“Yes Ma’am” he says over and over during my triage of him. His accent is thick and Southern. He tells me he is “here in beautiful Maine with a Christian group doing some work at China Lake Christian Camp and that he has a little problem with some chest pain.” This young man—early 20’s—is a big burly kid with a smile that lights up the room. He is jovial and kind, but nervous about his pain. He tells me about an irregular heartbeat that usually doesn’t cause pain. As I talk to him he continues to call me “Ma’am” and just smiles every time he says it… He calls the doctor, “Sir” and the lab tech “Sir”…he is so polite I can barely stand it. (He is not our usual patient.)