen which is what it looked like Joan used.

I like the conjecture about Joan and the army or previous medical experiences but they did say she was at SC for nearly 10 years. That doesn't leave us much adult time prior for medical experience. Her father could have been a doctor...

I also like that she jumped in. Frankly, if you watch that scene again, it is really a statement of human instinct and behavior. As a person who has first aid and lifeguarding certifications and worked with paramedics, you would be shocked and amazed at how some people react in an emergency. Ken was in shock (at least he thought to yell call 911) and the extras in the scene all stared in horror but no one moved.

I think Peggy was shocked at the severity of the event & I think many of you are right in that the writers wanted her to faint into Pete's arms. I imagine they wanted someone to faint and that sounded like a nice little piece of action. (Side note: I am dying to see what happened after Pete caught Peggy)

As for Joan, I think as office manager, it was HER office and there was an emergency in HER office. She took charge right away and certainly knew her way around the first aid kit. I think her reaction falls right in line with her character. She is a fixer, a problem solver.

I think the foot thing was there and the writers saw an opportunity to show that Pete, for all his outer rudeness to Peggy, actually still cares for her. It wasn't romantic. Like you say, Betty Crocker, it's a mundane thing. If someone falls, you catch them if you can. But this wasn't by chance. The writers chose to put Peggy and Pete there together, despite having been at different places before the accident. I don't think they would have written in Peggy's fainting if not for the part of Pete catching her?

Having said that, and trying not to make a big deal out of this, because I do believe this was an afterthought on the part of the writers, does it remind anyone of the scene in Persuasion where Captain Wentworth chooses to put Anne, of all the ladies, in the cart when she is exhausted from the long walk, when previously he had been ignoring her.

@Betty Crocker: Strictly off-topic: Have you ever eaten at The Lucky Platter restaurant on Main and Chicago?

She works in copy

NNT--LOL---YES! I love the Tandoori Chicken Salad!

Re Joan and some sort of medical background: I am pretty sure she's pushing 32+ years old. What year did her ID say in that episode where someone (likely Mr. Pseudo-Intellectual) put her ID on the bulletin board? Like 1931 or something? So 12 years ago, she'd have been 20 and that's about right for some sort of service in Korea, no? I don't know enough about war history and women's roles in the Korean War (v. WWII, which they served in the thousands) and what type of medical roles in the army there are besides full nurse, doctor and medic. Meaning, were women ever medics?

I'm really thinking that Joan in a M.A.S.H. unit in Korea IS plausible. We should look at Season One (?) to see if there are any redheads tending to "Dick Whitman" just before he was discharged. That would be too funny! "Army olive green" would have looked stunning on Joan. Oh yes...she wore green while heroically helping the Brit. Hmm. Very interesting.

Regarding Joan in the Korean War, maybe here real name is margaret hoolihan, and during a artillery salvo on *M*A*S*H 4077 she got amnesia and picked up the dog tag of a dead nurse lieutenant named Joan Holloway. :-)

According to the Inside Mad Men video, Christina says that Joan "probably took a first aid course". I think you guys may be speculating a bit too hard on this one. I've recently ceased being a long time office manager and as trite as it seems, it's all "part of the job". You just jump in and do it.

Of course, today they do not recommend tourniquets at all as they cut off complete blood supplies. Today, direct pressure is all that is recommended unless the limb is completely severed.

60s Child: funny, I posted also the exact same things about Joan. Also, she said she would "close" the light. More than one reference to hospital food, but the food too close to the bed would not bother the worker, just the patient. I think we're going to learn more about Joan's background.

Now that we've had the deus ex machina moment, it could have been that Joan worked her way through college as a hospital orderly. She was 31, I think in S2, which would make her 32 now. Thirty-two in '63, drop ten years of SC experience makes her 22 in '53. With a college degree. Could have been in Korea (it ended in '53) but very, very unlikely due to the years she'd have to spend in the Army/Navy.

Or she could have been a candy-striper who really paid attention.

Or she could have a degree in Nursing but quickly learned she didn't like hospitals and clinics. (Yes, I know there are lots of other possibilities.)

Putting on a tourniquet almost guarantees loss of the tied-off limb after five minutes as I recall - cellular death. One theory (don't know how successful it was) was to tie it off for two or three minutes and then loosen it for a minute to get oxygen to the tissue.

Once again, we don't know much about a character's background.

I know! She had concussive amnesia and forgot all her medical training until the John Deere incident which is why she never mentioned it to Dr. RB or any of his colleagues. Yeah, that's the ticket.

I'm with Zab guys. I think you're over thinking this. If she'd done a tracheotomy on the guy THEN I'd believe that she'd been a nurse sometime in her past. But for heaven's sake, I learned about tourniquets when I took a first aid in high school. Likewise and HELLOOOO! Girl Scouts anyone?

Joan hardly needs to have been a nurse or part of a M.A.S.H. unit to know how to wrap something tight around a limb to stop the bleeding--she really needs only to have been a Girl Scout. And after 10 years as the office manager of THAT office with all the secretaries and ad men doing crazy stunts--with all the liquor and scissors and heavy typewriters that might fall off a desk, files slammed on fingers, hot coffee spilled....

No, of course, she's probably never had to deal with anything this dramatic, horrific or severe, but it's not like she hasn't dealt with all kinds of other crazy accidents. Hence, the first aid kit. Hence, her cool-take-charge-no-fainting. Hence her being able to handle a medical emergency that required no more than putting something tight around a limb to stop the bleeding.

We don't need to make her any more than super-office-manager-secretary Joan, just as she is, just as she's always been over these three seasons to understand how she did what she did so well.

Or maybe she knows this because she is married to a doctor! At any rate her tourniquet seems to have caused Guy to lose the foot. Another laugh from the writers about all the stuff we didn't know back then?

@Ritt!: "That's the ticket." I love that line....

RE: Peggy Fainting. It wasn't the blood (though that would have done it for me). It was the managed foot combined with the blood. And when she faints, you'll notice that Pete is taken by surprise. So it wasn't gallantry on Pete's end, it was just that he was standing there when she fell and if he hadn't caught her, he'd have gone down too because she fell onto him :-D

I learned about tourniquets in my old job's first aid, but I NEVER had the opportunity to use that knowledge, thank god.

Plus, in the few emergencies I've been around for, I never quite took charge and took the lead lifesaving role. Someone else more "confident" got there first...

So I was talking more about her confidence/take charge way of handling this emergency--I mean, I guess that's her nature, but if she had had some sort of "real" medical training, it would have been more instinctual, perhaps. She's such a good actor, she had me convinced!

But then again, if she had more extensive experience treating bleeding, she might have known NOT to apply a tourniquet except as a last resort and absolutely necessary to save a life.

I am CERTAINLY not implying some sort of soap opera coincidence though. Lots of people served in Korea, so it's possible she did, if that happened to be in her character's background.

@13: Pete was standing there because the writers put him there. If they just wanted Peggy to faint, Ken or Sal could have caught her.

I agree with some of the earlier comments: Pete would have caught any woman about to faint. However, the moment is really only significant because he catches PEGGY. Matt Weiner has said he never misses an opportunity to show that these two characters "know one another." This seems to be one of those opportunities - the writers knew they wanted to juxtapose Joan's competency (in spite of her more "girly" image) with Peggy's squeamishness. They could have just had Peggy faint onto the floor, had someone else catch her or just had her look squeamish without fainting. Pete catching her was significant...I'm hoping it means more juicy Pete-Peggy scenes (like in the Fog) to come.

@BettyCrocker - I have to tell you that in that position, you see a bunch of stuff. I've always said someone could be cut in half and it wouldn't bother me in the slightest. Adrenaline kicks in and you just do what you have to do.

And please, don't use a tourniquet today. They are not good for much.

Pete will probably put Peggy on the couch in one of the offices and sit with her until she comes to, and then they can have a "dialogue".

ROFL! Margaret from MASH was a major! I know this because I'm watching MASH right now as I have been for 35 years.

Yes, Joan does seem to have the emergency know-how when it comes to emergency situations. She very well could have been in Korea, the Korean war lasted only until 1952, present day in this season is 1963, and since she's been with Sterling Cooper for 9 years, and she's 33, it's very plausible. She could have been a nurse in a "former life". She may have just been a really good Girl Scout. They used to show you basic first aid and when I was a girl scout, I learned how to apply a tourniquet as a last resort. I think the mystery is all part of her mystique.

Seeing somebody get their foot chewed off would make me faint, and I'm not a fainter. Just because she fell into Pete's arms doesn't mean anything. If we're going to go down that rabbit hole, why did Pete reach for her...hmmm...? I don't think she was kissing up to the Brits, she sounded like, "Duh, I'm writing copy, I'm a copywriter."

@NeverNotTasty: An Austen fan? I love her. Persuasion is my favorite novel, and yes, it is rather like that moment in Persuasion---in fact, Peggy is very Anne Elliot-ish, the plain jane overlooked for fancier birds, yet so steady and capable. Remember what Captain Wentwort says, "...no one so proper, so capable as Anne."

Ahh...Ta-town girl: I knew we would meet again. Why am I not surprised that we also have the same taste in literature? Persuasion is my favourite Austen novel as well.

@Old Soul: I already did go down that rabbit hole. See my comments at 4:53 and 6:17.

Maybe the thought of a mangled leg and all that blood just made her ill.

Yeah, I'm not getting how Peggy being such a hard worker and driven woman makes her equipped to handle every trauma with aplomb--does that mean she could be a Navy Seal or firefighter or parachuter or executioner or alligator wrestler, etc. LOL.

"Lots of people served in Korea, so it's possible she did...."

While this is not impossible, I do think the facts make it highly unlikely. Look. She's 33? She went to work for SC ten years ago. That was 1953. Before that, she went to collage! She had a collage roommate (one she had a wild time with--while she was taking nursing classes?). Most girls go into college right out of high school. So let's say she was 18. She's in college for 4 years, till she was 21. That's '51, a year after the war has started. So it's "possible" that she went to Korea as a nurse if she took nursing in college.

But look at Joan at the dinner party with all those doctors. This is not a woman who knows how a hospital works, how doctors can make mistakes. If she was a nurse, even if only for a year, why doesn't she know how to get along with all those doctors, talk their talk, etc.? She comes across as totally--and honestly--ignorant. An outsider, not a former insider. And just to add, only 5232 women went to Korea as nurses (fact from here: http://www.archives.gov/research/korean-war/nurses.html)--a tiny percentage of the female population in the U.S. at the time. So if we're talking women, then, no, a "lot" did not go to Korea.

After a year in Korea (1952) learning how to be one hell of a nurse, she doesn't go into nursing as a profession, but decides to become a secretary and, I guess, takes a year to study that before joining SC in 1953...? So yes, it's possible to shoehorn Korea into her background, but it's not easy to do. And since basic first aid and ten years of being the cool-headed and competent office manager of SC gives her more than enough talent and experience to handle even a terrible emergency, wouldn't it make more sense to leave nursing and Korea out? Occam's razor here-- "when you have two competing theories that make exactly the same predictions, the simpler one is the better."

Which brings me to something about this supposition that troubles me. I know it's fun to speculate, but in this case, doesn't such speculation undermine what Joan did by implying that a mere "secretary" couldn't have done that? That only someone who was a nurse and/or in the Korean war could have handled that emergency the way she did? I can't say for sure, but I kinda think the writers would rather have her be the "ordinary" secretary. Because if she is a former nurse then what she did was not so big a deal. "Well, she's a nurse! And she was in Korea! Of course she's seen worse, and knew how to keep her cool and save his life!" we say. But if she's not, then we can say, "Wow. Too bad she didn't get the medical eduction instead of her husband!"

For myself, I'd be sorely disappointed to learn that she was a former nurse in Korea. Because when an ordinary person does what she did, that's special, admirable, heroic even. It would make what she did so very un-extraordinary if we were to find out she was once a combat nurse. It would turn the "wow!" of that scene into "so what?" And that, to me, would be a sad thing to do to brave, heroic Joan.

I agree with earlier comments - I really don't see Joan with much more than a Girl Scout first aid course and a cool head under pressure - something that's seems to be the core of her character. (I can't believe any one would ever think of her as 'delicate'.) Joan's no-nonsense. There's blood flying - stop it. She's always in charge. Get busy or get out of her way.

As for the original question ... well, Peggy IS the 'go-getter' - kind of. She knows what she wants, but she's not always sure how to get it. She usually has to psych herself up to make a move. Faced with a crisis, she sometimes checks outs - whether it's turning away from her baby or fainting at the sight of a mauled limb. (And I have at least one sturdy guy friend who gets woozy at the sight of blood - although he made it through his daughter's birth.)

@Thirteen - She went to collage? Maybe she should be working in the art department - scissors, paste, advertising! I know you meant ''college'', but Sterling-Cooper does not put up with typos!

Wah! I made my own typo! ("that's seems" ?)

Thirteen: I remembered Joan on the accordion, singing in French, and I thought, "she must have been in Paris!" Jean Seberg in Breathless even looks like she could have been a younger, less curvy Joan...

So I refreshed my memory on French conflicts of the 50s like the Indo-Chinese war and the Algerian War for Independence, and then I realized 'C'est Magnifique' was a Cole Porter song written for 'Can Can', a broadway production in 1953, so it was readily accessible to New Yorkers...

Also I trashed this idea because Joan seemed like she knew what she was doing, but not like she'd done it a million times.

Still, where'd she learn to play the accordion? Wasn't it kind of a non-American instrument then? Did university kids pick up the accordion like most of us pick up the guitar today? And she can speak French, or at least it seems like she's more than just mouthing the words the way non-English speakers sometimes sing English songs.

Also, the tourniquet has long been standard military procedure (see http://en.wikipedia.org/wiki/Tourniquet) so it is possible she was trained this way.

Allow me to make a conjecture:

If she's 33 in 1962, then she'd have been 24 in 1953, the year she started at SC. She could have never finished college, she may even have been one of the performers on broadway in 'Can Can', which would explain her need to really know that song. Something horrible could have happened to her to make her hate hospitals and seek a different career. Or something horrible could have happened to somebody else that would make her REALLY want to be ready for such emergencies in future.

Peggy passing out--Despite how far she comes, and how much she's been asserting that it's 'her time', that she's ready and that she's independent and capable, deep down she's still the wide-eyed Catholic girl blinding people who've been around longer than her with her earnestness. This event might make her reevaluate just how tough she thinks she's become. Metaphorically, it had to be Pete, because they really have only each other to lean on.

Joan's assisting that "guy" just shows how capable she is and how overlooked she is for that time period. Remember how well she handled the T.V. accounts way back when but didn't get the credit. She is unfortunately stuck in the steotypical "just a secretary" role. My opinion is she could just as easily be as successful as Peggy and maybe more if someone took her seriously. One of her faults is being too curvy/beautiful.

I don't know...somehow the sight of Joan sprinting across the office in high heels and then jumping right on top of the mangled foot does not say "Girl Scout" or some one-time first-aid training course to me. She's either a totally natural Florence Nightingale or she has done this before. The writers teased us with her negative hospital food comment, so I for one can't unstick that from my mind. I know she seemed naive while at her party entertaining the doctors, but maybe Joan keeps a lot close to the vest for some reason. It could be she was a caregiver to a parent and thus the disdain for hospital settings?
It is true that you don't have to be a nurse or a doctor to jump into a crisis. I had to stop someone from bleeding once in a workplace setting, while a coworker cleaned up the blood...and someone else turned pale...and someone else called 911. It wasn't as horrific as this scene by any means, and I just did what felt right. My person wasn't screaming though....that takes everything to a whole new level. Bravo, Joan!
Back to Peggy: some people, no matter how spunky or brave in the face of corporate shake ups, just cannot stand the sight of blood....or gosh, slashed up flesh. Count me in on the latter.

Hi everyone!

I need to comment on a few things that have been said.

Based on the blood gushing from the man's leg he had an arterial bleed. If Joan had not slowed down or stopped the bleeding, he could have died by the time an ambulance got there. It comes down to saving the limb, or saving a life.
Considering how long it would take an ambulance to arrive at SC, Joan did NOT cause him to lose his foot, she saved his life.

I have been an RN for over 31 years, and I have learned that sometimes to save a persons life, you have to compromise other things.

Tourniquets are still used today. Anyone who has had blood work drawn, or an IV inserted lately knows this.

I was also glad to hear the phrase "someone call an ambulance". If they had said "call 911" that would have been a major blunder since the 911 system did not exist then.

Peggy is not as "strong" as one may be led to believe. I think her strength comes more from the previously mentioned: HUBRIS.

Each morning Peggy WILLS herself forward.

"Still, where'd she learn to play the accordion? Wasn't it kind of a non-American instrument then?"

Artie, not in the least! The Accordion was, for a short while, one of the most American instruments around and it was not at all unusual for kids to learn how to play it.

From Wiki: "accordionists during 1930s-1950s taught and performed for radio."

We do not know where or when she learned to play the instrument, but it's altogether possible that she learned as a kid. It's a totally typical American instrument, though more popular in cities.

Once again, Occam's Razor people. There's no reason to give Joan a complicated history of stage shows and combat nursing. She has not yet done anything that requires years of exotic and special training only gotten in a Kung-Fu monastery or harpooning whales with Eskimos in order to do it. A woman who goes out and lives life for at least 33 years (remember how she tells Peggy to advertise herself as wanting to have fun?), who has rich and varied experiences, and learns things along the way is all she needs to be in order to be able to play the accordion, make a pot roast, run an office and, yes, even save a life.

Think of your own life. What things can you do that you learned along the way and which required no special training. Which only required say, harmonica lessons when you were a kid, a first aid class here-and-there, on-the-job-training and a cookbook? Make a resume of your talents sometime, excluding anything that took special training (like being in the army or working for years with a circus). You'll be amazed at how experienced you are just from the lessons you learned along the way.

What would you say if someone said to you, "You must have worked on Broadway to learn how to play that instrument! or You must have been in Iraq to know how to handle that situation!" You'd look at them like they were crazy. "This? This is nothing," you'd say. "I learned this from an old friend while working in an office," or "I learned this from my roommate when we were in college," or "I taught myself how to do this when I was living in an apartment in a bad neighborhood..."

We learn things in a lot of ways. Why couldn't Joan?

I wasn't surprised that Peggy fainted. it may not have been at the SIGHT of the blood and mangled foot only but combined with the SMELL of blood, which can be quite nauseating.

I was very impressed with Joan's quick reaction, but I just assumed she had Red Cross first aid training - many people did in those days, particularly people in responsible positions like Joan's. There was no EMS and an ambulance could take awhile to respond. I was in Girl Scouts and our whole troop earned the FA badge.

I remember we were told not to use a blanket to put out a fire because blankets were no longer woolen, but were now (early 60s) made from synthetic material that would ignite. In a lot of old movies and in old first aid training films, they said roll a person in a blanket; our instructor made certain we understood that we now knew better.

Joan gets more intriguing with each episode. We know from a previous remark to Roger in the hotel room about not eating food on trays near beds that she must have spent some time in a hospital either as a patient or a caretaker. Her use of 'close the light,' coupled with the accordion and French song suggests some early French language acquisiton. I wonder if she spent time in an orphanage or children's home in Quebec or some place that was run by native French speakers? In the 1930s and 1940s, when Joan was young, it wasn't unusual for children whose parents were sick or whose siblings were sick at home, to be sent to children's homes while a family member recuperated.

@gavinhastings - I think that's a really good point about Peggy not being as strong as some fans like to think. She has a tendency to repress things (i.e. the whole being pregnant and giving birth to a child) that isn't healthy (and, interestingly, is a quality Don shares). Joan may not have the man's job, but she has way more confidence and self-assuredness than Peggy does.

@thirteen - Kung Fu Monastery? Good lord, on my best day I would have never imagined that! I can see Joan now, kneeling at the feet of the Kung Fu master, learning the art of tourniquets. Of course, whaling with Eskimos does sound more along the lines of a job that could cost you a limb, but I just can't picture Joan in Eskimo clothing.

I feel for Joan in the sense that no one believes she could have these skills without massive training. Honestly, my friends all think I can do anything because I don't run screaming in emergency situations. I remain calm. So does Joan. Honestly, as you said Thirteen, everyone should evaluate their own skills. If your child walked in - right now - with a half severed arm, would you faint, run screaming or deal with it. I'd say three-quarters of you would deal with it.

My brother once chopped into his arm with an axe, severing an artery. He yelled for my mom, who took one look and went running. They teased her later about running away, but she was running for towels to put on the bleed. She held on all the way to the hospital and never broke a sweat. I'm sure you could do the same - well, if you've had any experience with BOY children.

You can do lots more than you think you can.

Now, transfer that thought to Joan. Joan's grit is real. Peggy's is pretend. Peggy is "faking it until she makes it". Joan already has it.

Hi, Maddicts!

Thirteen's mention of Joan's seeming lack of knowledge of how things work in hospitals reminded me of remarks she made when Greg was telling her he didn't make chief resident. She kept asking him how that would affect his future in a way that betrayed she was unsure of hospital politics, and the clincher was when she said, shakily, "Well, you're still a doctor, aren't you?" as if she wasn't sure he still was. For me, that conversation pretty much showed she was not a player in that milieu. She may have not wanted to betray to others whether she had a medical background, but that conversation was just too earnest. Something's gone on in her background, I agree, but my bet is as patient or family caregiver.

As far as tourniquets, I'm a retired RN, and frankly tourniquets were never out of favor to my knowledge, they simply were a last resort tactic. When I worked ER, there were always people coming in with unnecessary tourniquet applications, applied by friends or relatives. There were efforts at the time to educate the public on the dangers of unnecessary/uninformed application, but during my time it was not discontinued medical practice when necessary. As 60's child says, there have always been times when one would have to sacrifice a limb to save a life, and Joan saved Guy's life. He most likely lost the foot due to the trauma.

Because of comments to the contrary, I went looking for present practice. One recent JEMS article I found proposed "Tourniquet First!" instead of as a last ditch effort. Recent policy seems to be changing as a result of studies of those wounded in war. Here are two very interesting articles for those interested:

http://www.ncbi.nlm.nih.gov/pubmed/19106667

http://www.jems.com/resources/supplements/the_war_on_trauma/tourniquet_first.html

I have to say I was surprised when Peggy fainted, and it was cool when Pete caught her, but he did it instinctively, and his attention immediately went back to Guy and the horrific happening. I also hope we get to see the conversation between Pete and Peggy when she wakes up!

@renatae: I read that info too - it seems that in military situations they are using tourniquets, but in a different way in an attempt to not crush cells. They recommend a wide tourniquet instead of the "string" type. I was surprised to see it still in use because of the unnecessary/uninformed factor. I agree that it's a "last resort" method - direct pressure is what we were taught, but in using common sense judgment, if a limb is completely severed and you can't get immediate transportation, you'd try a tourniquet. As a lay-person, I would assume that my application would not be optimal like they are using in the military now.

It appears from the second article that not only is that a completely new kind of tourniquet, but the facts they are basing "tourniquet first" on are essential a "one responder" situation, where direct pressure would compromise other situations, such as attending to patient breathing, etc. And the first article says that the tourniquet should be applied in the absence of shock" for the optimum effect.

So, that being said, my conclusion that a regular person in a regular situation (ambulance close by, hospital close by, more than one person assisting), direct pressure is still recommended. However, should I be the only responder to a severed limb in a situation where help is lengthy, I would seriously consider it now, based on the new information. Thanks for sharing that!

Hi renatae!
Nice to meet a fellow professional! And congratulations on being retired...I can't wait!!

Thanks also for the site links, I am not computer savy enough to do that, so I speak from education and experience.

Hope you understand the points I was trying to make. I have ER experience also (years ago). I strongly believe under the circumstances Joan did the right things to save this man's life.

What amazed me was that Joan was thinking like a professional in that she acted to stop the bleeding, save his life, worry about the foot later.
I believe, as you do that his foot was so mangled, there would have been no way to save it.

I also was considering the length of time it would take an ambulance to get through the streets of NYC. He probably would have bled to death at the office had she not used the tourniquet.

I look forward to your posts!

Haven't had time to read this entire page but scanning it just want to make one comment:

@60's child. You are right. I bow to your expert experience. Joan saved his life by stopping the bleeding. Spoken like a true professional: "It comes down to saving the limb, or saving a life." Guy will live and be once again, an accounts man, and gosh darn it, play golf. All thanks to Joan!

Btw: no sarcasm here.

Tasty

Hi NeverNotTasty!

Thank you for your kind words! I would never say I was an expert in all areas of nursing/medicine.
I just try to share my experience and knowledge with others on this Forum.
I do like to look for accuracy in MM when it comes to medical scenes. Matt W. must have some good medical advisors, so far, so good! And, I really enjoy hearing from MDs, nurses who were practicing during the MM time period.

Anyway...I'm rambling again.

And I agree with you, I hope Guy will walk and golf again!

Hi, again, everyone!

zabadu, thanks for your comments, and I think your assessment of what you would want to do in such a situation, in light of the articles, is spot on. There's always the risk/benefit factor in anything done medically, no matter by whom. I'm glad to have found the info - it's always good to be up on the latest. Things change in the medical world with such regularity that it is difficult to keep up.

And, 60's child, I understood what you were saying and agreed - I posted what I did in support of what you had said. :) It's been a long time since I worked ER, most of my experience was in Labor and Delivery and pediatrics. When my hubby was in the service, I worked at Ireland Army Hospital, where they rotated us between L&D, post partum, and neonatal, which also included the area neonatal ICU. (Thus my amusement at the "transition" comment by Betty's doctor - which still wouldn't have been said during most of the 70's, much less the 60's.) I too, like to check for accuracy for the time!

It will be interesting to me to see if Greg goes into the service, and whether Joan follows along. The whole Joan/Greg story is getting very interesting to me, even though I would really like to see him "offed" LOL. I enjoy seeing a fellow nurse around, especially from the time period. I'm an early retiree - so young for my age, haha. Born in '47, you have to do the math. ;)

Oops, missed one thing - didn't notice your mention of "severed limb" zabadu. If there is a severed or near severed limb, the only option is tourniquet - even if it's a skinny thing and not the optimal. There's really no way, IMO, you can get enough direct pressure in such a situation - it's even difficult with a tourniquet. People can exsanguinate too quickly in such a situation.

@renatae: I would have to agree with you there. Those arteries pump out blood quickly. I would feel much more comfy putting one of the newer tourniquets on now, the old protocol just seems wrong. In a pinch, use a wide belt!

Thanks for sharing your knowledge; I love learning new things!

PS: If my older brother were alive, you'd be the same age!!

'60'schild got it summed up, and with very few words too!
Fainting is not related to gender or a person being feminine, weak or any of that sort. It's really an involuntary response and is a direct result of lack of oxygen to the brain--anybody could experience it. Also, someone said it here--the smell of blood is nauseating.
Twice in my life, for reasons unknown to me, I have jumped pretty much like Joan to the scene (once a row of fingers being mauled with blood spurting by an electric saw and once a finger tip being cut off by a blender). I even drove the second person to the hospital--yet later, while they cauterized it, I fainted.
Mind you, I have always been the intimidated sort, nervous stomach type, But, I'm the one if you have a life-threatening emergency. Emergency is the operative word---if I know ahead of time then I'm out the door, queasy, and likely to hyperventilate and well, even faint. I understood Joan through the whole scene.
PS: I'm not in any way in the medical field.

Hi fanomad!
Thank you for your kind words!

I congratulate you for what you did in those very tough situations! Not easy, even for professionals!

I have done things in emergencies, and thought about them later. It's when it's all over and you have time to think that the reality and sometimes the physical symptoms that go with the experience set in. Fainting, exhaustion, and unfortunately killing the memories with alcohol or drugs.

You're right about the smell of blood being nauseating. The odd thing about blood is there is no smell until it hits the air, the older the blood, the worse it smells. And you may have fainted during the cauterization because of the smell of burning flesh. That to me is the worst!

OK, that's enough of that...
Hope to talk to you about nicer topics in the future!

Hi renatae!

Your specialty was maternity? That's great, you are the expert we needed during Betty's labor and delivery scenes!

I didn't remember the OB/GYN saying "she's in transition" until I re-watched the episode. I was basing Betty's transition to her mental/emotional status and the nurse saying she was at 7cm dilated.
I didn't know that the term transition wasn't used until the late 70s. I learned about it in college in 1975 maternal-child nursing courses.

I never practiced in maternity or pediatrics. My experience in those areas are limited to my education, having my son, delivering a baby in a car once, and preping lesson plans for teaching nursing school. My areas were med-surg, critical care (mainly cardiology).

And, again, congratulations on your early retirement! Though I have often been told, once a nurse, always a nurse!

60's Child -very good points, all. Nice to have your insight and expertise!

I agree with the poster who said possibly the sight and smell of blood reminded Peggy of her childbirth trauma. We know that was so bad for her that she took a little vacation from reality for awhile.

OOH - the idea of Joan in a Candy-striper'soutfit: Delicious.