Saturday, June 28, 2008

- Arrest

We're minding our own business, getting off what seems to be one of the infinite number of transfers they have in this area, when they page us out to Redneck Central for a code.

We give a whoop of joy, and head off to the scene.

I've talked about that excitement with my aunt, who's a NICU nurse in North Carolina. I think from an outsider's perspective, it's ghoulish, This rush of endorphins and adrenaline the fuels my rebel yell, that lights my senses. Really, I'm not sure I can compare it to anything I've ever experienced in drug-free living. Maybe the excitement of finally asking a crush out and them saying yes, or that gut wrenching surge when you're sure that someone is standing on the other side of the shower curtain, only multiplied by 1000.

I have an addictive personality. They told me when I left treatment to watch out for the emotional highs and lows of the job. It was the consensus of some of the staff that I not go back to this gig at all, that it would be too dangerous and might cause me to relapse. I think the people at the place I went to knew what they were doing, for the most part.

It would be to their dismay that I don't agree with them.

But excitement turns to frost in my veins as we hear the fire department, two minutes ahead, radio back to us : "Advise unit XX patient is 7 month old, repeat 7 months old, hurry it up guys, he don't look too hot!"

One thing most medics know is that paradox Red and I have suddenly entered. when you know you're going fast, too fast, but it feels like you're driving that crawler that moves the space shuttle in position, barely creeping along.

We arrive on scene to find the fire department carrying the kid out to me. I can see the kid's limbs sticking out roughly, ramrod straight, it seems, from his car seat. I have barely had time to walk to the rear of the unit.

Someone might mistake the condensation on my head for sweat, but really, it's all glacier inside me.

Icy calm has descended. A far reach of the creative, emotional part of my brain realizes this is the first time this has ever happened. Several times I've watched sick children be carried from the household, and I've always had what I now realize is the luxury of turning to someone else and asking them "What do you need me to do?".

The smokies are ten feet away from me now, and Red turns to me. "What do you need me to do?" she asks.

"Get in the back. Grab a pedi bag and set up fluid. Pull the IO out."

A tsunami in navy clothes and black boots, the fire department surges into me, breaking around the rock of my unit. The firefighter with the kid in hand starts spitting out a report as we step into my unit.

"7 month old, has had a cold and fever past two days, found having severe difficulty breathing by his mother. When we got here he looked like a fish, wasn't moving any air. Mom couldn't get us no history. She's that lady rolling around in the grass."

I pull the baby out of the car seat and lay him on my stretcher, flat. he is a mottled, ugly pale, like something you'd see on the cap of a mushroom you'd find in a deep cave. His limbs are sticking out, his head is turned to the left, his eyes looking left, through my side door. He is seizing. White mucus is all around his nose and mouth.

"Suction and bag him!" When this call is all said and done, we will have pulled out over 70cc of mucus from his lungs.

We do not take the time to play with an IV. I slap our pediatric paddles on the child, and my backup drills in an IO needle.

I remember thinking how cute the little needles and pediatric paddles used to look to me, when I was ignorant of their ugly functionality, the brutish nature what we use them for. Seeing only the outside, not the potential inside the sterile wrapping.

"IO is good."

"Versed, check the tape for the dose."

The baby's heart rate is in the low sixties. Oxygen saturation is lower than that. I can feel a pulse. We lay out the tape, pull up some versed, pump air, do math. The versed goes in and the baby goes flaccid after a few more trembles.

I pull out the tiny tube, the baby blade, and peer into his mouth. I can't see, and pull out. There is still a lot of mucus. We bag and I suction a little bit more, and finally I think I can see cords. The baby squeaks once, and with the noise the cords, feather quick, move toward and away from one another. That clinches it.

I get the tube. The kid's sats don't jump instantly, but we get an End Tidal CO2 reading of 20. I'm in. We secure the tube, and when his sats do begin to rise, it is rapidly, all the way to 100%.

My backup calls in a report as I continue to breathe for the kid. We bring him to the hospital.

And after they get him stabilized, we bring him to the local PICU hospital.

His color has returned, and he is now a uniform light brown, the color of good coffee and milk chocolate.

Red is crying a little when I walk back to the unit. She wipes her eyes.

"It's different when you have kids," She tells me.

I nod, but inside, I disagree. As she walks to the front, I walk to the back, and let out a shuddering breath.

-MM

Sunday, June 22, 2008

- Rebel Without a Clue

Ok. Although AD just bought him a big ole bike for travel and what not, I've not yet made the plunge myself. I don't really know anything about motorcycles, and have only ridden a dirtbike a few times as far as experience with them goes. So imagine my surprise when one of my moms orders one of these:








Yeah.


Well, it finally came in yesterday. We put it together, fueled it, oiled it, hooked up the battery. Mom had a very little amount of ride time in her past but was able to helmet up, hop on, twist the throttle, and zoom off down our neighborhood street. By this time, I have a bunch of James Dean and Marlon Brando images running through my head. I run inside, throw on some jeans, and get ready to twist the throttle. How hard can it be? It's just a moped. Right?






I should've known this was a mistake.

I did real good, at first. Mopeds are not that complicated. I enjoyed the breeze and sensation of zipping up and down the road in front of our house. I got confident....real confident. You can see it on my face. Look at this sexy hunk of man-meat. That's right, ladies, he's single!








Yes, I am ugly, and not well proportioned. Damn you, cheeseburgers and nature.

Well, I did real good, and was smiling, and was happy, which basically shows fate a big flashing neon sign that reads "Mess with This Guy".


I did not dump the moped in the road.
I did not dump the moped in traffic.
I did not run a stop sign and get creamed.




I dumped the moped in my carport.


Anatomy of A Disaster:

1. Left over from my application of oil to the moped, a slight slick was left on the surface of the carport.

2. I am an inexperienced rider.

3. My helmet was not fullface.

4. A little too much speed coasting in.

5. Tennis shoes, no grip.



As I come into the driveway, I managed to slow down OK, but am probably still going too fast - in this case, probably 1 mph instead of 0.5 mph. As I pull in, my shoes slip in the oil and the moped tips me over at a 45 degree angle, right into the picket fence. I am going 1 mph, and everything is in slow motion. I flashback to every bad motorcycle wreck I've ever run, and realize the guys that make it through OK usually have riding jackets, full face helmets, leather pants, heavy boots, and, oh yeah, usually know what they're doing. I, on the other hand, have on:




Old T-Shirt
Cheap Jeans
Tennis Shoes
Underwear, now soiled.



And of course, my helmet. As I rhythmically konk my head on each picket of the fence (konk...konk...konk) I realize that I'm too far over to be able to reach the back brakes, and that each time I try to squeeze the front I'm twisting the throttle. I cannot stop this bad dream, this death at one mile per hour, and just want to close my eyes until it is over.




I flounder helplessly, a prisoner to my own incompetence, and finally, the nightmare comes to an end. I never did actually manage to find the brake, but my dead weight body has managed, through friction, to stop the runaway scoot-scoot. My helmet emits one last konk as I wheeze to rest.




I sigh, stand up, and inspect the damage. My mouth is bleeding, and realize that my upper lip got caught on the handlebars as I went down. My jeans are ripped up pretty good, and my elbow is pretty scraped.




Oh no, I think, mom saw the whole thing! She gets so emotional! She's gonna freak!




I walk inside to my my mom, down on her knees, hand clutched to her chest, face red, unable to breathe.

Shit, I think, it's the big one.

As I step closer until the living room, I realize that Mom is not having the big one.

Mom is laughing so hard she cannot maintain sufficent oxygenation to stand up.

As the last little shards of my self-esteem crumble to bits, I grab a paper towel and try to wipe the blood up from my arm.




"Why....why...hahaha, hoo! Why didn't you STOP HAHAHAHAHAHAHAHAHAHA!"




FINAL DAMAGE REPORT:

1. Road Rash where my jeans opened up: two scrapes on my right knee.
2. Laceration, one inch, to the right elbow.







3. I'm sure there's a medical term for this that I don't know: it's the little piece of flesh that connects your upper lip to your gums. Well, I no longer have one. It is completely gone:


4. The bike got some paint scraped onto it, which wiped off with some serious sponging.

5. Dignity has not yet returned,.

As I shower out, gingerly touching my upper lip, memories of my wretched scooter abortion still fresh in my mind, I think:

Man, I've got to get one of those!

I walk out to head over to the LAEMT conference, I say goodbye to my mom.

"See you later!" she says. "Oh, and MM?"

"Yeah?"

"Drive safely! BWAHAHAHAHAH!"

-MM

Sunday, June 15, 2008

- Occupied

We've been busy lately. I finally had a sit down with my supervisor to tell him what's going on with me and my burnout, and how I'm this close to pulling a Mailman and showing up to work in a dress with a submachine gun if I get off late one more day.

"It's ok. We'll move you next pay period."

Well, ok.

Fast Forward: It is next pay period and I have gotten off late 8 shifts out of 11. I have not gotten my schedule changed because it would be to hard to flip around everyone's overtime, which is cool. I understand that. No one told me till last Sunday that I'd be on my shift for an extra two weeks. I mean, that should be on the list, right? Surely someone should tell Burnt Out, on the Verge of Tossing Down his ID and Keys and flipping the bird, followed by a set of deuces*, and storming out MedicMarch what the dealio is, right?

It's ok though. I'll be moving back in with my former roommates, back in my hometown, hopefully getting my old shift back, and hopefully going back to school in the fall.

Also, that BAND I mentioned last month? Well, as it turns out, they needed a bass player. So, now I am in a band again. It's a real stress reliever for me, and considering how much I've found myself inching into the red the past few weeks it's been pleasure to pick up my guitar and play a little. I had forgotten the importance of getting out of my own head from time to time - I used to just numb it all with drugs so I didn't have to worry about anything, almost at the cost of my life. I just need to build up my calluses again, cause my dainty Vaseline glove lady fingers are not made for shredding.

They've had me and my partner precepting new basics lately. I gave one a really bad review - this rookie was a mess. Poor hygiene, inadequate skills, unable to deal with the pace of things. We got a call, not even a bad one, but when things started moving a little quick she froze up, and I couldn't get her to get back in the saddle.

I would like to see more effort on the part of the preceptee, I wrote. Although they will follow commands I issue there is no independent thought or initiative.

I signed my name at the bottom. The next day, talking to another medic, he brings up the same preceptee.

"Totally froze up on me. I don't think they can hack it."

This individual is not XXXX company material. But we are hurting so bad that they are guaranteed a spot. I'm by no means a rowdy, gung-ho, XXXX company medic, but I do not think this person meets the minimum standards, and I do not want them wearing the same uniform as me.

Damn. When did I start caring?

I'm going to go jump over to Peter Canning's blog's greatest hits and check out that preceptee entry again. I don't think it'd hurt for me to read it one more time.

-MM