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!
Wednesday, May 25, 2011
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!
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
Paprika
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.
Variations:
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
Paprika
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.
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
Paprika
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.
Variations:
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
Paprika
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?
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.
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!
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.
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.
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