Expectations

I had a recent encounter with a family who had expectations for me that I didn't meet. They called for their unconscious family member.  Having met this patient before, I work very hard to not fall into 'The boy who cried wolf' mode.  I take every call seriously until otherwise informed. 
This person was unconscious.  Or were they?  It is my job to figure out why they're unconscious.  I see they are breathing sufficiently, I pry open their eyelids and look at their pupils. I feel their pulse on their wrist.  I pull out the glucometer to check their blood sugar.  This is when the yelling started.  "Why are you doing that?!"  When I fail to match their anger, they get angrier.  "I don't know why you're doing that.  [they] don't have a sugar problem!"  Again, my answer is too calm.  I continue my assessment, take their blood pressure, and wait for my partner to return with a device to get their limp body out to the ambulance.  More abuse comes my way "I don't even know why we called you." and "You know what?  I don't like you!" is shouted at me.  Meanwhile they were refusing to answer any of my questions, produce medications the patient was on, or tell me anything of any use including the patients birthdate. An observer may have thought that I stood there with my arms crossed and did nothing.  They may have thought I was smothering the patient.  They may have thought I was requesting unreasonable things.

The whole thing really took me aback.  I really didn't know what to say, knowing that anything I did say would spark more anger, so I landed on "I'm sorry I'm not meeting your expectations."  But really I meant, "Please tell me what you want me to do?"  "This is standard assessment and treatment for the unknown unconscious person (who isn't dead)."  "There are only two of us, I'm here assessing this patient and my partner is getting ready for transport, this is how it works." 

But are these people thinking "I wish that the people I called to help us were as hysterical as I am."?  Did they want me to throw the patient over my shoulder, carry them down the stairs, across the yard and into the ambulance?  Did they want me to inject a miracle elixir?  I really don't know, and frankly, I don't think they did either.  Somehow, even though they call us for our expertise and experience, that isn't good enough unless they hear what they want to hear.

So where does the solution begin?  I wish I could tell you that I counseled these people and they came around and we all held hands and skipped through a field.  But I don't know how to fight such unearned anger. They don't know that their expectations are skewed, but I am certainly not telling anyone that in the heat of the moment. 

Patients are usually non medical folk, they're scared, they're at the end of their rope with chronic illness. There is certainly a lot more heartache and trouble in their lives than in mine, but does that mean I have to answer for that?  All medical providers are just the patsy, the scapegoat.  We are people who can be blamed for problems larger than ourselves.  We are in a society where more emphasis is placed on the temperature of a drink than the quality of patient care; it's hard out there! An individualistic society that blames all problems on everyone else.  A society that forgets that there are 6 billion other people who are all trying to be the lead in their on life story. 

Okay, I'm sorry.  I rant.  I think I only wrote this down to make me feel better.  I guess I do.  The problem still goes unsolved. On this small scale, I decide to fight anger with kindness.  Maybe one day it will work.

Take the time

The other day we went for a medical alert call.  The good ol' "I've fallen and I can't get up." call.  These are some of my favorites.  Sometimes they are over fast.  The patient is embarrassed, we pick them up, put them in a chair and they thank us but want us to leave before the neighbors see the ambulance outside.  Sometimes we get to break stuff.  If all the doors are locked and the patient can't get to them to open them, things get broken which is always good fun.
And, sometimes we get to stay a while.
In the last year I've picked people off the ground many times, but one lady about four times alone.  I don't mind going to her house because she is fiery, funny, and likes to talk.  Boy does she like to talk.  The last time we were there we picked her up, cleared away the mess she had inadvertently made, took trash out and whistled at her new pet bird. 
On this occasion, one of our volunteers who works in a big town was rushing things.  He couldn't wait to leave, which he was free to do at any time, but I sat at the kitchen table with our patient.
Because I knew her and he didn't, I wanted to take the time, be sure she was okay, be sure she felt safe, be sure she was wearing shoes instead of slippers which is why she keeps falling.
The rusher did leave but made me think about this aspect of the job. I think it is as important as anything else we do. 
I have been having difficulty recently connecting with humanity.  These calls have become my primary way to do just that, and taking time is the key. 

Some of the only calls I can remember of late are these social calls.  A woman who couldn't work her new portable oxygen tanks.  She was an old immigrant, full of energy and, once we got her oxygen working busied herself trying to get us something to eat.  I called her doctors office, her son, and gave advice to her neighbors.  We fixed her a coke and went on our way.  15 minutes of our day where I actually felt like I did something.

My old partner and I picked a guy up off of his kitchen floor.  His thankfulness broke my heart.  A retired marine with an ailing wife in the nursing home.  He had struggled for ages to get up before calling.  We picked up the trash he had upset, vacuumed coffee grounds from the floor and petted his cat. 

I am retelling these to remind providers that we are working with humans.  If there is no need to rush out, what is the big deal to take a few minutes and make sure these people are squared away before we leave?  No, this isn't medicine.  It isn't saving lives, but it is doing what we had set out to do when we sat down in EMT class:  to help people.

I know being able to take this time might just be a luxury of working in a small town, but sometimes people just need someone to take the time for a chat, or to solve their menial but real problem.  Maybe all they need a cold coke and to know that someone cares.
 

Yeah

Yeah, I haven't written since June.  Not here at least.  Yeah, I don't really know why.  Yeah, I've kind of waited to get over my crisis of hating the job before I wrote again.  Yeah, sometimes I hate the best job in the world.

It's kind of my biennial problem of getting a little burned out, working a little too much, and encountering a few too many people that just make me wonder where the world is heading.  Although, now I've feeling far more Zen about it  than I ever have.  Because, for the first time, I talked to people about my problem.  Not a professional (maybe next time) but I felt other people out about my misgivings and low and behold, it worked.  I found that I am certainly not alone in my feelings.  Also, if I need to benchmark myself against the best people, I have a few in mind.

It's easy to lose sight of hope in this business of EMS.  At least I think so.  We do see a lot of silly things.  Sad things, gross things, dumb things.  It's the dumb that's been worrying me.  How can these adult people really not know how to function properly?  Can they ever get out of their desperate situations?  Why do they keep dragging innocent children into it? 
I get tired of waiting for that 1 in 100 call that makes me feel anything but frustration, makes me work, makes me use the skills I have.  But I reached a conclusion and have decided to put the energy from that one call I'm waiting for into all of my calls.  Everyone deserves to be helped, even if their crisis is not a crisis, even if their house is unclean, even if it's 4am.

Yeah, there are more important things in the world than their problem.  Yeah, they could have driven themselves.  Yeah, staying home can prevent spread of illness.  Sometimes, I have to put these thoughts behind me and just complete a task.  Not because I want to, but because it's my job.  Someone's asked for help and I'm the one who showed up. Sometimes, yeah, they are alone.  Yeah, they don't know what to do.  Yeah they should know better but they don't.  People don't know what they don't know and a shitty attitude isn't going to help them change their ways.   

I know this is a little disjointed, but I'm rusty.  I'm just trying to say that I still like my job.  I like to help people.  I wish that I could change myself to be able to say that sentence without putting a 'but...' at the end. I'm trying.



 

19 May 15

Fixed the problem of the offending screw/metal bit/whatever cut me. Take that, air filter!

11 May 15

Community!

A&P

Like a nerd, I had always wanted to re-take Anatomy and Physiology.  This is an incredible class.  I took it first in 2003 and to be a qualified PA applicant, this class must be within ten years.  So, I am getting my wish.  I felt like I remembered a lot from that class.  I remember it being fascinating and overwhelming.  An entire lexicon I had never heard before.  Amazing, amazing things going on inside my actual body at all times.  I distinctly remember that after hearing the lecture about muscle function I could barely move, now knowing how complex even the smallest motion was.  I guess what I remember most about A&P was that it was hard.
Now, a few weeks and several quizzes in, I am shocked by what I forgot.  I am horrified by what I never knew.  Or, maybe I did know it, but who knows?  Looking through my flash cards (which I did find and will prove useful) I must have known a lot of stuff.  But most of that's gone now.  I guess I don't often use the origin, insertion, and action of the gastrocnemius (one of my favorite muscles).
So far, (which is so early in the A&P game) I am still stoked.  I am dedicating the time to the class that I should have in 2003 but didn't because, you know, college!

3 May 15

I am Root.  This baby was under my old patio and was quite difficult to remove.  Tree long dead.  

1 May 15

You thought I forgot.  The whole blogging world has been wringing it's hands worried that I forgot to post a photo a day for May of 2015. Well, I'm back, baby!  I took these pictures in time, I just didn't post them in time.  What I did forget was to bring my real camera to work for two days, so excuse the cell phone crappyness.  Off to a fine start at the firehouse.

Not My Emergency

I have been working for the past few months on a genuine ambulance, as opposed to being the ALS chase car.  I had not realized how much nonsense I'd been shielded from over the last eight years.  So many silly calls that I was canceled on before I even got there.  But now all of those calls are mine.  The good and the bad and everything in between.  So, I must thank all of those BLS crews for keeping my standards high, prolonging my faith in humanity, and staving off my own insanity.

The general public would really not believe what people call 911 for.  Growing up, my career goals were fed by Rescue 911 and ER. Fed by the genuine, 'I'm stuck in a laundry chute', or 'I am inches from death' type emergencies.
I still remember learning how to call 911 in kindergarten (or somewhere around there) and from then until I became an EMT, I believed that, like me, people only called 911 in an actual (universally agreed upon) emergency.  When I started really riding ambulances, I was shocked by two things.  The first was what people considered an emergency.  As it turns out, their definitions and mine were completely different.  They still are.  The second thing was that people would pretend to be sick or unconscious.  Why?  I would ask feebly, my naivete protecting me from drug and attention seekers.

Over the years, and stop me if I've said this before, I developed the understanding that people are different.  Some can cope with a crisis, some can't.  Some can make a sensible decision, some can't.  Some people enter adulthood with strength and poise and character and some don't.  I began to meet people and say to myself: "They believe this is an emergency.  I don't, but that's okay.  They still need my help."  Damn, that is sensible.  That is most assuredly, something they should teach in EMT class.  It's not an empathetic view as such, it's just practical.  After coming to this conclusion, I no longer got annoyed.  I just did the job and believe me, that is easier than dwelling on things outside of my control.  Too many times I've watched my colleagues attempt to 'educate' these people, wriggle out of doing work, or get mad about these types of things.  I quickly learned that it's just not worth it.  Just get the job done, life is so much easier.

I am writing this in the past tense, but that is misleading.  I still look at the job this way.  But, I can already feel my theory eroding.  I am still in a fairly rural, fairly slow area, but now I am seeing every call through.  There is no hope of cancellation.  It is a challenge of language to see if I can get people to make doctors appointments, get into their own car, or stay home instead without getting into trouble.  These three options seem manipulative, but some of these calls are...seriously dumb.  This is all while trying to convey that I genuinely care about their suffering, but I also geninely believe that going to the emergency room via ambulance is inappropriate.

Honesty is tricky in medicine.  Meeting patients and patients families expectations is difficult, especially when they believe an emergency has occurred and I don't.  You don't want me to think it's an emergency because that means something is seriously wrong.  I will take a calm, collected, precise, and deadpan medical practitioner over a jumpy, nervous, indecisive one any day.  That, and people with the flu don't want to be told that there's nothing anyone can do for them.  They don't want to know that they're exposing more susceptible populations by going to the hospital.  They don't want to hear that they will be suffering for a week no matter what.  And usually, I have to take them anyway.      

Blogiversary 10

Like all previous blogiversaries, number 10, the one that deserved a party the most, has gone by without mention.  In fact, much to my shock and yours, blogiversary 9 was completely overlooked. But this year, I did remember and I did start this post on time, but then, predictably, I got distracted. At least these days I am getting distracted by actual things like education.  Who am I kidding.  Video games were the culprit, I'm sure. That or Top Gear.  Either way,  here we are.  Ten years on.  The modern gift is diamond jewelry.  Well, thanks blog for not getting me diamond earrings.  Oh, I didn't get you diamonds either?  Well, I gave you a fresh layout.  That should count for something!  Okay, let's not fight.  Love you too.

I know, the blog is not what it used to be.  If it ever had glory, it is certainly former. But...I have hope.  I have so much musing/whining about going back to college that surely that will fill a couple of posts.  Also in the next year I need to come up with some really good arguments for going to PA school (for entry essay) and I think I'll use the ol' blog to flesh them out.

And, having reviewed blogiversary 8, I had some big talk about a 'non-blog writing project'.  That is still going, believe it or not, and is periodically neglected just like the blog.  It isn't finished, but is actually pretty darn close.  Missing just a title (marginally important), a chunk of narrative toward the end, and some damn good editing/cleaning.  It is something I want to finish before I am "a qualified applicant for a PA program."   So that is still something for you, dear reader(s) for you to look forward to.

Outside of that...desperately seeking topics.

Happy anniversary, blog.  I miss you.  

Back to School

In preparation for potentially, maybe, hopefully applying for and going to PA school, this year I'm going to be taking (and re-taking) some prerequisites.  I figure that that this is a necessary step,  a review for what I will actually need to retain now, and serve to ease me back into academic life.
I had my first class today.  I've been joking that I can't wait to be the older adult student who screws up the curve for everyone.  Today, though, I realized that I (at 31) just might be the oldest person in the class.  I sought refuge by sitting next to who is probably the second oldest person in the class who just so happens to be working on getting into PA school.  So, I'll have to kill her.
I am excited to take A&P again, after 10 years of secretly wanting to retake it because the material is so amazing, but so abundant that I definitely lost (or never had) much of it.
The class was fine and basically nothing happened.  I remember loving the first day of class, oh, a whole session dedicated to having a syllabus read to us.  But that was before!  Before I was paying for it. Before I felt the urgency to learn it all.  Teach me something, man!  It is funny how that attitude changed over the years. Also, when I went to buy books, I actually considered buying all of the supplementary texts, something I never would have considered in my 20's.  (Because only nerds did that).
You know?  I've never gotten rid of my old flash cards from my first A&P class.  Who's crazy now?

My second class of the day (and term), Microbiology was canceled due to weather.  First day back and already enjoying a snow day!  Result.  We'll see what fresh hell awaits me there on Wednesday.  (I am far less confident about that class).

Now, I'm going to find those flash cards.

Calls Round-Up

Looking back in the blog, I see that I used to at least mention calls I'd been on that week/day/month.  Over time, I realized that all of this documentation could have gotten me in trouble. That, plus the novelty does wear off, even in a business like EMS. So, the call logs tapered off.  But, I also realize how many calls I've forgotten in recent years.  In fact, I've even forgotten the calls I've written about!

So, here are a few that I remember.  Closed broken ankle- single step won.  Open broken ankle, driveway won (but it was for a a good cause).  Great old crack on the head that looked like a murder scene...he was fine! (More or less).  A guy had a seizure and fell onto something that busted a huge gash in his face.  Insult to injury (or the other way around).  A lady with restless leg syndrome.  Yes, this is totally a medical emergency (did you get the sarcasm?)  A guy who 'bumped' his head and felt like going to the hospital.  I love it when people answer me with a shrug, then fail to take my advice.  Go ahead and wait in the ER for 8 hours, that doesn't bother me at all.  A kindly old lady with few ailments other than loneliness.  A lady with diverticulitis who actually hyperventilated herself into unconsciousness.  That was a first, but a relief for everyone.  A drunk pregnant lady who threw a trash can at her boyfriend.  

College is for Everyone

Yes, I'm one of those assholes.  The one that says "Well, I know college isn't for everyone." while secretly thinking, "Except for my kids.  Only idiots don't go to college."
But the truth is, college isn't for everyone.  Countless non-idiots have made it their whole lives without going to college.  In fact, most people I know didn't go to college and they're doing just fine.  It's only weirdos like me who can't seem to get enough.

And the thing is, college is no longer a golden ticket to a 'successful' life.  I recently ran into an old friend I knew in high school.  She went to college and majored in (what I would usually phrase as) something useless like...drama.

I made that face.  That face that every asshole makes when someone tells me they majored in drama, or art, or dance.  That face that says "way to waste all of your money and four years of your life."  That face that says "How's working as a waitress working out?"  That face that tells them I have judged them for that major and that's just not fair.  I try to hide it, but I am a bad actor.  This friend even minored in something useless!  Then she got a master's in something useless!  Before I could feebly cover up my telling face, she stopped me.  "But you know, it's not like I was good at anything else.  What was I supposed to do, get a master's in chemistry?"

And that is it.  Why do we judge these people?  These creative types that we willing to sacrifice all of their money and four years of their life knowing that in the end they probably won't be doing the job they wanted.  Was my friend supposed to minor in biology or something?  Would that have opened doors for her?  Are all art majors supposed to fall back on something they're not good at?  So, to all of those people: I'm sorry.  I'm sorry that your dreams and talents didn't lead you to financial stability.  I'm sorry for all of those times I made that face.  All of those times you had to justify your dreams to assholes like me.  Thank you for being passionate about things that the rest of us take for granted.