A Work in Progress

You are mad, you need an IV, and unfortunately you are 9 months old. The nurse asked me to take a look. A tight tourniquet around your arm, and my fingers become my eyes. I feel a tiny vessel in your AC. I can't see it, but I know it's there. Three of us are holding you down. You are angry and crying, and squirming. I take a literal stab at it and amazingly, a flash! You have surprising strength and are wriggling like crazy. It is so crucial that you stay still at this second. You give a few sharp pulls as I attempt to stabilize the catheter. My partner attaches the lock as I hold your arm as firmly and gently as I can. Wriggle, wriggle, wriggle. I push the plunger on the flush and the vein is blown. Damn! The most honest damn I have ever uttered. Back to square one and you are still mad. One look in your sad face and my anger is gone.

Oh, what a strange career I've chosen when a 'good day' includes people dying. I will reiterate that it is not that I want people to become sick or injured, but if they are to get sick or injured, I am happy when it happens on my shift. Our call came out as a fall, which could mean absolutely anything. Further information was they it was down 5 steps, but they weren't sure he was breathing. Hmm, that's certainly when the call took an interesting turn. We got on scene and a guy ran up to me, shouted, "You've got to hurry!" and ran back into the house. I followed him to the head of the basement stairs. At the bottom of them, was a guy on his back in a pool of blood that was more or less pouring out of his nose, as his wife was doing CPR. Initial thought: "Oh, shit." I head down with my partner right behind me. The wife stood up, said 'Thank God' and ran up the stairs never to be seen again. So we didn't really know the story...

I was pedaling along, minding my own business of course. I was thinking about whatever it is I think about when I'm alone on the road. Suddenly, I heard shouting to my right and look over to see a dog running full on toward me. I'm not a dog expert by any means but I can say without trying to be dramatic that this dog was a pit bull. All conscious thought was gone and my instincts told my legs to pedal like crazy. The dog was next to me within seconds, pushing me into the oncoming lane. It was so close that I could have kicked it easily (not a good idea). I believe that it either would have run me off the road completely or run into the bike causing me to crash. It was keeping up with me, which concerned my instincts so I just started yelling. I think I yelled "GET OUT!!!" and wondered to myself why I said that given that it made little sense. Either way, that, and an aggressive turn toward the dog made it stop. I continued to pedal, increasing the safe distance betwe...

Having spent two candy and crap food filled holidays without actually consuming any candy or crap this lent, I was particularly excited to end my candy and crap fast. But I discovered, increasingly with every Easter, that I'd rather just eat normal food. I can't have just Peeps for breakfast anymore. And, now within a week, I have pretty much completely returned to my pre Easter diet. Easter was a non holiday holiday for me, as I was at work the entire day. It was pretty easy money as we only transported two patients out of six calls. I got to split from my partner and venture out on my own in the truck which was equal parts frightening and exhilarating. I was only afraid of getting lost, but miraculously, I knew where the call was! It turned out to be a refusal. Last week at part time work, I got to experience some advantages to working in the ER when we gave adenosine twice in a row. One guy came in with a heartrate of 170 and was fixed with 6mg of adenosine. And about hal...

My hands are cold. My shoulder is cramped. My cheeks are red and hot with windburn. My lungs work fast to take in gulps of air. My heart is beating faster than ever. My ponytail is in a windswept tangle. My quads are tired and begging to stop. I have never felt better.

Okay, I'm just going to throw it out there, because I am not ashamed to admit that I am lonely. I am now a card carrying, real money paying, t-shirt wearing, annoying commercial making member of everyone's favorite online dating service: eharmony.com. Okay, I am a little shamed. It's mostly the paying money to meet strangers that bothers me. But, I figure that no matter how I meet people, it will cost me money. Online dating costs less than taking a class, going to bars, getting arrested for selling myself on the street, and those shady mail order husbands. Plus, all of the embarrassing rejection takes place in my house and is witnessed only by my cat. So I am doing a trial run. The basic facts are these. If you don't find anyone at school, work, or through your friends, you won't find anyone. Well, that's my theory anyway. I don't have the time or money right now to begin higher educational pursuits, and everyone at work is older, creepy, or married. The th...

We had an ATV accident where a kid, guy, whatever, it's up for debate, launched himself off of his four-wheeler and face planted into something (well, the ground, but something put a nice cut on his face too.) Aside from the cut and scratches all up ons, he was basically fine, (we know now) Although at the time he was acting mental, resisting help, screaming like a girl, carrying on and such, so that we couldn't rule out a real head injury. Possibly the best part about this call, aside from the amazing amount of amusement I got from his screaming like a girl, and the presence of a helicopter which is always fun, was that he was off the road on a farm lane that was an absolute mess. The lane climbed the side of a hill and not only had potholes big enough to knock your teeth out, it had these large humps. I can only believe these were made to guide floodwaters somewhere else so that the lane didn't become a river, but they were so big that I think that if I had driven over on...

Last week I got to use CPAP for the first time which was fun. If you looked up emphysema in the dictionary, there would be a picture of our patient. emphysema: 1. a chronic, irreversible disease of the lungs characterized by abnormal enlargement of air spaces in the lungs accompanied by destruction of the tissue lining the walls of the air spaces. (dictionary.com) 2. Ellie's patient the other day. He was on 4 liters of oxygen at home all the time and neb treatments every 4 hours around the clock. He was just finishing up a treatment when we arrived and it wasn't doing anything for him. Well, before he took his neb treatment, he just finished the other kind of breathing treatment: a cigarette. (I'm about to give up on understanding people) We got him in the truck, did a duoneb and an albuterol. After those he was wheezing more, which was actually a good thing. He was still struggling quite a bit, so, with about 10 minutes to the hospital we put him on the CPAP, which was...

Last week I went with my friend to the Philadelphia Flower show. We went back in high school and decided to go back. It's also a lot of fun, in the nerdiest of nerdy ways. On our bus it was the two of us and about 40 other retired old people which amused me greatly. I actually bought plants this year, and had my first Philly cheese steak ever. It was good! Here are some pictures of Flowers A few weeks ago I got to test drive a Smart car. It is not a car that thinks for itself but a 71 hp, 40 mpg minicar with just 2 seats and about a foot of storage space. It is awesome! Needless to say I need (an absentminded typo that I'm keeping) want one. But alas, not cost effective while I still owe on my truck. Oh well. But think of the gas savings! It would be significant. Think of how hilarious a 16 foot kayak would look on an 8 foot car! That's probably not legal. Think of the turning radius! Head in parking in a parallel spot is also probably not legal. Think of a highway speed a...

So, apparently it is possible to be shot through the head and survive. I have heard that my patient is still intubated, but is following commands, which lead them to believe that he will eventually not have a terrible neurological deficiency. And by terrible neurological deficiency, I mean be dead. So, yay! Another life saved, almost for real this time. (Full time) work has been work like, with basically almost no patients that stand out in my mind. The white cloud has officially caught up with me. We had a two week old with nothing wrong with it, but an overly worried mother, whom I can't blame at all for being worried. Another patient had nothing wrong with him, except that he woke up with a sore throat that had since resolved itself. 911 is no longer an emergency number apparently. In the interesting call category, today we had a guy with major sepsis, so much that his temperature was 105 and he was literally red hot. Ew. Yesterday at (part time) work, I had a lady who was havin...

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 hav...

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 ...

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 gu...

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...

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.

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...

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 ...

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.

So, hospital orientation was as torturous and terrible as I expected. There is just no improving it without getting rid of it altogether. Which, in my mind would be fine. We did in fact have an annoyingly detailed tour of the hospital. I can’t imagine an instance when I would need to know where the sleep lab is. In fact, I don’t even remember. I don’t remember anything I did for two and a half days. Well, I remember three things. The hospital has a whole host of values and of course, a mission. Why does everything need a mission? Shouldn’t it be as simple as ‘We’re a hospital. We treat patients.” Instead, our mission statement has to give us a warm fuzzy feeling. “Careful delivery of high quality patient care focused solely on improving overall health and physical stamina for the people in our community and to make the longest run-on sentence in the history of mission statements because we care about you.” The most important thing I remember is that I will be saving $175 each...

Putting in notice at work was not just a passing remark, but one of the best things I’ve done in a long time. A small hint of what I hope will be the beginning of a new and more hopeful and happy chapter in my life. I have changed my status at what will now be known as ‘crap work’ to part time. I equate this to when you tell your boyfriend that you just want to be friends, when what you really mean is that you never want to see them again. I am still part time there mostly because I felt guilty about using them for a free refresher class. I’m sure I’ll be over it soon. Also, at my new job, oh yeah, NEW JOB!!, I am taking a bit of a pay cut, so it may be handy to go and do a shift every once in awhile at crap work. And there are some good people there who I’m happy to have as friends. I finally have landed a full time spot on a chase car not too far from home. (not the same as my part time job) It’s a 24 hour schedule which is super sweet. But I think the best part is the ...