Tuesday, May 31, 2011

A is for...

Well, here we are at A, and if you are blogging about EMS what should A stand for? Ambulance? Nah…to predictable. How about…Adrenalin? Already covered it. I know…A is for Acting! It makes no sense, but believe it or not, I came to this career through acting. Before I became an EMS maven, I was a professional actress. I studied theatre in college (the first time around) and I spent eight years hitting auditions, doing commercials, traveling the country in search of work (living out of my car) and I was totally, 100%...miserable.

Oh I loved acting in plays. In college, I was able to portray some of the finest heroines to grace the stage; Portia in “The Merchant of Venice”, Maggie in “Cat on a Hot Tin Roof”, and Blanche in “A Streetcar Named Desire” to name a few. But, acting in college plays and making a living as a professional actress is not the same animal. There isn’t a lot of artfulness in hawking laundry detergent, and doing silly farces night after night in dinner theaters while people pick roast beef out of their teeth doesn’t get the old creative juices flowing. Something was missing from my life, but I couldn’t for the life of me figure out what it was.

One thing I did figure out early in my show business career was that I would have made a terrible famous person. I like my anonymity and if I want to go out looking like a reject from the trailer park, I’m going, and if you don’t like the fact that my bra strap is held together with a safety pin and falling off my shoulder, then don’t look at me! No, if someone jumped in front of me with a camera they might be pooping lenses and f-stops for a week. I would have made Sean Penn look like Pat Boone.

Trouble was I had no idea what I wanted to do with my life. I had no skills other than the requisite table waiting and bar tending kind that are a must when you are a “professional” actress, and I had no burning desire to acquire any. I couldn’t type, and would have self-combusted in an office environment anyway, so I didn’t see the need to learn. I was drifting in a sea of perpetual dieting and meaningless auditions that might net me a cereal spot or a voice over and then it was back to the grind of just trying to find some work. My life lacked meaning and that’s when I met…the Captain.

He was a part time actor and we had the same agent. I had done a couple of shoots with him and we were on “friendly acquaintance” terms. We got stuck together on a really long auto dealership shoot that went over time and budget and lasted several days. We had a lot of down time and that’s when I learned that he was a fire Captain when he wasn’t selling cars on TV. Cool…I’d never met a fireman before. I bent his ear for two days and by the time the shoot was over I had procured a coveted “ride along”.

I showed up at his fire station breathless with excitement. You might have thought it was at the prospect of seeing hot sweaty firemen, but I had a wrinkle in my brain that I couldn’t quite smooth out and it had something to do with the chat I’d had with him about his life’s work. I began to put a name to what seemed to be missing in my life. It was…a sense of purpose. I had never been able to find it in my show business pursuits and I was starting to think that I had missed my calling.

Don’t misunderstand me. There is a higher purpose in the arts. I am still an avid lover of all things cultural, but as an observer. I personally did not find happiness and contentment in my attempts at creating; I am at home being the one who the culture is created for, and by the time I left the fire station at the end of that shift, I knew I had found my calling.

The journey itself is too involved to completely cover here, but I returned to college, received a degree in Emergency Medical Science and have blissfully been plying my trade for the last 25 years. The odd thing that I quickly discovered about my new profession was I had more acting challenges in EMS than I ever had in the theater. Such as, acting like I wasn’t scared out of my gourd or acting like I knew what I was doing. And these acting gigs are all improv…the calls aren’t scripted, the bad guys don’t throw stage punches, and I love every minute of it. People often ask me if I regret not pursuing my acting career any further than I did. My reply is, “Why would I want pretend drama when I can have the real thing!”

Monday, May 30, 2011

B is for Bill Clinton

I don’t want to seem immodest, but I am the most powerful person in America. How do I know this? Because I, single handedly, not just once but twice, elected Bill Clinton, President of the United States of America. Yes, my single vote in 1992 and then again in 1996 kept him in the White House for eight years. What, you say? There must have been others who voted for him! Not so I say! I have tried to find someone, anyone, who would admit to it and none can be found.

Granted, my search hasn’t taken me far out of the circles of my present location and profession, both bastions of extreme right wing Republicanism. Tea Party? Ha! Long before those lightweights came along we had the Beer Party down here. Comprised of mostly white, male, conservative Good Ol’ Boys, these guys wrote the book on “stay outta my back yard” politics. I’ll have to admit, that though my politics swing to the left, I do agree with these guys on the gun issue. You know, the whole “when you pry them from my cold dead hands” mentality? Hey, I am a Rural Southern Liberal Democrat after all.

Most of my co-workers thought that Bill Clinton was evil incarnate. I think that he was one of the best presidents we have ever had and I believe that history will view him the same way. You disagree? Fine I’m up for a debate. Read the last paragraph…I think I can take you!! All kidding aside, wouldn’t it be nice if the biggest news story and the worst problem we were facing in this country were some stains on a blue dress…but I digress.

In 1994 Mr. President Clinton was scheduled to give one of his televised town meetings at a local Charlotte television station. The preparations for such an event are exhaustive. Before any Presidential visit, a team commandeers a treatment room at our trauma hospital and sets up a command center in case #1 ends up there for some reason. They install a bank of secure phone lines that go directly to God knows where, probably every major head of state in the world. These advance teams are always pretty tight lipped about such things. This visit was no different, but included much, much more since this event was to be so open and placed the President in a more precarious security situation.

When the memo went out looking for a crew to man a dedicated ambulance for the event, I felt that being the only openly practicing Democrat in the organization that it was not just my duty, but my birthright to be on this crew. Imagine my surprise when I went in to claim my rightful position and found that two of the aforementioned GOB’s had already snatched up the slots. Now, over the years, I have been known to jump up and down on a superior’s desk to get what I want. That day, I jumped from the desk to the file cabinet and hung from the light fixture, all the while screaming the one hundred and ten reasons why I should be the Charlotte paramedic to personally attend Mr. President Bill Clinton…of course I got my wish. I was assigned as a third on the unit which suited me just fine. I just wanted to be there.

We were to be part of the official entourage and motorcade the entire time the President was in our city. I had been so excited about being a part of this historical event that it wasn’t until a couple of days before his arrival when the advance team did background checks on the three of us, that the enormity of what could happen hit me. What if something did happen to our President? Was I up to the task of performing the skills that were so second nature to me in probably the most intense situation possible? I got my answer when we met with his medical team on the day of his arrival.

We first were assigned a Secret Service agent that was to be our liaison for the entire event and he arranged the meeting with the doctor and nurses that accompanied the President everywhere he went. This affable MD shook our hands, thanked us for our service then said, “You will never touch the President. If he has any medical emergency of any kind, he will be transported in his limousine with his medical team in attendance; you are basically here in case anyone else has an emergency”. I guess not having a bullet proof ambulance was an issue, not to mention the fact that relying on three strangers to attend a sick or hurt President of The United States wasn’t a mistake this thorough team would make…silly me! I’m not sure if the sigh that escaped me was one of disappointment or relief, but I was quickly caught up in the excitement of where I was and what I was doing.

Our Secret Service agent didn’t quite fit the stereotype you see in the movies. He was a tall, gangly and gregarious guy who was eager to help us and answer any of our questions. He wasn’t particularly fond of Mr. Clinton either, and admitted that he didn’t vote for him. When I heard this, I asked him the inevitable question; “Would you take a bullet for him?” It was if I had said the trigger word some night club hypnotist had given him. He got very serious and his eyes kind of glazed over…I thought he was going to start barking like a dog. He quietly assured us that he would die to protect the President of The United States of America without a second thought. Yikes! These guys are for real!

The experience did not disappoint. We traveled through the city in the motorcade, and convened at the television station. There were a couple of hundred people involved in making sure this thing went off without a hitch. We were staged outside and couldn’t see or hear what was going on in the studio, but our agent had radio contact with everyone and gave us a play by play of all of the happenings. At one point he chuckled. The sound men in the studio were complaining that the snipers on the roof of the station could be heard through their equipment…could they be a little quieter please? I looked up at the dozen or so men on the roof toting high powered scoped rifles and thought that I’d let those guys do pretty much whatever they wanted!

I talked our agent’s ear off. I had so many questions and he answered the ones that he could. He explained how the presidential limo was constructed to just about withstand a nuclear attack and gave me an insight into what day to day life was like at the White House. I had been eyeing a large, custom SUV with a high roof and completely blacked out windows that had followed behind the President’s limo the entire time, and was presently parked behind it in front of the station. I asked him what it was for and he got a little smile on his face. He talked into his cuff where his radio mic was hidden, yes they really do that, and then he took the three of us up to the SUV. “Put your face up to the window and look in the back”, he instructed us. We did and saw a friendly guy waving at us from behind a huge anti-aircraft gun. The roof was designed to open up and this dude could shoot down an attack from the air. Nothing like being prepared!

All too soon the event was over and we accompanied the motorcade to the airport where Air Force One was ready for takeoff. They had us park our vehicles and then instructed all the emergency personnel to get out and line up at parade rest, on the tarmac beside the entrance to the air plane. We were going to meet the President! I have often thought of all of the important things I would like to say in such an auspicious situation, but when President Clinton stopped in front of me an shook my hand I was dumfounded and blubbered something inane I’m sure, I can’t remember what I said to him. I do remember looking into his eyes and seeing total exhaustion, but he was gracious and thanked me for my service with sincerity. I was floating; I just wished that I could have had a photo taken to mark this event in my life. I mean, how many people get to meet the President of The United States?

A few weeks later, a package arrived at my home with a Washington DC return address. It was a photo of President Bill Clinton shaking my hand. I never saw the photographer and I never gave anyone my address (like they didn’t already have that), but everyone who had been in that receiving line got a photo of them meeting Bill Clinton. I looked like a goofy, gushing school girl in mine and Mr. Clinton looked…well, he looked Presidential.

Friday, May 27, 2011

C is for Christmas

Twas The Night Before Christmas

(Medic version…with deepest apologies to Clement Clark Moore)

Twas the night before Christmas, and all through the station,
Not a Medic was stirring, it caused great elation.

The pagers were tucked in their chargers full power,
For not a call had gone out, for nearly an hour.
In holiday slumber, the crews were all basking,
And the only thing heard, was the sound of gas passing.

When suddenly to our collective disdain,
The once quiet pager sang out its refrain
We climbed in our gear, we ran to the truck,
They told us “one shot!”, and we said OH… (gosh darn?)

With red lights a blaring and sirens a screaming,
We rushed to the scene to find the place teeming
With dozens of nosy neighbors galore
And a man with a hole in his chest on the floor.

His brother was violent, his mother was nuts
(his girlfriend was guilty and already in cuffs)
The poor man was thrashing, saying. “I’m gonna die!”
When I tried to lend aid, he slung blood in my eye.

In route I tried to call to the docs
(while choking back puke from the smell of his socks)
The radio crackled, the reception was choppy,
And all that I heard was, “18 we can’t copy”

Doing my job, I went for a stick
(all the while thinking I just might be sick)
I spotted a vein, a big one I see,
The truck hit a bump, and I missed the IV.

The second one flowed,
I said, “Finally, a truce!”
And at that very moment…
His bowels let loose.

We finally arrived at the emergency room,
And BELIEVE me it was not one moment too soon
Bedraggled and covered in blood stem to stern,
I gave my report to a brand new intern.

With wide-eyed ambition,
This new doc did listen,
Then asked if the man
Had a private physician.

I threw up my hands right there in x-ray,
I wrote my report and I left in dismay.
As we left, the rig slid on ice (yes unsalted)
Just as dispatch piped in, “18-one assaulted”.

I shouted in glee as I stepped on the gas,
Merry Christmas to all!...let’s go kick some ass.

D is for Death

Being a paramedic is all about saving lives, but no matter how hard we try, patients often die. In my twenty-five years in EMS, I have been in attendance at the final moments of dozens of peoples' lives. Some might think that I am hardened to its effect to be able to see so many people die. That is so far from the truth. It is my life long fear of death that ultimately led me into this line of work. I have a complicated history with death that goes far back into my childhood, a history that I will revisit to shed some light on how and why I do what I do.

I used to lie awake at night as a young child, terror stricken because I thought someone was in the house. We had an old gas heater that ran loudly and when it shut off, it would pop and creak and every sound it made was a footstep, a door opening and I would lie there with tears streaming down my cheeks and snot pouring out of my nose. I was totally silent for fear I would attract attention and this intruder would commit unspeakable horrors against me. I would try to go to sleep when the heater was running because I couldn’t hear those “footsteps” and somehow that would comfort me. I never feared monsters or ghosts…I feared this being and I was certain that he was looking for me. This happened every night so I took to going to bed early, long before my parents, so I would be asleep before the house was dark and quiet.

I experienced this for years. During the day, I would laugh at myself and feel silly because I let these ridiculous thoughts bother me…then night would come, and I would dread the approach of bedtime. I would pray…pray so hard that the Lord would take these nighttime terrors away from me, but they came. For years they came and I was 10 or 11 years old before I could sleep peacefully without that faceless man creeping through my house night after night. He was my imaginary friend and he was as real to me as Santa Clause and God.

During adolescence I forgot about those night terrors. I made good grades and was involved in school and extracurricular activities. I had two best friends, Yvonne and Voneda and we were the Three Musketeers. They used to joke that I needed to change my name to Eva or Violet so we would all have a V in our names…I would tell them that they were stupid and we would all three burst out laughing. We were always spending the night with one another. Yvonne snickered one night as the three of us sat in her room. We were going through puberty and all had recently had the cardinal come home to roost for the first time. She said breathlessly between her giggles, “Do you realize we can have babies now!!” We three screamed and swore that we would never “do it”…Well, maybe with our husbands, but only in the dark! Who could imagine being naked in front of a man…EWEW! I still have some of the notes we used to pass in the halls. The ones written on notebook paper and folded into triangles that said little more than, “Hey…I really hate this class” or, “Don’t you think (so in so) is cute?”, but were always signed…LYLAS (Love you like a sister).

I can remember like it was yesterday… December 18, 1973. The day Voneda called to tell me that Yvonne had been killed in a car accident. I couldn’t believe she was calling me because I was just starting to call her and Yvonne to tell them that a good looking junior had just asked me out. I answered the phone, and when I heard Voneda say, “Cyndi”, I started babbling about my upcoming date. She said my name a second time and I heard something in her voice. I stopped and waited. I could hear her crying and all she said was, “Vonnie’s killed”. I must have screamed because my mother took the phone, talked to her mother and found out what had happened.

My parents took me to the funeral. I was so scared. I gripped my father’s arm as we approached the casket and all I can remember thinking was how frightened I was to look at her. She didn’t move. I had never seen anything so perfectly still in my life. “She’ll move”, I said to myself, “Nothing can stay that still for long.” I remember staring at her hand and willing it to move. “Just one finger, please move just one finger so I’ll know that everything is all right”. My dad had to coax me away from the casket. I didn’t want to leave because she hadn’t moved her finger yet.

That night, as I lay in my bed I heard it again… “Pop –Creak”… He’s back. Go in the kitchen and turn on the light. Quick! Shut the door, he’s in the living room. I’m fifteen years old…this is not supposed to be happening…I got rid of my night terrors years ago. But there he was, my imaginary friend, returning to torment me and the thing I knew at fifteen that I had not known at five, was his identity…He is Death.

Thus I began my quest to beat Death. Not by being overly cautious and careful, no I have met Death on his own turf and I have reveled in beating him. Riding rodeo, white water kayaking, rock climbing, rappelling, I have rappelled down a mountain face first, and out of a hot air balloon at 1500 feet. I went to motion picture stunt school and have fallen off a four story building, been shot off the back of a motorcycle, had my arm wrapped in asbestos cloth and set on fire, I was a volunteer fire fighter and I became a paramedic.

I initially found solace in the science. Death wasn’t a personified evil being. It was sometimes the result of a catastrophic traumatic event, but most often, it’s a steady cellular breakdown, one piece at a time. Our cells become hypoxic and the vital organs stop receiving oxygen and fail, one by one until the body no longer functions and that is what we call death. There have been times when I have literally brought people back from the brink of death. No heartbeat, no spontaneous respirations, and through the miracle of modern science I have been able to reverse that, and it is the ultimate high and the ultimate victory over death.

Over time, an unexpected shift has occurred in the way I view death. My career has given me a wealth of experiences that defy scientific convention, and has brought me to a belief in the existence of miracles and a renewed faith in God. Miracles don’t always end with death being defeated. I have come to realize that death is simply part of our journey and one that is not to be feared. I have experienced many deaths both professionally and personally. I have lost quite a few people very close to me including Voneda. She died six years ago from ovarian cancer and we were still best friends. There is only one Musketeer left and I miss the other two terribly, but I am not afraid of following when my time comes.

Our time here on earth is limited and life is for the living. We all have the same fate; only the time and methods differ so the best thing to do is choose to be happy. When my death is imminent, there won’t be a faceless man creeping in to steal me away, I will just transition to the next part of my journey. In the meantime, I plan to live life to the fullest…and still snatch folks from the jaws of death whenever I can.

E is for Emergency Workers (all of them)

I wanted to write about why we emergency workers do what we do and I remembered this song and video. I can't say it any better. Just listen to the words as you watch the images. This says it all

I wasn't able to put this up as a link, (my computer skills are minimal) but just copy and paste to your browser...oh and you might want to have a tissue handy.


Wednesday, May 25, 2011

F is for Fear

There isn't much that I am afraid of. I like snakes and spiders, except for Black Widow spiders, those witches are evil. I'm not afraid of heights or closed in spaces. I'm not afraid of the dark. But there is one thing that I am afraid of. It is an irrational fear, as most fears are, but I am totally, completely and deathly...afraid of trains.

I don't know why. Trains have never done anything to me. I did spend a year one night on an Amtrak to Miami, but the ride on that rolling back alley has nothing to do with my phobia. I have been afraid of trains as far back as I can remember. I never go around the crossing arm, no matter how long it stays after the train has passed. Hey, there might be another one coming! I have been called many a name while other drivers are going around me to cross the track safely, but there's always the chance that a train might sneak up on you!

The tracks near my county home have no lights or arms, just the black and white RR sign. I always stop completely, roll down my window and listen, look and feel for the rumbling hulk that may be my demise. When my daughter first got her driver’s license, I was already white knuckling it in the passenger seat when she barreled through a crossing without so much as a passing glance down the tracks. My screaming banshee fit almost caused her to lose control of the car and I made her sit on the side of the road for half an hour as I listed one thousand, three hundred and twelve reasons why she should never do that again.

In my job as a paramedic, I am often faced with unpleasant situations, calls that test my nerve and resolve to always be professional and deal with whatever may arise. I had a call that just about crushed that resolve. Yes, this call involved a train. Now I have responded to many patients over the years who have been hit by trains. For some reason, more people than you would ever imagine fall asleep on railroad tracks. Perhaps they are drunk and just trying to find their way home and the tracks are an easy path to follow, but the outcome is usually not too good. Now, these calls don’t trigger my fear because the train is long gone by the time we get there and we are left to pick up the pieces…literally.

That night, when we received the call for “one hit by a train”, I had no reason to think that this was going to be any different, but when we arrived…the train was still there. The engineer had seen the man just before he hit him and had stopped the train as soon as he could. There was a cluster of first responders with flashlights right near the crossing, and when we got to them we found that this patient had been one of the lucky ones. He hadn’t been lying completely on the tracks when he passed out; just one leg had been on the rails when the train went by. That leg was presently missing, but the patient was surprisingly conscious and stable, and thankfully, very drunk.

This was early in my career and I wasn’t the lead paramedic so I was at the mercy of my crew chief as to what job was going to fall to me…stay with the patient, or go looking for the leg. Being less experienced, I was handed a flashlight and sent on a limb finding mission. It would seem that I could just walk along side of the train and shine the light around and under the beast to try and find the missing appendage, but there were steep embankments on either side of the tracks, so the only way to search was to follow them…under the train.

I tried walking on my hands and knees, but the gravel between the rails was too sharp and I couldn’t control the beam of light with my hands on the ground. So, I began to duck walk, under the mile long machine, looking for a severed leg. You would have thought that the driver would have turned his train off when he stopped, but it was still crunk, or cranked, oh hell, the damn thing was still on…and it was breathing!

Pshhhhhhhew…crrreeeeaaak. The unmistakable exhale was coming from somewhere up the track near the engine, and the sound of straining metal was all around me. It was as if the monster was angry at having to stop and was poised to resume its merciless journey and it had just tasted blood…did it want more? I thought about trying Lamaze breathing to slow my rising panic, but I was afraid that I might start pushing, and I was already close to pooping my pants, so I figured I should just try to concentrate on finding the leg.

Hours passed…ok five minutes, but it felt like I had died and gone to hell and was destined to duck walk under a train for all eternity, when my light beam illuminated a boot. It indeed was attached to piece of blue jean clad leg that ended in gnarled array of bone, meat and gristle…I had found the man’s amputated lower extremity. Not wanting to spend another minute under the train, I tucked the leg under one arm, the flashlight under the other and waddled in double time back to the crossing. The patient had been stabilized and loaded and I jumped in the back with my partner and a first responder drove us to the trauma center.

It wasn’t until much later that I realized that I was so freaked out by the train that it never occurred to me how weird it was to be walking around with a newly severed leg under my arm, so maybe my fear was a blessing in disguise. It would have all been worth it had the leg been viable, but the trauma surgeons took one look at its frayed end, and tossed it aside as they prepared our patient for life as a below-knee amputee. The experience didn’t help me with my fear of trains either. I still don’t like them. You can have your Thomas the Tank Engines…I hope I never have to get near one again!

G is for Geriatric

When a person aspires to a career in EMS, they are drawn by many things. Some seek excitement, an adrenaline rush, a job that is different every day and appeals to the adventurous. Others have a desire to help people, they want to feel that they have a job that matters and they want to make a difference in the world. Most of us were drawn by both of these aspects. In recounting stories from my career, I usually relate the most exciting, the funniest and the most poignant memories of the last 25 years. These musings make up about 10% of what I have actually done during the span of my career. The other 90% of the time… I was taking care of old people.

When I first started in this business, I imagined heart pumping trauma calls, shootings, stabbings, massive pile ups on the interstate and tense domestic situations. Yes, I have had my share of these calls and more, but the vast majority of my time on duty has been spent caring for the elderly. Hardly a shift goes by that I don’t respond to a nursing home. Sometimes it is for a true emergency, a heart attack or other acute medical situation, but more often than not, it is to transport someone to a doctor’s appointment, or to the ER because of abnormal lab values in routine blood tests. Residents of these facilities often pull out their feeding tubes or urine catheters and have to be transported to the hospital to have them re-inserted. The majority of responses to private residences involve the over 70 crowd as well. Think about it…who is most likely to get sick? An old person!

I’ll have to confess. I did not choose this path because I had an affinity for the elderly. I admit I was one of those adrenalin junkies looking for excitement at every turn, and early in my career I hated the nursing home calls, the non-emergency transports that often made me miss an exciting auto accident or other trauma call. I felt like my training and talent was being wasted as a taxi service for Grandma. Over time, my attitude has changed. I’m sure that the fact that I am now a grandma and am rapidly approaching old age myself has something to do with my shift in thinking, but I had changed my mind about the geriatric crowd long before my offspring had offspring of their own. I was surprised to discover years ago, that I truly love…Old People!

Whether a nursing home or private residence, I get to enter into these people’s lives, if even for a short while, and see the fruits of a lifetime. Photographs, mementos, awards, all proudly displayed in peoples’ homes gives a glimpse into the decades prior to them becoming sick, old and infirm. I once took a little old woman home from the hospital who was weak and barely able to speak. She wasn’t ambulatory and we had to lift her from the bed to our stretcher. When we arrived at her home, the walls were adorned with photos of our patient as a much younger woman holding and caring for chimpanzees. There were framed newspaper articles extoling her work with primates and memorabilia from her travels all over the world.

I have also had eye opening and informative discussions with elderly patients in the back of my ambulance. When there is no acute emergency, there is time to talk. I have learned many things from these people and I relish the conversations with them. They are at times intelligent, funny, inspiring and sometimes dangerous.

I once transported a 101 year old woman for chest pains. She wasn’t showing any signs of having a heart attack or other acute illness, and her vital signs and all other assessments were normal, but I followed our chest pain protocol just the same. When it came time to start the IV, I explained to her what I was going to do. She said, “Don’t you stick me with that needle”. I patted her hand and told her it would be alright and would only hurt a little bit. She replied, “If you stick me with that needle, I’m going to hit you.” My response was to pat her hand some more, and tell her that she really needed the IV and it would be over in a second. I mean, how bad could she hurt me, she was 101!? Well, I stuck her with that needle and she punched me. I don’t mean she slapped me, or swiped at me with her bony little fist. She cold cocked me in the jaw with a powerful right hook. I saw stars, and I learned that when a 101 year old woman tells you something…you better listen!

EMS is an exciting and rewarding career. The youngsters coming into the field remind me of myself many years ago. Eager and chomping at the bit to hit the streets and participate in the spectacular events that most people only read about in newspapers and see on TV. I just hope that they come to the same realizations that I did; that the calls that don’t make the news are often just as rewarding and yes, exciting, and there are many things that can be learned by just taking the time to listen to what an old person has to say.

H is for Homeostasis (and other "medical" terms)

Homeostasis is defined as, “The ability or tendency of an organism or cell to maintain internal equilibrium by adjusting its physiological processes". It is one of the many medical terms I learned when I went to college to study Emergency Medical Science. I had expected that there was a whole new language to learn, and I was right. I actually took a course in Medical Terminology and it was infused throughout my other courses as well. I became so proficient in the understanding and usage of these specific terms and phrases, that I just knew that I would have no difficulty with the language of the job. That is before I got into the field and learn that there was more than one kind of medical terminology out there.

The first thing to hit me was the prevalent use of abbreviations. The texting generation has nothing on medical professionals when it comes to shortening words and phrases to expedite their documentation. Let's face it, patient charting is a necessary and vital part of any aspect of the medical field, but it's tedious and boring, and it gets in the way of doing the cool stuff, so everyone from doctors to nurses to paramedics utilizes a long list of accepted abbreviations to quickly complete the task.

An example of a patient care report may read as follows...

Pt. 76 y/o, w/m, c/a, c/o, s/s, n/r, c/p, 8/10, x 4 hrs, w/ r/d, n/no/v. PMH=MI x2, HTN, IDDM. Rx=ASA, HCTZ, Lantus, Novolog. KDA= MS, PCN.

The patient is a 76 year old Caucasian gentleman who is awake and talking. He has been having pains in the center of his chest for four hours. The pain does not move anywhere and he rates it an 8 on a scale of zero to ten, with zero being no pain, and ten being the worst pain he has ever felt in his life. He also is having trouble breathing and feels nauseous but has not vomited. He has had two heart attacks in the past and has high blood pressure and is an insulin dependent diabetic. He takes aspirin, Hydrochlorothiazide, Lantus and Novolog. He is allergic to Morphine and Penicillin

Medical terms and abbreviations aren’t the only variations on language that an EMS provider has to learn. Patients often have their own words and phrases to describe various ailments, diseases and medications. I can only speak to the lingo used here in the South, but I am sure that every area and region has similar, if not some of the same, colloquial terms. Being born into a rural Southern family, I used many of them myself before I learned the “correct” terminology, so it was a big help to me in translating what a patient was trying to tell me.

Here is an example of what a patient interview may sound like…

Me: Sir, what sort of medical problems have you had and are you on any medications?
Patient: Well…I have high blood, shot sugar and the grouch, an’ I sometime have skeezures cause I onest had the Smilin’ Mighty Jesus and now I got to eat them peanut butter balls.

The patient has a current medical history of hypertension, insulin dependent diabetes, and gout. He has epilepsy as a result of a past medical history of spinal meningitis and is on Phenobarbital for same.

It is important that you always speak to your patients in words and phrases that they understand. To use big, long medical terms when talking to anyone who isn’t in the medical field doesn’t make you look smart, it just makes you look like an ass. I have called out more than one new resident in the ER for doing this. Yeah, I know, I’m just the ambulance driver, but I won’t hesitate to correct a wet behind the ears intern who is trying to prove how important he is by talking over a patient’s head. We as medical professionals must find a balance between our training and the real world…an equilibrium of thoughts and ideas. We must always try to achieve…well, homeostasis.

I is for Injury

Injury is something that anyone involved in EMS deals with on a daily basis. It is, after all, why we do what we do. When someone is injured we respond, intervene and transport. We are a vital part in a patient's chain of survival. The injuries that we deal with aren't always the patient's. We are often injured ourselves. We are routinely exposed to multiple hazards such as fires, chemical spills, combative and/or hostile patients, inclement weather, and dangerous accident scenes to mention a few. We are required to lift patients weighing 200, 300, 400 or more pounds (with assistance) on a regular basis. I love the (with assistance) part. That was added to our physical requirement guidelines after someone pointed out that no one can lift a 400 lb. patient by themselves.

In my 25 years in EMS, I have had my hand broken by a patient, my face kicked and glasses broken and had the breath knocked out of me by a roundhouse to the chest. I’ve been attacked by an intoxicated man in the back of the ambulance, had my knee cartilage torn requiring surgery and fell five feet off a porch onto a brick wall injuring my hip, again requiring surgery. My co-workers have broken bones, injured backs, had heart attacks in their 30’s and one guy lost both his legs above the knees when he was pinned to a guard rail by a vehicle while he was assisting accident victims on the side of the interstate.

Why in the world would anyone do this job? The answer is simple…I love it. Every time I drive to work, I love knowing that I have no idea what the shift will bring. I love the excitement and I love the down times. I love pulling up to an accident scene and quickly processing a ton of information at once. How many cars, how many patients, how fast were they going, how bad is the damage…and that’s all before I get out of the ambulance. I love making sure an elderly woman’s cat is safe and has food and water before we transport her to the hospital. I love knowing the homeless peoples’ real names and birthdays. I love when my efforts are successful and I am able to save a life, and I love being the one to tell the family when they are not, and a life can’t be saved, because I know that I am going to tell them with compassion. I love my job.

I know that there will come a time when the physical requirements outstrip my physical abilities. I am 53 years old and have been doing this for a quarter of a century, but it will be a sad day when I reach the realization that it is time to relinquish the position to a younger, more able bodied individual. When that day comes, I will hold my head high and leave with dignity…but I might just kick that whipper-snapper’s ass one last time for good measure!

Monday, May 23, 2011

J is for Juice

One of the coolest things you get to do when you’re a paramedic is defibrillate. You know, like on “ER” when they grease the paddles, slam them on the patient’s chest, yell, “CLEAR” and jolt the patient off the table? Yeah, that’s really cool to do. Defibrillation is the medical term, but there are several industry lingo phrases used to describe this procedure. “Light them up” and “give them Duke Power” (our local utility) are often used, but most commonly we just say…”Juice ‘em!”

We no longer use the paddles, we now have pads that we stick on their chest and back and can activate with a button. It’s not quite as much fun, but it’s safer and gets the juice through the heart better and is more effective. Oh, and they don’t come off the table like they do on TV, they just kind of give a little jump, but it’s still really cool. This procedure is only done on someone who isn’t breathing and doesn’t have a heartbeat; so essentially, it’s done on dead people. If you can get to them when they are newly dead, it can restart the heart and they won’t be dead anymore…really cool. If they have been dead too long and it doesn’t work, well, you can’t make them any more dead so basically it’s a win/win situation.

There’s a type of defibrillation called cardioversion that’s not as much fun to perform, because it isn’t done on dead people, it’s done on people who are very much alive, and awake and looking at you as you shock the “you know what” out of them. Now, if you are faced with having to do this, then the patient is in danger of not being awake and alive much longer and your job is to “juice ‘em” at a much lower wattage and keep them from becoming dead and needing the higher wattage defibrillation…definitely not cool. We typically give them a mild IV sedative prior to this to dull the pain of having electricity coursing through their body, but let’s be real…it still hurts like hell! When it works, it kind of reboots the heart and makes it beat normally. After a successful cardioversion, you are the ultimate in post treatment cool, but leading up to and actually administering it really raises your “pucker factor”.

The scariest cardioversion I ever had to perform happened several years ago. We were called to a posh country club on a Signal 19…Heart Problems. When we arrived, we were directed to the golf course and were met by a first responder who told us that there had been an 18-hole tournament for retired cardio-thoracic surgeons. When they finished and gathered in the club house, one of the participants collapsed. We were told that he was in his 70’s, was still conscious, but looked “real bad”. When I asked if he had any medical problems, I was told that he had a history of recurrent Ventricular Tachycardia…which meant, he probably was going to need cardioversion.

My “pucker factor” went to a plus ten. Let me explain. It you are driving and come within centimeters of being hit by a semi going 87 mph, it would cause a PF+10 and you would be picking seat foam out of a certain orifice for a week. Since I wasn’t sitting down and didn’t have any material for the pucker to suck up my butthole, my PF+10 just caused my ass to invert on itself.

When I entered the clubhouse, I saw 180 distinguished looking elderly gentlemen in pastel shirts and plaid pants. Wait, my horrified memories of this event has caused me to embellish the number of heart doctors who were there; there actually were only 75…OK…30 retired cardio-thoracic surgeons watching me walk across the room with a pronounced pelvic thrust.

When I reached the patient, I found a man in his 70’s in V-Tach and he indeed looked “real bad”. His skin was the color of biscuit dough, and was very cold and clammy to the touch. His vital signs were in the toilet so I had to act fast, or he was going to get dead real quick. I told my partner to start an IV while I prepared the sedative. I voiced that I was going to give the patient 5 mg of IV Valium prior to cardioversion when I heard a weak whispering voice croak, “That’s too much”.

It had come from the patient, so not only was he conscious, he was completely oriented and wanting to participate in his treatment decisions. Now, 5 mg of Valium is a conservative dose. I could have given as much as 10, but I didn’t want to knock him out and in his present condition, that was a distinct possibility. I got close to him and whispered back, “You know what I’m getting ready to do to you, don’t you?” “Yes”, he replied, “Just give me three”. “You’re the doctor!” I answered, and drew up three milligrams of Valium in the syringe and pushed it through the IV.

We were still using the paddles back then so there was no way I could stand to the side, discreetly push a button and pretend that it was someone else attempting to shock this beloved doctor in front of all of his doctor friends. No, I had to get up close and personal while 60 trained and experienced eyes watched me as I rubbed the greased paddles together, laid them gently on his chest, called “CLEAR!” and jolted the bejeezus out of him.

“HOLY SHIT!” a loud and booming voice shouted. At first I thought it was one of the surgeons who had made the exclamation because he couldn’t believe I had just electrocuted his buddy. But, when I looked at the patient, he was rubbing his chest and cursing up a blue streak. That wasn’t the only color I saw…his skin was turning a nice pink rosy color, and when I looked at the monitor, it was loping along in a perfect rhythm. His vital signs had returned to normal and after the initial shock (so to speak) he was visibly relieved and very thankful that he had been snatched from the jaws of death.

We loaded him for transport and his former partner and best friend accompanied him to the hospital. He had no return of symptoms during transport and the doctors in the ER complimented us on a job well done and scheduled the patient for a cardiac consult. He was going to have an internal defibrillator placed that would automatically juice him whenever his V Tach returned.

His partner shook my hand and thanked me profusely for saving his friend’s life. He then asked me what my background was. “I’m a paramedic”, I answered. “No, I mean what sort of education and training have you had. You obviously know more than your typical paramedic”. I thought about trying to explain to him the advances in pre-hospital medicine since his retirement but it was clear that this guy wasn’t ever going to get it so I replied, “I had three years of medical school before I dropped out for a career in EMS”. That seemed to satisfy him. I don’t think he could have lived with the knowledge that mere ambulance drivers were performing tasks that only doctors were qualified for only a few short years ago. I didn’t care. I had dodged another bullet, and another patient was going home to his family. I went to the bathroom and threw up…all in a day’s work!

K is for Kitchen

Several years ago we were housed in fire stations and some of the fondest memories of my career come from that time. There was a camaraderie that developed between the paramedics and firefighters that extended beyond the down time at the station and into the field. We still have a good working relationship with our first responders, but I miss the cohesiveness that came with us all being part of the same big family.

As in all close families, life often centered on the kitchen. I was assigned to a three piece station. There was an engine, with four firefighters, a ladder with four as well and an ambulance with two paramedics. Ten people, working 24 hour shifts and there was some cooking going on! I would like to share a couple of recipes that can feed an army, because that what is was like at meal times, a loud and boisterous army sitting down to eat together. Of course, more often than not, our repast was interrupted by a run, so we had to cook meals that not only could be made in vast quantities, but were good reheated as well.
These recipes can be halved or quartered, but if you are cooking them as is, make sure you have a big, industrial sized baking pan. Enjoy!

Sausage and Egg Casserole
12 – eggs
2 – lbs. pork sausage
6 – cups whole milk
4 – cups shredded sharp cheddar cheese
2 – sleeves saltine crackers
Salt and pepper to taste
Pre-heat oven to 400 degrees f.
Fry, crumble and drain sausage
Butter a large baking pan
Crush crackers in their sleeves and sprinkle in pan
Mix all other ingredients in large bowl and pour over crackers
Bake for 30 minutes (or till edges are golden brown) Sprinkle with paprika while hot.

Add dice tomatoes, green peppers, onion and jalapenos for a Southwestern version
Substitute spinach and mushrooms for the sausage to go vegetarian

Chicken and Broccoli Casserole
2 – large cans cream of mushroom soup
2 – large cans cream of chicken soup
2 – 16 oz containers sour cream
8 – cups cooked cubed chicken
2 – heads of broccoli florets, steamed
4 – tablespoons curry powder (more or less to taste)
Salt and pepper to taste
3 – cups rice, cooked
4 – cups shredded sharp cheddar cheese

Preheat oven to 325 degrees f.
In a LARGE pot, mix soups with sour cream over medium low heat until thoroughly blended
Add curry, salt and pepper to taste then add cooked chicken.
Simmer for at least 30 minutes
Place rice in large baking pan and pour mixture over rice
Cover with cheese and bake for 20 minutes
Sprinkle with paprika when done.

Wednesday, May 18, 2011

L is for Lawsuits

If it weren’t for litigation, I don’t think I would have a job. So much of what I respond to is driven, not by illness or injury, but by the prospect of easy money in the form of a lawsuit. Many lawyers, after all, are referred to as “Ambulance Chasers”, and I have been deposed on numerous occasions for claims of life altering pain and disability after accidents that barely knocked the dust off the bumper.

I once responded to a minor fender bender and when I ask one gentleman if he was hurt, he actually responded, “No, I’m fine, but you better take me to the hospital for litigation purposes”. Children are taught young how to work the system. I checked on a two year old secured in a child safety seat in a car involved in low speed little bump-up. I said, “Hey Sweetheart, how are you?” She replied, in a tiny little Cindy-Lou Who voice, “My neck and my back hurt”.

We, as medical responders, are not immune from being targeted as well. I remember one young lady who was involved in a minor accident. She was complaining of back pain and minor shortness of breath, so I placed her on a backboard and administered oxygen to her. Several weeks later, my employer received a letter from a lawyer seeking damages for this woman. She was claiming that she had excruciating back pain from being placed on the board, and suffered from chronic sinusitis as a result of being on 2 liters of oxygen for 30 minutes. I had followed protocol to the letter, so I did not receive any disciplinary action, but I am sure the county settled with her to avoid the hassle and expense of a trial.

I have encountered instances of “insurance-itis” even outside of my work. I was standing in a long line at a department store just before Christmas one year and was privy to a conversation between two sweet little grandmother types ahead of me in line. I say I was privy to it, but they were making no attempt to keep the topic of their discussion confidential. One was relating to the other how long it had taken her to get “her money” from an establishment that she had sued after slipping on a wet floor. The other lady replied, “Oh honey, you need to go fall down at (censored). I got my money real fast from them”!

It would seem that society would simply say no to the influx of frivolous lawsuits, but the fact of the matter is, people do suffer life altering injuries as a result of the negligence of others. The cases aren’t always cut and dried either. I have seen serious, even fatal, injuries in vehicles that have very little damage, and I have seen people walk away from crashes that render the cars unrecognizable. A person can be walking around, with no visible deficits and have a cervical spine fracture. A seemingly minor bump on the head can manifest as a bleed in the brain and the person often will not get definitive treatment until it is too late. This happened to the actress Natasha Richardson. After hitting her head during a beginners skiing lesson, she refused medical treatment twice. She did not experience any symptoms until seven hours after the accident. She was diagnosed with a subdural hematoma and the doctors were unable to save her.

It would be nice if there were a magic wand that could be passed over a person that would determine, without a doubt what was ailing (or not ailing) them. Unfortunately, that only exists is sci-fi movies. Is it acceptable for society to accept one hundred bogus lawsuits to keep one deserving victim from falling through the cracks? How about a thousand? I don’t have the answers. Do You?

Tuesday, May 17, 2011

M is for Mechanic

Automobiles are often personified. Men like to refer to their rides as "she", and give them human names. Remember Christine, the red 1958 Plymouth Fury with the malevolent grin and a deadly jealous streak? It may seem a stretch to directly compare cars to people but the internal combustion engine has many similarities to the human body.

They both run on fuel, a car needs gas and a body needs calories. The stomach is our gas tank, the blood is our oil. Our transmission system would be our musculature; our computer of course, is our brain. Both utilize oxygen and produce CO2, and both have an exhaust system that pollutes the air.

I am a paramedic. It is my job to help fix people when they are broken. In that way, I am a mechanic. I studied the way the body is constructed and I understand the way it is supposed to run. When is isn't running right, I systematically go through a checklist to figure out what is wrong then follow a set of guidelines to get it back on the right track. This allows me to be efficient when time is of the essence. When a person has sprung an oil leak, I must plug it. I don't think of how horrible it must be to be losing oil. I don't wonder what it must feel like to have your oil pouring from your body. If I did that, it would paralyze me and I would be useless.

There is a mantra that I have repeated in my head for so long that it has become part of my psyche. "I didn't cause this...my presence here is only a positive...no matter the outcome". This is not to say that I don't consider a patient's emotions when I work. A person's mental state is part of their makeup and has to be addressed as much as any other working component of their body. I can sit with a wife who has just lost her husband and compassionately give her the news. I have stayed on scene for an hour or more to assist families with situations that have caused them grief. But, when I leave, I can go get a cheeseburger and think about my plans for the weekend.

There have been patients that have broken through my personal barrier. I have a short list of calls that have stayed with me over the years and will bring a lump to my throat and a tear to my eye when I recall them, but it is a very short list. I would not have survived 25 years in this business if I didn't have this approach to my work.

This mindset not only allows me to function in heartbreaking situations, but it also allows me to be efficient and professional when I am faced with unpopular ones as well. It doesn't matter if you are a Yugo or a Rolls...you get the same treatment from me. It is my job to fix you, not judge you.

One of the most unpleasant stories in my repertoire involves a call I ran many years ago. I was dispatched to the jail on an attempted suicide. When I arrived, I found an inmate who had deeply sliced both of his wrists and was bleeding profusely. The first responders and infirmary staff were halfheartedly bandaging the wounds and seemed repulsed at having to touch and even being in the same room with this man. I quickly understood why when they told me who he was. It was front page news. A man had raped his four month old daughter. That's month...not year. She almost died and had to have her pelvis surgically reconstructed. This was the man charged with that heinous crime.

Most of the people in that room could think of nothing but his alleged actions. I saw an oil leak that needed plugging. You can think that I am cold; you can think that I am heartless, but when I start placing value judgments on my patients, it is a slippery slope that would eventually end in disaster. When I first read of this man's crime and thought of that precious baby girl, I was sickened and heartbroken. When I followed the story of his trial in the newspaper, I thought he deserved any torture that the mind of man could come up with. But, when I was faced with saving his life, that's what I did. Not because of some higher purpose or a desire to see him face a harsher justice. I didn't have time for such complicated musings. I saved his life because it was my job to do so.

The reader must think that I am uncaring, but that is simple just not true. I care very, very much. I care so much that I have developed this mindset that allows me to do what I do. All the tears in the world won't fix a busted fuel pump and they won't fix a busted heart either. Both require a trained professional to assess and treat the problems accordingly. I am glad that there are mechanics out there to take care of my car and paramedics, nurses, doctors and surgeons out there to take care of my body. I don't really want any of them crying about my problems when they need to be fixing them.

Monday, May 16, 2011

N is for Night Shift

The title just states "Night Shift" but what I really want to address are the off duty lives of night shift workers. I have worked some form of night shift for most of my 25 year career in EMS so you would think my family and friends would be used to it by now. Everyone has some form of sleep routine. People who work days typically sleep at night. It should be understood that one who works at night would sleep in the daytime. It should...but it isn't.

I usually get home around 7 am and am asleep by 8. I learned years ago to turn my phone off because, no matter how many times I have reminded folks of my schedule, hardly a day goes by that someone doesn't call by 11 am. When I return messages late in the afternoon and repeat for the umpteenth time..."I work nights, I was asleep when you called this morning", the inevitable response is, "Well I thought you'd be up by 11!" "Uhhh...that's three hours of sleep. If I call you at 2 am are you going to be awake?" That statement usually gets some sort of haughty response about it not being the same thing. (why?)

When I forget to turn off the ringer, I love the snide remarks when I am awakened and groggily answer the phone. "It must be nice to sleep til noon", or my favorite, "What a life!" It's not just the morning after a shift that causes conflict. My kids are grown, so I have been able to alter my sleep schedule on my off days to keep my circadian rhythms consistent. My husband works from home and sets his own schedule, so it has been easy for us to adapt as a couple. On my days off, we typically eat dinner around 10 pm, go to bed around 2 am and sleep until 10 or 11. Not the exact hours I keep on duty, but a lot easier on the old bod than trying to flip back and forth from nights to days. The response I usually get when I make my routine late afternoon return calls is, "Why were you asleep, you didn't work last night?"

It's not just friends and family. The bulk of the business world doesn't get it either. My husband gets Fed Ex packages just about every day for his business. I have hung signs on the door, called the corporate office, and pleaded directly with the drivers...Please Don't Ring The Doorbell!"...ding dong! My sympathetic spouse finally placed a light switch in my closet wired to the blasted thing so I can turn it off when I am trying to sleep.

It is not just EMS workers who face this adversity. Anyone who has ever worked nights knows what I am talking about. It is hard enough to get the right window coverings to make your bedroom dark, adjust the tempurature so it resembles a cool night, and find just the right fan to create the white noise needed to block the daytime sounds from outside. Should we really have to face discrimination because we aren't like "normal" people? Should others be allowed to hurl offensive epithets with impunity?
Vampire, Rumplestiltskin and the most hurtful of all...Sleeping Beauty! I am not a fairy tale! I am a woman!

I have often thought we needed to launch a campaign to raise awareness of night shift worker abuse. A nationwide call in may be in order. If all night shift workers were to call someone at three am on the same night, it would ripple across the nation like an earthquake and shed light on our plight. Second and Third shift workers unite! Power to the (night) people!

Saturday, May 14, 2011

O is for OCD

Dirt and filth left by a slob,
These are things seen in my job.
Nursing homes that smell like pee,
That is why I'm OCD!

Cock-a-roaches by the score,
Human feces on the floor.
What's that? Oh, a thousand fleas,
That is why I'm OCD!

Nasty dishes, nasty clothes, nasty smells stay in my nose.
Nasty people, nasty dogs, why do some folks live like hogs!?

Dirty diapers on the couch,
A rat just bit me! F***ing Ouch!
Think I'll bathe in bleach and lye,
I'm OCD...now you know why.

Friday, May 13, 2011

P is for Partner

(The names have been changed to protect the guilty)

In retrospect the whole situation was quite funny. At the time though, I questioned many of the decisions I had made in my life. Generally, why I had decided to pursue a career in EMS, and specifically, why I had agreed to partner with Brad. The owners of the small private ambulance service that I worked for were quite taken with Brad. He was a newly graduated paramedic who wowed the medical board during his interview. His knowledge of the academics of pre-hospital medicine was indeed impressive. Unfortunately, he was having difficulty translating that knowledge to the field and was failing miserably at applying it to the actual treatment of patients.

I’ll call Brad colorful, though that adjective doesn’t really paint the picture of this slight pompous little man. My grandmother would have described him as a “Banty Rooster”, strutting around, sticking his neck into places better left undisturbed. He had a decided effeminate air and never hesitated to espouse his opinion in his high-pitched, Southern drawl. I had to remain on high alert to keep Brad from turning a routine call into a fiasco while still performing all of the skills necessary for treating heart attacks and accident victims.

That Thursday morning had been quiet. We served a rural area, and the pace was usually relaxed. We occasionally had horrendous accidents on the interstate, and had the usual cardiac and medical calls, but the low population base meant that we didn’t experience the abuse of the 911 system seen by many larger areas. The one exception to this was Windward Estates. The auspicious title belied the fact that it was assigned to one of the filthiest, most run down trailer parks I have ever seen. Here is where we usually responded to the few shootings, stabbings and domestic calls that came into our tiny dispatch center. When we were called to an “unknown medical” at an address that I recognized, I anticipated that it could involve more than just first aid and transport to the hospital, but never dreamed that I would be wondering if I would get out of that trailer alive.

The inhabitant of this hovel was Melva Lackland, a tiny, profane, raisin of a woman who called 911 on a regular basis for all sorts of emergencies, both real and imagined. Let’s just say that if Melva’s brain was a credit card, it would have been maxed out years ago. It was just past 10 am when we turned into the patch of dirt that served as a yard for her mobile home. My pulse quickened when I saw the gathering of men loitering in her front yard. I had heard that the biggest, the meanest of her grandsons had just gotten out of prison, where he had spent far too little time for the crime of killing his brother. It was apparent that he and his remaining siblings were celebrating. I guess if you are known for fratricide, your surviving brothers are hesitant to cross you. So, in spite of the fact that he had eliminated one of their own, he and his family were pretty much wasted in reverie. I guess when no one has a job, you don’t have to wait till the weekend to party, and any old weekday morning will do!

When we exited the ambulance, Melva came running onto the rotting redwood deck, her coke-bottle bottomed glasses magnifying her already wild looking eyes. She was even more agitated than normal and screeching the following demand…”Gitcher ditty bag ‘n here, there’s sumptin’ comin’ outta this girl’s asshole!”…”Okayyy”, I thought. “What the heck have we gotten ourselves into?”

I grabbed my medical bag and hurried into the dilapidated dwelling, where I found a plump young woman, fully clothed, in no apparent distress sitting on the couch watching a soap opera in total boredom. As I was trying to ascertain the exact nature of her emergency, Melva was flitting around like a mosquito, buzzing something about the girl being pregnant and things seeping from orifices that shouldn’t be presenting themselves, when Brad brought the entire drama to a dead silence with the following order, “Ma’am! Ma’am! You must exit the residence while we examine the patient…you must leave NOW!!!

Now, the condition the dwelling notwithstanding, it was still Melva’s home and no one could make her leave, save the police on the frequent occasions she had to be arrested or committed, and then it took two or more of them to restrain and remove this 100 pound woman. As she began to hyperventilate into an inevitable eruption, a shadow darkened the room as the silhouette of the recent parolee filled the open doorway.

He had been lurking just outside and had heard Brad order his grandmother out of her abode. He stooped as his 6 foot 5 inch frame stepped through the door. The unmistakable bouquet of Jim Beam and B.O. stung my nostrils and I think I saw the minute movement of lice burrowing into the rope of braided hair hanging down his back.
I heard a “click” and it caused me to freeze. The source of my inertia was the gleaming switchblade that had just been flicked open. It shined like a beacon, the only clean thing in the trailer, and he cracked a decaying smile as he tossed the weapon from hand to hand.

He staggered toward Brad, his newfound anger in direct conflict with his drunken delight in the pain he was going to inflict. I was trying to think of something to say to deter the felon from resuming his career, when he growled, “I’m gonna kill you”… he then turned his putrid grin in my direction…”and rape her”. I could have sworn the lump in my throat was my heart, but nothing prepared me for what happened next. Brad squared off with my would be rapist, puffed out his chest, placed his hands on his hips; arms akimbo and countered…”You can’t hurt us…we have a radio!”

The utter ridiculousness of the statement caused all of us to ponder and scratch our heads, but I quickly saw our window of escape. For once Brad followed my lead without question, and we both bolted out the door. I vaulted the deck railing like a pommel horse and covered the littered yard in a few short leaps and bounds. As I threw the rig into a reverse spin, Brad swung the passenger door open and nearly climbed into my lap as I put the Lacklands’ in our dust.

We radioed for police as we raced to the safety of our station. When we arrived we gave our statements and the law took over. I guess communicating threats and brandishing a weapon were minor offenses for someone so steeped in crime and we never had to testify against our near assailant. I heard later that he had killed someone else and had returned to prison…hopefully for life this time.

I had a newfound respect for Brad, in spite of the fact that his retort was foolhardy and made absolutely no sense, his willingness to stand up for me warmed my heart and we enjoyed our partnership and became good friends as well. The one question that remains unanswered to this day involves the young woman who was the subject of the original 911 call. When the police arrived at the scene that day, she was nowhere to be found and Melva and the rest of the family denied her existence. We never discovered who she was, and never found out what was coming from her derriere that day.

Thursday, May 12, 2011

Q is for Quixotic

I remember my first year in EMS. I wondered if my palms would ever stop sweating every time the pager went off and I remember I thought I was going to save the world. I envisioned my days spent averting tragedy at every turn. In reality, I discovered that they were filled with long stretches of exhaustion and boredom occasionally punctuated by moments of sheer terror. I found that I was OK with that.

Idealism is a necessary trait when entering this profession. I was a field training officer for twelve years. It was a revolving door of eager fledglings who felt much as I did in the beginning, and it was my job to teach them the mundane and mind numbing parts of the job and help them to function and deal with the harsh realities of emergency work. Many of my trainees went on to become fine paramedics. Most did not. There aren't many who make a career out of EMS. Some leave to go on to bigger and better things, most just leave because it wasn't what they expected.

I could always tell when a new employee wouldn't stick around long. They were the Don Quixote's who thought that they would achieve adulation and glory, get to drive the ambulance real fast, make lots of noise and force people off the road...WOOHOO! One such young man jumped in the driver's seat his first day, turned the radio to a hard rock station and shouted..."YOU READY TO LOCK AND LOAD!?!?!". I told him to get in the passenger seat, turned the radio to the classical station and very quietly explained that this is an ambulance, not a Humvee. We are medics, not combat soldiers. We don't carry weapons, and we... dont...lock...and...load. He was gone after a couple of months.

I had made myself a promise that when I could no longer remember what it felt like to not know how to do this job, I would no longer be an FTO. I reached that point several years ago. It became like reading. I can't remember what it was like to look at a page in a book and not know what the letters meant, and I don't remember what its like to look at a sick person and not be able to decifer what is wrong with them (usually). I knew that when I lost that empathy for a rookie's greeness, that I would no longer be effective as a trainer, so I passed the baton to other FTOs.

I am happy with the balance in my career. I like the calm, sedateness that the majority of our calls bring and there is just enough excitement to make it interesting and keep me working well into my third decade as a paramedic. But, occasionally I still feel my palms get sweaty and I'll tilt my lance toward a windmill. After all, though I never force people off the road (not cool), I still get to drive the ambulance fast and make lots of noise, WhooHoo!

Wednesday, May 11, 2011

R is for Reunions

I got that sinking feeling as we pulled into the intersection. Anyone who has ever worked in EMS knows the feeling I'm talking about. It's the one you get when you first see the scene and you immediately know that this is going to be bad...real bad.

The front of the four door sedan was untouched. The driver, a beautiful young mother and her young son, who had been sitting in the passenger seat, were fine. Well, I guess I should say that they were uninjured because they were far from fine. The right rear of the car, the area that had taken the impact of the three-quarter ton pick-up that had run the light, was crushed, and judging from the woman's anguished hysteria, I knew that there must be someone back there.

There was...it was her thirteen year old daughter. They were on their way to basketball practice. The girl was a nationally ranked youth league player, and college scouts had already discovered her. She was an excellent student, a devout Christian, and a bright and successful future seemed to be a sure thing. It wasn't. In the blink of an eye, this child's, this mother's, this entire family's future had been horribly altered.

She was alive, but barely. Just before the crash, her mother had reminded her to put on her knee brace. She had just recovered from a sports injury and was wearing one as a precaution during practices and games. She had taken her seat belt off briefly to do this and that is when the truck hit them. Seat belts have saved countless lives but in this very rare instance, not having one on saved hers. The impact threw her to the other side of the back seat, and had she been wearing her belt, she would have been secured to the right of the car and would have been crushed.

She was still breathing but had sustained a very serious head injury and was unconscious and bleeding profusely…we had to load and go. I began suctioning her airway immediately, my partner quickly stabilized her neck and spine and we took off for the trauma center. In route, it was all that I could do to keep her airway clear. Blood was pouring from her nose, mouth and ears and as it spread across the white stretcher sheet, I saw an unmistakable yellow haloing…cerebrospinal fluid. The blood was coming from her brain.

At the hospital, she was immediately taken to surgery to relieve the pressure on her brain, and later that evening I went to the ICU to check on her and found that precious child bruised, swollen and on a ventilator. She was in a deep coma and her prognosis was not good. Dozens of family members were in the waiting room engaged in deep and fervent prayer. Her mother saw me and we fell into each other’s’ arms. I don’t typically become involved in the aftermath of calls that I run. It would be logistically and emotionally impossible to follow up on patients on a regular basis, but I felt a strong connection to this family. I had a thirteen year old daughter of my own and I not only felt professionally responsible for this girl’s life, I felt maternally responsible as well.

Her mother and I formed an immediate bond. I became a regular visitor to the ICU and got to know her father and other family members as well. The waiting room was never empty, and a prayer chain of thousands had spread across the country. Weeks went by with no improvement. The doctors were giving very little hope that she would ever regain consciousness, much less have any kind of normal life, but her family never wavered in their belief that God had something else in store for this sweet child.

We soon discovered that our daughters’ birthdays were only two weeks apart. I suggested that we have a combined fourteenth birthday party for the two girls and we excitedly began planning one. When I left the hospital I thought that maybe I shouldn’t have committed to something that wasn’t likely to happen. I too was beginning to think that she would never recover, and I felt that it was irresponsible of me to suggest such a happy event that would probably never take place.

I was wrong. The family’s prayers were answered and just a few months after the accident, she went home. She had indeed regained consciousness and in a miracle that stunned even the doctors she made a complete recovery. She was unable to return to basketball, but she graduated high school and college and is a remarkable young woman today.

We did have that birthday party. I was talking about it at work and someone suggested that MEDIC sponsor it. It was held at our headquarters and there was a cake with both girls’ names and “Happy 14th!” spread across it in gooey icing. All of the people who had been thrown together in tragedy were reunited in celebration that day.

That party started a tradition at my agency. Patient reunions have become a yearly event here. A man who a suffered cardiac arrest and was resuscitated, a baby who couldn’t wait to get to the hospital to be born, and a child who would have choked to death had it not been for a paramedic are just a few of the patients who have had reunions with their rescuers. It is an uplifting event and helps us to remember why we do what we do, and it’s all because one little girl refused to give up, and one family never stopped praying.

Tuesday, May 10, 2011

S is for Suicide: A Paramedic's Perspective

It was a typical evening downtown for my partner and me. Running a paramedic unit in an urban area is an exhausting job, and this night was no exception. The normally high call volume was even further burdened by an incessant downpour, broken only by spontaneous lightening flashes and deafening claps of thunder. Hollywood couldn’t have produced a more appropriate setting for the call we received shortly after midnight. We were dispatched to “one unresponsive” on the outskirts of town. Unfortunately, all units were busy that night and even though we were a good distance away, we were the only unit available and had to take the call. We were wet and tired, and the extended response time put us on edge, so we weren’t in the best of moods as we turned into the gravel driveway leading to the darkened address.

Set far off the road in a grove of trees, the monstrous old mansion stood three stories high. Adorned with gables, eaves and a rounded tower jutting off the northern wall; it presented an eerie picture as we approached. The house looked abandoned. There were no street lights this far out, and the interior was totally dark. In fact, there were no lights on anywhere, and I figured the storm must have knocked out the power. As I climbed out of the ambulance, I noticed that I stood in a parking lot. I then saw a sign at the bottom of the front porch steps. My initial assessment of the house had been colored by the gothic atmosphere. It wasn’t the sinister home of some eccentric old spinster. Instead, the Victorian structure had been renovated and sectioned, and was now home to several small businesses.

First responders and police were already on the scene. I approached the fire captain and asked what he knew. He told me a man had come to check on his father, an architect, who had not been heard from since the day before. His office was housed in the building, but when the son arrived, the place was locked up tight. Not having access to a key, he climbed the porch railing, followed the broken roof line, and looked in his father’s office window. He thought he saw a pair of feet sticking out from behind a partition, so he called 911.

I asked the captain if he had gained access, but he informed me that the place was a fortress. It would take a battering ram to enter through the front door, so his men were trying to gain access through the man’s office window. “So, where is the office?” I asked. The captain turned toward the northern wall of the house, and that’s when I saw the two fire-fighters perched on the narrow ledge outside the tower window. It was clear we were going to have to access the most treacherous part of the building. I asked my partner to get the cot and equipment ready and wait at the front door. I took a jump kit and headed for the ladder that the fire department had set up. At least I didn’t have to climb the porch railing.

I tightened my rain gear and started the climb. I don’t usually suffer from a fear of heights, but as I picked my way across the rain slick roof, I felt the unmistakable paralysis of acrophobia trying to needle its way into my brain. I somehow kept it at bay and when I reached the tower, the fire fighters had pried the window open about twelve inches, and were standing there looking at me. It was clear that this was as good as it was going to get. I looked at the two Charles Atlas types and quietly handed one of them my jump kit. Dimensions and logistics had silently voted me most likely to fit through the window. As I squeezed through the foot high opening, I suddenly had a strong urge to backtrack down the roof and return to the safety of my ambulance, but I didn’t.

Once inside, the men handed me my kit and a flashlight that had seen better days. I trained the light on my surroundings and it took me a minute to get my bearings. The high ceiling room was a jumble of drafting tables, easels and partitions haphazardly placed in a makeshift attempt to create separate work areas. I concentrated on the partitions since one of them reportedly sported a pair of “feet”. After what seemed like an eternity of following the weak beam of light as it attempted to slice through the darkness, the beacon passed over a pair of Nikes, toes up, protruding from the corner of a cubicle.

I turned to the fire fighters for support, and all that I could see were two hulking silhouettes in the window, occasionally being framed by flashes of lightening. I took a deep breath and turned toward the running shoes. After all, I am a professional…this man needs my help. I sensed the futility of calling to the man, but I tried anyway. Silence. As I made my way across the room, I was thinking of the possible directions this scenario could take, but I was totally unprepared for what was hidden behind the carpeted particle board.

He wasn’t exactly old. Well maybe, it was hard to tell. He had that trim, well preserved look from the neck down. Designer jeans, new athletic shoes, he was definitely a man who kept up with the times. The flashlight beam traveled the length of the man’s body. When it finally illuminated his head, I stumbled back, almost knocking the partition over.

His face was barely visible through the plastic bag. His lips were retracted, leaving his mouth in a gaping, half-grin. The eyes were open, staring through a milky film. His entire face was engorged, swollen, filled with blood. Blood that was frozen by the tourniquet effect of the wide rubber band that was buried in the man’s neck, holding the bag in place. The rubber band that created the vacuum that caused the man to die.

When you are a paramedic, you think you are immune to the horror of death, then when you least expect it, all the elements come together and your entire death repertoire seems to culminate in one call. Not the specifics. Pictures of blood and gore didn’t flash through my mind. Instead, I found myself longing for a time when I thought of death in abstract terms. That romantically frightening journey that we all are destined to take at the end of long and happy lives. Blessed ignorance was gone forever, and I was overwhelmed with the inevitability of my own death and the death of those closest to me.

I shouted to the waiting firemen that we had a 10-67, “one dead one the scene”. The silhouettes left the frame of the window and I was totally alone with the victim. I was suddenly frightened. Though the man had obviously been dead for quite some time, I hastily scanned the room to insure that I was truly alone. My light revealed several drafting tables in various stages of disarray…except one. The table nearest the dead man was completely clear, save one small piece of paper. I looked. It contained only three short lines…

the pain
the pain
I can’t take any more pain

The man had taken a plastic bag, placed it over his head, and secured it with the rubber band. With his succinct note in place, he had lain on the floor and allowed his lungs to slowly be deprived of oxygen until his body could no longer function, and he died.
At that moment the door opened and a bevy of people entered the room. The man’s wife had arrived with a spare key and the police had come upstairs to investigate. I addressed the sergeant in command, pronounced the man dead, and returned to my ambulance.

I never heard what had happened to him. Such is the nature of my job. I shared with him the few private moments between his desperate and lonely act, and the shift in the universe that undoubtedly happened as the reality of his decision hit the ones who loved him. I left just as that universe was unfolding and went on to the next call and went on with my life, but I have thought about him often since that night. The note he left raised more questions than it answered. Was the man ill, his pain so great that he chose death over tolerance? Or, was his pain in his heart? Had he suffered a loss too great to bear? Perhaps he just didn’t want to live with himself any longer. This possibility disturbs me most of all and causes me to reflect on the many times I have indulged in self-loathing.

I know that his life was not in vain. Though our encounter was brief and long after he had drawn his last breath, I learned a lot from this man. This happened over twenty years ago and I carry those lessons to this day. Of course there is the obvious. There is nothing romantic about death, especially death by one’s own hand. But more importantly, I learned that no one has the right to place value judgments on another person’s feelings. To claim the ability to measure the depth of someone else’s pain is the ultimate form of arrogance. Please God, don’t ever let me be that arrogant.

T is for Thanksgiving

The spate of fiascoes actually started on Wednesday night. I am a public servant by vocation and a paramedic by trade. Unfortunately, as so often happens in my chosen profession, I was scheduled to work on Thanksgiving. We had recently bought a farm that put us a solid hour’s drive from the city where I work, so I had retired early to be well rested for my 24 hour working holiday. Barely an hour into my slumber, I was awakened by our two yard dogs. They were engaged in a litany of vociferous yelping which of course roused the two house dogs sleeping at the end of the bed, and I was soon wide awake in the middle of a cacophony of kennel chorus.
“Dagum deer”, I mumbled as I threw on my robe and stepped into the freezing night air to scold the pups into silence. From my front porch, I looked across the pasture in the direction of the barking. A few hundred feet from the house, I saw my two labs loudly protesting, yet keeping a safe distance from the slinking silhouettes lurking in the shadows of our watershed. Coyotes…just the word make my skin crawl. I sprinted barefoot across the frozen ground, screaming wildly while hurling stones at the would be predators. The nasty curs momentarily stared at me with their soulless eye, and then loped away in a manner that seemed to say, “We’re only leaving because we want to”.
I scurried back to bed and turned my electric blanket on high. My racing heart finally slowed, and I drifted back to the brink of slumber. My reverie was short lived. Less than twenty minutes later, the intruders returned and the scenario repeated itself. I wrapped my pillow around my head and lived with the canine argument that lasted into the wee hours of the morning. I groggily awoke to find that I had hit the snooze button one too many times and was scheduled to clock in at work in exactly four minutes. I hastily showered, hurried into an un-ironed uniform and raced “coffee-less” to work. Thoughts of fire department tables piled high with Thanksgiving treats bolstered me as I made the trip in forty-seven minutes.
I had just poured my first cup of coffee when the pager summoned and my partner and I spent the entire morning tending the truly sick and the occasional lonely forgotten soul…two categories of patients that I relish serving. Around two o-clock my generous spirit was starting to wane. We decided to forgo trying to make it back to the station to eat and looked for the closest thing open that would sell us some food. We spotted a family restaurant with a bustling parking lot. Just as I was braking to make the turn, the radio crackled and we were dispatched on a non-emergency call. We further postponed nourishment to pick up an elderly woman at the hospital and take her back to her nursing home.
When we arrived at the patient’s room, she had just been served the hospital’s version of Thanksgiving dinner…pressed turkey, canned peas, and congealed salad. We propped ourselves against the wall outside her room as the 85 year old, 90 pound woman laboriously ate her meal, with her fingers, one pea at a time. When she finally announced that she was finished, we removed the tray and began to move her onto our cot. Smack! The shriveled elfin creature had slapped me across the face. “Take my dentures out and wash them you @$^*%!” she screeched in my direction. “Did you just call me a @$^*% ma’am?” I retorted while massaging my bruised jaw. Whish! I had seen it coming and ducked to miss the second blow. “You &#$*@, I told you to take my dentures out and wash them!”
My experience has taught me when its time to concede to a situation, so I donned a pair of gloves, slid my fingers into her mouth and pulled out her teeth, bringing with it pulverized peas, bits of pressed turkey, and a string of mucosal saliva. “You got it on my gown you &*$^#!” Noticing the souvenirs from lunch spread across her chest and belly, I failed to see the severity of this but we cleaned her up as best we could and I quietly hummed holiday tunes to myself as she continued her sailor’s tirade all the way to the nursing home.
The long shadows of late afternoon were spread across the parking lot as we renewed our quest for rations. The radio and pager were quiet and the rush of calls seemed to have abated. It actually looked as if we were going to get something to eat as we trundled along toward a welcomed, albeit re-heated meal. Suddenly we heard a loud “SKREE SKREE SKREE” The ambulance began to violently shake, and the cab filled with a noxious smoke. We crippled to a halt, and baled out of the truck coughing and hacking. It was clear that it was going no further, so I shut it down and called dispatch for a tow truck. It being a holiday, it was going to be difficult to find one large enough to pull an ambulance, so we settled in for an unknown wait.
We would have sold our souls at this point for even a vending machine, but nary a cracker nor a moon pie was in sight. My partner then remembered that she had a week old bag of party mix at the bottom of her back pack. We started to pounce on it then realized that not only had we not eaten all day, but it had been hours since we’d had anything to drink so just the thought of gobbling a salty confection parched our throats. She then thought of the sterile water. We keep sealed bottles of it for irrigating wounds, so we fought each other to the cabinet, tore open the seals on the bottles and guzzled the warm distilled fluid while cramming stale cereal and pretzels in our mouths. Though not nearly sated, we survived the two hour wait on the side of the road with stories about our families and happier Thanksgivings past.
It was fully dark when we were finally rescued, had been assigned another unit and resumed our quest for food. Alas, it was not meant to be. We had barely rolled down the road when we were summoned to a patient with an altered level of consciousness. When we entered the house, we were met with a most unusual site. A very large black man, clad only in white briefs, missing one leg, was thrashing about on the floor, screaming incoherently; while a petite and very frightened woman was cowering behind the couch. We called to her from the door; steering clear of the man’s flailing, three remaining limbs. “Ma’am, is he a diabetic?” She nodded yes through her tears. We got to work. I had four strapping firemen at my bidding, so I had them hold the man long enough for me to prick his finger and siphon a drop of blood. I plugged it into the glucometer…20…BINGO! Normal blood sugar is 80-120. This family was not far from a return to normalcy. The only hurdle we had to overcome was establishing the IV and keeping it patent long enough to infuse 50 cc’s of Dextrose. The firemen held the man in a safe, manageable position while I, with a penlight clamped between my teeth, bent over his arm intently searching for a vein. I made my choice, cleaned the site and poised the catheter for insertion. “Whack!” the needle went flying out of my hand and I pitched face forward onto the carpet. Black spots clouded my eyes, and for a moment, I wasn’t sure where I was. My head soon cleared and I scampered out of the way as the fire guys renewed their efforts of restraint. Initially, they had underestimated the agility of the remaining third of the patient’s left leg, neglecting to include it in their holds. Not only had I been pimp-slapped by a profane geriatric waif on this Thanksgiving, but I was just stump-clubbed by a near naked African American amputee!
I finally completed my task, and a few minutes after receiving the simple infusion, the gentleman transformed into a genuinely nice guy who wondered why all of these strangers were in his house. His wife proclaimed us angels sent from heaven. I sighed deeply and with a little smile said, “No ma’am, he just needed a little sugar is all.”
Fate finally smiled on us and we hobbled to the station for leftovers. We had just enough time to finish eating before being called to duty again. I didn’t mind. I had a full tummy and another incredible shift to tell my grandkids about.

U is for Urban EMS

I started my EMS career in a small, rural system, but I have worked most of the last 25 years for a large, urban based agency. The differences in the two are like night and day. Oh, people always have heart attacks, auto accidents and the like, but ambulancing in the city is unique. Country people call 911 when the grim reaper is knocking at their door. They feel that it is a waste of resourses and down right wimpy to summon EMS for any other reason. In the city, we tend to be innundated with unnecessary, sometimes comical calls we lovingly refer to as...(and I am paraphrasing) Bovine Fecal Matter.

Once during an ice storm, my partner and I traveled across town on slick treacherous roads to find a woman whose washing machine was broken. When I admonished her, telling her that 911 was for emergencies only, she bowed up and shouted, "This is an emergency, I gotta get these clothes clean!" I have been called because a guy wanted to bum a cigarette, a woman wanted us to go get her prescription filled at the drug store and someone's shingles had been blown off their roof during a thunderstorm. One distraught woman demanded that we get rid of her roaches.

We also encounter some pretty strange reasons for requesting transport to the hospital. One very healthy young man wanted to go because his mouth was dry. I told him to drink some water and he replied, "What am I going to do when the water's gone and you're not here?" (Huh?) We are required to transport upon request, regardless of the reason so you can imagine the looks we sometimes get from triage nurses at the emergency room.

I always comply with the transport rule, but I had a call many years ago where I made an executive decision not to. We arrived at a residence to find a man sitting on his front steps looking dejected. His wife was locked in the house and had refused to come out or let the man in. When we got out of the ambulance and approached him we found out why. He had been sprayed by a skunk. The stench was overwealming, and he wanted us to take him to the emergency room to get it off. I don't know what he thought the hospital was going to do for him, but I knew that if I put him in my rig that it would be out of service indefinitely and the ER folks would have my hide for bringing him in. I did feel sorry for the guy though. They lived in the projects and obviously had financial issues, so I gave his wife twenty bucks and told her to buy several bottles of tomato juice and have him bathe in it. I had that smell in my nose hairs for the rest of the shift.

We routinely get calls for runny noses, stumped toes, hang nails, pimples, cut fingers...the list goes on. One guy called because he dreamed he got shot. It upset him so badly he wanted to go to the emergency room, so we took him to the emergency room. I don't know the percentage of BS vs the real thing, but it is pretty high. These useless runs tie up advanced life support ambulances and drive up the cost of health care. There are many in my profession who are constantly angered and stressed by these calls, but I just look at them as an unfortunate reality. Besides, they are easy runs. After a string of auto accidents, cardiac arrests, and really sick people, I welcome the little break you get just giving someone a ride to the hospital.

So, the next time you sneeze...call 911! Hey, it's job security.

Monday, May 9, 2011

V is for Vultures

The dictionary lists three definitions for the word...Vulture.
1-Carrion eating Old World birds of the family Accipitridae.
2-Carrion eating New World birds of the family Cathartidae.
3-A person or thing that preys, especially greedily or unscrupulously.

I have never encountered the first two in my EMS career, but I regularly have to deal with the third. They are called...reporters. Now, some of my best friends are reporters. I was originally a communications major in college and several of my fellow students have done quite well in their journalistic pursuits. I am a firm believer in the first amendment and I think the United States has the strongest, most influential media in the world…but, sometimes them doing their job gets in the way of me doing mine.

I understand it must be difficult to get the good news stories and get them first. Reporters have to use all means necessary and be bold and fearless in pursuit of a scoop. This includes having scanners that pick up on all police, fire and ems dispatches, and ignoring things like yellow police tape and the sanctity of the back of an ambulance. I learned early on to lock the doors in the back as soon as I load a patient because I have had more than one eager Lois Lane hop in with microphone in hand before my partner could even get in the front of the truck to pull away.

Accuracy isn’t high on some reporters’ lists either. If the story isn’t juicy enough, it isn’t above some in the media’s scruples to add a little spice. Several years ago, I was dispatched to “one stabbed”. When I arrived, I found that the victim, who had made the 911 call, had greatly embellished his injury. His girlfriend had gotten mad and took a swipe at him with a knife. She barely nicked the skin above his eyebrow and when we arrived, it wasn’t even bleeding. Some soap and water and a band-aid was all that it required, but he was really pissed and insisted that he be taken to the hospital. So, we obliged him and said we’d be happy to give him a ride.

As we were exiting the residence, I was suddenly blinded by a camera light and a reporter stuck a microphone in my face shouting, “Can you tell us about the stabbing!? What is the extent of the victim’s injuries!?” Normally, I don’t talk to reporters. I don’t have time, and we have PR people that handle that sort of thing, but this guy was literally blocking my way. I couldn’t see anything because of the light in my eyes and I had a momentary lapse in judgment, so I looked directly into the camera, held up my fingers about a quarter inch apart and said, “He has an itty-bitty, teeny-tiny little cut on his forehead”. The chagrined reporter lowered his mic and said, “That’s not news …is it?” I replied, “Nope…no news here!”

Oh how I should have known better. The lead story on the 11 o’clock news was MAN STABBED ON THE WEST SIDE!!!!!!!!!! My audio had been edited out of the footage and I was seen miming weird hand gestures to the camera while the reporter described the terrible stabbing in voice over. I looked like an idiot and had to explain to my superiors why I was wasting time talking to the media when I had a priority stabbing patient.

I know I’m being a little hard on our information gathering friends, most of the time they are efficient and professional. If the truth be known, I have personal reasons for my vitriol against the media, and it involves my own sense of vanity. Our uniforms are intended for functionality, not fashion. They are of a material and design that tend to accentuate the negative aspects of the female form. I typically have to bend over to reach my patients, and the media is usually somewhere behind me when they are taking pictures. This has resulted in there being way too many images of my polyester clad ass floating around in cyberspace, and I have had people come up behind me and tell me they recognize me from a news story…before they even see my face.

So, the next time you watch the news, take the information with a grain of salt and please…don’t judge the emergency personnel by their photos. There are real people in front of those posteriors!