It's a sad thing when I lose respect for someone. It has happened more times that I would like. In the real world I've learned that you don't need a swastika tattoo to lose my respect. On a related note, I hate bigots and their existence.

I'm new at work so I'm not ready to rock the boat, so to speak. I usually stay pretty quiet until I get to know people or a subject comes up that interests me. Even when people point out my quietness, they are usually the most talkative person in the room, and I say, yep, I just don't have anything to say. But I digress.

A, um, (co-worker, person, acquaintance) of mine, whom I liked, said the 'N' word in front of me, in a sort of conversational way. I'm not sure which disturbed me more, the fact that she said it, or the fact that she said it so easily, as if she either gave no consideration to me, or believed that I wouldn't mind. I will reiterate here that I'm not one to rock the boat, and note that I have only been offended only once in my life so much that it led me to take action. (surprisingly, not at a firehouse)
I really wasn't sure what to do with this. I didn't say anything to her, nor anyone else. Of course, she is a person well liked by everyone else, and as a newbie (or an oldie) I don't want to be the one who gets her in trouble. What a world we live in.

I feel ashamed that I played it safe and did nothing in order to maintain a friendly status with my colleagues. Should have I sucked it up, written her up, and risk remaining quiet at work for the rest of my employment?

I don't know sometimes and it makes me sick.

Hemorrhage? I'll say

The call went out for a hemorrhage. We headed out and the call information came over the radio: "subject shot in the head, conscious, police report the scene is safe" We both did an absolute double take and I searched through the map with a renewed sense of urgency. I located the call, as my partner fired up the roof and hit the gas pedal with purpose.

En route, we called for the status of the nearest helicopter, which was 20 minutes away. Send it. It took us 10 minutes to get on scene, which seemed like an eternity. We arrived to have a cop come up and let us know that indeed someone had shot themselves in the head, and directed us into the middle of a field. This call was getting stranger by the second. We kicked on the four-wheel drive and headed into the muddy unknown.
The police had been called and I'm not sure of the exact order of things, but basically this person was missing and there was a suicide note involved and the police had come to check it out. The cop on scene told us he about gave up looking when he happened to glance into this field and saw our patient sitting there covered in blood. The cop approached him with gun drawn, shouting at him to show his hands when the patient just slumped over. How ironic that he almost got shot again. He called EMS without getting too close, which is why it just came out as a hemorrhage.

So, I got out and found this guy on the long backboard, blood everywhere and a bandage around his head where he had shot himself in the temple. It appeared that it was through and through with an entrance and exit wound. I pried open his eyes and saw that one pupil was blown and the other barely reactive. I asked him his name and he told me. I think that was the weirdest moment ever as I was so shocked that he answered me. We got him on the cot and into the ambulance. He had nothing else wrong with him other than two holes in his head that shouldn't have been there. He answered questions correctly, had pulse motor and sensory in all his extremities, never lost consciousness or had a seizure. By the time the helicopter got on scene we had 2 large IVs in him, on the monitor, a decent blood pressure, and were ready to help them RSI him. The flight crew came in and almost immediately knocked him out and tubed him to protect his airway for the flight. By that time, the patients' eyes began to basically bulge out of his head from what I can only assume was his frontal lobe swelling into his orbital cavity. Ooh, cool! So, we packaged him up, carried him to the aircraft and off he went.

Hopefully, either in the next few days or few months, I'll get an update of some sort. (Waiting for our trauma center to send their update, or see an obituary.) I wouldn't be surprised either way, either he is in a coma of some sort, or an organ donor. I would be surprised if I find out he is alive and well with minimal damage. If anyone can explain to me how you can be shot through the temple with a 0.38 and still talk and seemingly understand, please do.

Ironically the only other call we had before that was for a kid who took some of his moms Rx pain meds in order to...well, in order to get attention. He definitely didn't take enough of anything to do anything to himself other than to get a good nap out. (You call that a suicide attempt?!)

Six snippets

After my post complaining about not doing much at work, we did have one call after that for a guy with the flu. Since then, it has been a litany of people fainting, having chest pain, or being short of breath. Neb treatments, nirtros, and fluids for all!

We had one day of wintry weather that yielded no car accidents. What a funny thing to be disappointed about.

I had an 18 month old who had a febrile seizure and whose temperature was 105F. It was nice to have a kid who was crying. I was only weirded out a little when the dad didn't know his kids birthdate.

One lady who was having chest pains said that she had the pain off an on for two months. Two months! It didn't occur to her to get it checked out, and the only reason we got called this time was because she had pain while waiting at a doctors office.

Another guy 'couldn't stop throwing up' who thankfully managed to resist while in my presence; and the Zofran might have helped.

We did get to go to the mall for a guy with hypertension, and later got to go to Wal-Mart for a lady who fainted. These are my absolute favorite. I don't know why, but I love to go to public places on calls. Dunkins, the bank, concert halls, office buildings, clubs, busses, all good fun.

Blogiversary 3

Oh, it's that time of year again when the blog and I celebrate our anniversary. Three years on now and still going. (sadly, longer than any of my significant relationships.) In this, the 268th post, I must admit that I never believed it would last this long, or that I would even make it through the first post. (mostly because I was historically lazy about such things, thought blogs were silly, and never fancied myself a writer.) But, as I have recently learned, sometimes it is a good thing to be wrong.

Having abandoned my hand written journal about two years ago, (now the only hand written stuff is on bits of paper) I'm happy that I have kept up the old blog. As one commenter reminded me, it is nice to have a snapshot of my life in print. It has been an interesting year since my last blogiversary to say the least. And, well...if you're reading this you were probably reading then too, so I won't explain further.

With a renewed sense of purpose, a new job, and a wicked sweet summer planned, I can hope the blog will be less work and more progress.

On the Lighter Side

Here are some pictures of our PIMP trucks. I've pointed out the highlights, thus proving that I am a squirrel, am way too excited about the new job, and have too much time on my hands.

A bad way to start the day

Last week started with one of those calls where you really hope dispatch was wrong, but they aren’t. I panicked a little when I heard “Infant cardiac arrest.”
We all piled in the truck (‘we’ being my two bosses and another paramedic who has been on the job longer than I have been alive) and I was honestly feeling a little nauseous riding to the call.
I grabbed our peds bag and stepped into the ambulance. I panicked a little when I looked on the cot and saw that tiny baby and two EMTs doing their best with CPR. In that instant I already knew it was too late.
I took a millisecond to take stock of the situation and organize my thoughts. From there, it became business. I snapped into work mode: “Could you make your compressions harder and faster?” “Hand me the airway bag.” “Put that blanket under his body.” “I need a 2.5 tube.” “Could I have some suction.”
I was on airway and I panicked a little when I put my blade in and saw nothing. No landmarks at all, just tons of secretions. I gave it my best before someone else tried. Between myself and three senior paramedics, none of us could get the tube. But, we gave plenty of meds, and couldn’t convince the monitor to show us anything but asystole. My role transitioned to med timer and note taker and after only 15 minutes between us arriving on scene and getting to the hospital, we gave the baby the best chance it had.
In the ER we fruitlessly worked for another half a hour. It was not until then that I saw the parents. The doctor was very good to them, he let them in the room, and carefully explained what was going on; quiet words that would offer no hope, no comfort, but only cold hard truth.

Those are the facts and now I don't know what to say about it. I feel strangely unaffected. I am more worried that I feel so little than if I felt too much. I guess the self preservation side of me saw it as a challenge, an unexpected hurtle of my day. And, as I think about it, I can’t see it any other way. I simply can't see it for what it was: a human being, an innocent child, someone’s baby, a tragically short life, an event that could end a marriage, and will haunt a family for the rest of their lives. It is best not to dwell on these facts, important not to take on the sorrows of what we can’t change. It's why we cover up ugly wounds, drape a sheet over dead bodies, leave gruesome scenes behind; try to forget the truly bad. It's also why we laugh, discuss, ignore, decompress.

I went home and prayed for the baby.
I went to church and prayed for the baby.
It is all I can do.

Dodging the White Cloud

It has been a busy week. I am celebrating my fourth shift at new work and am enjoying it quite a bit. I managed to trick the white cloud for a few days, but today, it found me. With only three hours left in this shift, I have gone 10 hours today without a call. Yes, I am hoping that writing this will jinx us.
Up until last night I have had a large number of calls, including some career firsts. Well, one first that will be getting its own post once I figure out what to say about it.
I decided to stay for a late call yesterday that was canceled, and then two others right after that, also cancellations. That's one of the funny things about chase cars, you don't always actually get to the call. And sometimes, even when you do get to the call, you don't do anything but watch the EMT take a blood pressure and then cancel you. If you get too involved with an obvious BLS call (say, if you were first on scene) you have to release it to BLS when the ambulance gets there so that you don't have to 'ride it in'. This is more trouble than it is worth in my opinion because in this fine area of the country, you need to call a doctor to ask permission. (Don't get me started on the absurd hand holding that goes on here in terms of medical direction. What is a paramedic, if not an independent thinker and decision maker?)

I digress. So far, I have visited many houses, of course, most of the local nursing homes, a school, the floor of a pretzel factory (which was awesome), and a rubber recycling plant (which was also awesome.) I am easily distracted by interesting settings such as industrial plants and I'd like to have a tour of the complicated machinery before we leave.

In the recycling plant we had a guy having 11 out of 10 chest pain, whom we found writhing on the ambulance cot, sweating, crying, clearly in a panic, clutching his chest, while yelling about how much his chest hurt. The pain increased with deep breaths, was tender upon palpation, and he had no 12 lead changes. All signs pointing to a chest pain unrelated to his actual heart. We went through the chest pain protocol anyway and brought him in. Afterwards we speculated to each other that it was probably muscular and some social stuff making him panic a little. A couple hours later I found out that his cardiac enzymes were elevated and he was having the 'big one'. They ended up flying him to an interventional cath lab, reiterating to never ignore that atypical chest pain patient.

Other than that we had a litany of shortness of breaths, fainting, and generally ill people. Tis the season. Every hospital within 40 miles was on divert, which basically means they were all open. Today even, our hospital was toying with the idea of going on mini disaster. They must be quiet happy that we haven't gone out today.

I do have pictures of our PIMP trucks that are just about ready for publishing, (but they are currently waiting in my home computer).

A man with a swastika tattoo

has people who love him.
has a home.
has lost hope.
is an alcoholic.
stopped eating.
falls down a lot.
has uncontrolled diabetes.
won’t take his medicine.
doesn’t want anything done.

A man with a swastika tattoo

is unconscious in bed.
is maintaining his airway.
has been like this for a while.
is covered in bruises from falling.
is hyperglycemic.
is unceremoniously carried out of his house on a sheet.
got stuck four times because he is dehydrated.
was given futile medicines.
feels cold.

A man with a swastika tattoo

is dead.

The world is not a better place, it is the same.