A Work in Progress

Every year, I forget the lush color of too-tall grass. how bright the sun is on the way to work. my jacket at home, even when I need it. how long it takes for the trees to begin to bud. that mice can get into the house. the musty smell of impending rain. how soon sun lotion becomes essential. that carpenter bees love to eat my porch. how tired I get when the daylight lingers. the taste of a cold beer on a warm evening. my favorite songs that drive away the winter blues. that spring is my favorite season.

Midnight: Flank pain. Been seen in the ER three times already. "It just hurts." 0330: Woman thinks temp is 108 due to using a 50 year old unreadable mercury thermometer. Midnight: 30 year old with pain. Was in the ER this afternoon, left against medical advice with a diagnosed problem. Didn't fill prescription, didn't make follow up appointment, pain worsens. 0520: Shortness of breath that "just started" according to facility staff, been going all night according to patient. Midnight: 20 year old throwing up for 1 hour. Doesn't know what to do. 0400: 40 year old with weakness for two days. Why now? It just didn't get better. Midnight: 22 year old male with a fever. 2310: 29 year old with anxiety. 0230: 24 year old. Supposed leg infection. Just left er waiting room against medical advice. Walked to payphone, Called 911 0100: Short of breath. Just needed a chat 0245: 55 year old with blood in urine since noon. 0445: 26 year ...

Everyone wants to talk about overdoses these days.  My job is now not known for daring rescues and fiery crashes, but our menial contribution to a disease that has finally caught public attention.  I am baited upon meeting new people and I fall for it.  "What's your most common type of call?"  "Have you ever been on a heroin overdose?"  "Do you carry narcan?" Ah, damn!  Next thing I know I am in a conversation about the good old days, how kids are spoiled, or 'why don't they all just quit?'. One of my first calls as a student was for an overdose.  My first.  My preceptors 5000th. "Pump the brakes"  I am told. No, you won't get to intubate this patient. At best you will finish this call and not have been punched or yelled at. So, no, giving narcan is not news to me. Giving it on the regular in a town of 6000 residents, that is noteworthy.  That is something we've all noticed.  One thing I resolved to do was not "...

(way overdue but who cares?!) Everyone needs a set of friends whom move all over the country to new places and are the picture of kind and generous hosts.  Mine moved to Texas last year, a place I had never been, nor had more than a passing interest in until my favorite family was there. It took a while to get myself together, but headed to Texas for a week in April.  This was the first time I did anything remotely interesting with a spring break.  I think everyone else in the world is really onto something. I got a wonderful personal tour of Ft. Hood, Killeen, Waco and the surrounding area.  I went to my first real rodeo, but lasted only 7 seconds.  I really was happy to drive around a chase blue bonnets, the Texas state flower.  Texas in the spring spoiled me.  It is (allegedly) the only time when the weather is perfect and things are lush and green and flowers are in bloom.  A week or so in any direction on the calendar turns the T...

A lovely old man who fell down. We had to break into his house. Twice. A patient with sepsis. Nursing home claims she was 'just fine an hour ago'. A patient fell down the steps and died. On thanksgiving. Lady whom needed us to fetch and pack the entire contents of her closet and living room before she was ready to go. Dear oldie who gets picked up off the floor at least once a week by EMS. When you know the names of your patients' pets, it should be a red flag. Nursing home patient who had the worlds smallest laceration. “Everything must go!” Same nursing home gives patient three nitros within 10 minutes. Blood pressure changes seem to be a surprise. Woman noticed a problem. Called 911 eight hours later. WHY? So much why.

She was dead.  He knew it from the moment he saw the car, but he had to check for sure.  The worst part of the job.  Glass crunched under his boots as he approached the car, now barely discernible from the tree it hit.  Two fingers found their way through the broken window and onto the side of her neck and lingered.  Ten, twenty, thirty seconds.  How long to be sure?   He could have stood there all night waiting to feel a pulse, but he knew better.  He shook his head at his partner. The backboard in her hands made a soft rumble as she retreated, dragging it along the road back to the ambulance. He wanted to be sure that she was the only one in the car.  He shined his bright flashlight through the car and along its final path. Snippets of her life were now strewn along the road.  Cell phone, spilled purse, her favorite gum, a snapshot of friends.  He turned his flashlight to the woods, to the field across t...

I forget most calls by the next day.  Looking back on the old blog, I remember more from years ago because I actually wrote them down.  So, here's a few. A guy with bleeding ulcers that had been leaking for about a week or so.  Yeah, you have no blood left. A man whose dialysis shunt sprung a leak.  Yeah, you have no blood left. A house fire where I gave a cat oxygen.  EMS bucket list check. (Damn, no media coverage of that!) A benzodiazepine overdose. Ooh, drugs and unconsciousness. An unconscious stroke displaying Cushings triad. Let's intubate you and atropine you, and get you right down to the ER real quick like.

Someone recently asked how many of my calls were true "emergencies". I said 5%. 5% may even be an over-estimation Something I’ve come to realize and have to accept that we are not in the business of saving lives. We are in the business of solving problems. Boiled down, our job is to be the clear head in the situation where no one else can seem to get their shit together. Yes this is a great illusion. It is not why I got into this business or why anyone got into this business. Work has become like air travel, long periods of boredom punctuated by tiny moments of excitement. Like, when a meal arrives. But maybe this is a natural part of any job. Any job becomes routine. Maybe anyone with 10 years in any field would feel the same way. Maybe anyone would say that their job is at its zenith 5% of the time. Maybe I am lucky that I can. That, or we’ve convinced ourselves that public service is easy and rewarding which often it is not. There is no sense in dwellin...

As a paramedic, have to be a pretty good negotiator. Maybe you are surprised that negotiation is an important aspect of the job. Sometimes people call, and then when we get there and bring some calm, they get cold feet. I have to convince people to stay home as well. “You have the flu, please don’t come to the ER.” I usually say through a window using a bull horn. When hospitals get busy, I have to sell alternatives. When I want to start an IV, but the patient doesn’t trust me yet, I get that done. I have to coax kids into not crying, coax parents into not crying. I have to squeeze information from human turnips that just about drive me crazy. At the same time, I have to figure out if these people are drug addled, drunk, or just plain lying to me. All this talking to people, as an introverted extrovert, is exhausting, but sometimes a rewarding part of the job. The other night, I couldn’t make anyone do anything. We started with a lady who had a seizure and then fell and...

So, here I am bored at work and I wonder…what ever happened to that blog I used to write? Yeah, there was stuff about EMS or ambulances…something like that. Sometimes stuff about travel. Oh! And a whole month of just pictures. Weird. Then, I think that the job got boring, or sad, or both and the blog sort of stopped. Sure, maybe a few meager posts here and there, but nothing too exciting or deep, but thankfully, no sad poetry either. Perhaps the world is blessed by having one less blog. One less tangle of self obsessed prose. One less (pre) millennial bitching about how hard real life is. One less quarter life crisis immortalized with questionable grammar in ones and zeros. “Oh, my job is boring. I don’t get paid enough. I’m single. Everything sucks. Oh, I go on trips and rub them in everybody’s face. Oh, I’ve filled the internet with 1000 blog posts, look at me go. Oh, my pets are cute.” No one cares.  Then I remember. All those calls that I can’t actually rem...

New uses for backboard and crutches.

Kittah!

Temporary insanity in the house while getting a new plaster ceiling.

Best strawberry rhubarb I've ever made.

You're not prepared unless you have a backboard as part of your personal first aid kit.

Strawberry Picking

Glass in Norfolk VA.