18 April 2016

OD

(This may be the first in a series of posts where I outline how I am trying to love the job again....maybe.)

Suddenly all of the lay people I know are asking me if I am noticing an uptick in overdoses. The truth is that I have.  As the supply purchaser at work, I can barely keep up with buying BVM's (which can be used to breathe for people), nasal atomizers (a handy tool that lets just about anyone squirt narcan up their noses) and narcan itself (the handy drug that reverses heroin overdoses). 

The number of overdoses in America has (temporarily) captured attention.  This is how we are killing our youth.  For EMS, it is all too routine.  Never in my career did I think I'd hear medics (including myself) act so indifferent to patients that are on the brink of death.  I am not being over-dramatic- these people die.  They die often, because you can only not breathe for so long.  But most don't die.  Somehow they chip away at their nine lives and come back from the brink, only to overdose again.

I have been thinking about all of the recent overdoses and and how causally we take them now.  I missed an IV on one of these patients and heard with a chuckle "Oh, he's better at finding his veins than you are." from my colleagues.  Oh. HAHA.  But this is just one example of how we see these patients as not 'real' and as sub-human.  Yes, they lie to us. Yes, they don't believe that they were nearly dead.  Yes, they are unappreciative.  Yes, they are often homeless and unemployed. 

How easy it is to forget how shitty their lives really are, How easy it is to forget that these people are sons and daughters, fathers, and mothers.  Most of us have never truly been addicted. I mean sure...I love candy, chocolate, and playing video games, but those are not actual addictions.

I (do, but) shouldn't judge a person who is so addicted to something that they would do it over and over again to their almost guaranteed demise. I do not understand addiction that ends in ruined lives, children in foster care, and squalid living conditions. But I don't have to understand any of that.  What I have to remember is that these people are human and so am I.  Bad decisions happen.  I could just have easily made the same bad decisions, but somehow I didn't. Addiction is real.

I have to believe that these people want their lives back. They want their kids. They want jobs and to be members of society. I have to believe this because I feel myself falling into the idea that it is okay to joke and judge about addiction.  It is too easy to judge them, write them off, and fantasize about letting them die.

No, we cannot mourn for every ruined life or every dollar wasted, but we as EMS should be trying harder.  I am tired of being the band aid.
So, like John Oliver I want to lay out a rant and then set a challenge.  Mostly for myself.  There is no point in preaching if I can't enact a plan of action.  I have set a personal challenge to start with compassion.  I want to take a moment to remember that addicts are people, people who need help, and we just happen to be in the business of helping people.  I want to learn my local resources for these people.  I want to no longer accept refusals from these patients (but that's probably another post) and get them to the next step.

The last overdose I had woke up and said "I was going to go to rehab tomorrow".
I most sincerely and overly-heroically said "Well, now you have a tomorrow."

13 April 2016

Quebec

A few months ago, my sister proposed a trip.  Without thinking too hard, I immediately said yes to a winter trip to Quebec, Canada.  Now, I love trips that require special equipment and apparel, but this was next level for me.  From booking to leaving, my entire winter wardrobe was turned over, bolstered, improved, and tested.  As possible -20 degree temperatures loomed closer, the panic set in.  Are these boots really going to keep my feet from freezing?  Are four layers enough?  Will my mittens fail?  Will all of my digits snap off and I will get them all replaced via socialized medicine?

Happily, on our coldest day (-15 at noon), all of my fears were gone.  If anything I was more likely to have a heat stroke upon entering any establishment, as it is difficult to shed 15 pieces of clothing and still be able to browse.  The cold is a chore there.  There is no running outside to get the mail (well, maybe for locals).  There is no leaving anything in the car overnight.  There is no hitting snooze because getting ready to go outside is really like preparing for space travel (as in it takes a team to dress you). 

The cold there is part of the culture.  It's an ever present element and a source of pride at the end of every winter. (we survived!)  Québécois are a hearty people who know how to have fun in the snow.  They are so good at it that even I felt like I loved it.  We went snowshoeing, glissading, tobogganing, snow tubing, and, best of all, dog sledding.  (Seriously, dog sledding was the most exhilarating and terrifying thing I've done in a while.  It was awesome.) We went to their winter carnival in Quebec city and marveled at a hotel made entirely of ice and snow. 

I learned much, especially that one can get British candies in parts of Canada, roads to not need to be plowed and salted, and we (mid-atlanticers) are really, really bad at winter.

Also, they really take their French seriously there.  Yes, yes, I am the last person on earth to realize that in Quebec people really speak French and many only speak it.  My French consists of a bloody-ear inducing count to 10, so this really was a shock.

It was an awesome and exhausting long weekend and I really can't wait to go back.  But, maybe in summer next time.

11 April 2016

PA Update

I know that so many of you are waiting for an update on "Wild ass plan-apply to PA school". Well get ready! Basically, it's boring. I am slogging through my last prerequisite "Intro to organic and biochemistry". Did I save the best for last or what?! Truly, this is the class that I know I will struggle with. How do I know that? Well, it's been two weeks and I already am!
This class is offered at several schools but is accepted for all of the programs in my state. When we had our obligatory introductions on the first class, it became clear that I am not alone in my wild ass plan. Indeed, the competition for these programs was never made more clear. 28 out of 30 students want to be PA's. 28 out of 30 students went home that night and cried themselves to sleep. Those that hadn't already done the math of 1000 PA school applicants for a class of 35 were for the first time feeling the pressure.
It's a mixed bag of backgrounds and ages.  I am probably not the oldest aspiring PA, but the young ones are...so young.  My favorite part of talking to them is when they muse "What is the fastest, easiest way to get patient contact experience?"
As a good paramedic, I take this time to promote volunteer EMS and encourage them to take a 15 week class and get out there and treat some patients.  It's a win, win, win situation for them as far as I can tell.  I can only hope that we can, at the very least get some good EMTs out of these aspiring PAs. (Those who don't think that 15 weeks is too long.)
While exchanging backgrounds, I did worry that everyone would hate me as a pretty well qualified Paramedic, but it turned out that...no one has even asked what I do.  Ah, youth.

UPDATE TO UNPUBLISHED POST.
Now, many more weeks in, I still am terrified of this class.  Not one assignment as solidified an acceptable grade one way or the other, instead, as predicted, I am teetering on the edge of something okay, and something very annoyingly not okay.
But...I will keep plugging away, making attempts to understand the un-understandable.  If at a loss for direction-forward!