Wednesday, October 29, 2008

- Gol Damn

Just finished AD's BOOK!

Well done, and well written sir. After I got finished, I left it on the table at the station. Everyone else who's picked it up has loved it.




Tuesday, October 28, 2008

- Crossing The Line

"March, you are way too inappropriate."


"You don't have a filter. You always cross the line. You're funny but you always go overboard!"

"What? No I don't. You're crazy."

"YOU'RE CRAZY! Remember what you told me the other day? The belt sander comment?"

"C'mon. That was funny."

(She brought it on herself. My ex-partner and I were discussing winter, and leg-shaving and she had joked she was going to skip her thighs. So off goes my mouth, before I can do anything about it - "Holy shit. That's craziness. Your boy-friend is going to look like someone took a beltsander to his face!")

"Yeah, it would've been. But Bossman (our supevisor-ed.) was standing right there with the other crew!"

"They laughed. It was funny!"


I'm silent for a moment.

"Well, that's what you get for living in sin."

"Fuck you, March."
* * *

I can't help it. Maybe I've got Ausperger syndrome or some weird form of social anxiety. When people ask me about it I blame it on having a compulsion, but the truth is pretty much every time I've carefully weighed out saying it versus not saying it. It's just that saying it wins every time.

These are all from the past three days. Can you identify where I "Cross the Line "?:

Situation 1: A young, openly gay paramedic at my station is drinking a white substance

MM: What the fuck is that?
YGP: Protein Shake.
MM: Wow.
YGP: Yup.
MM: I thought you would've gotten enough of that from, you know, your lifestyle choice.

Situation 2: In my mom's convertible, on my way out to a picnic with an attractive school teacher I know.

YAT: Just want to make sure we get back later tonight. I've got laundry to do.
MM: Yup, we will. Couldn't have you going to work without clean panties.
YAT: Hahaha, I know, right? I don't want to go commando at school!
MM: Hahaha...
YAT: (smiling, enjoying the ride)
MM: I can see it know. "::sniff sniff:: Ms Smith, what smells like mayonaise and Catfood?"
YAT: ::silence::

Situation 3: Sometimes, even when I do manage to avoid saying something freaky, it comes out anyway. A Friend had just asked me who my favorite Disney Princess is.

MM: Well, Jasmine I guess. Course, she'd have to take a bath. No rubbing of oils or shit.
FRND: Cool.
MM:...course, I didn't want to freak you out.
FRND: Don't want to hear it, March.
MM: The fox chick from Disney's Robin Hood. She was HOT!


Wednesday, October 22, 2008

- MedicMarch's Baseball Mitt (Gustav: Aftermath)

I'm deep in slumber when Dee the Desk Clerk walks into our temporary bunkroom at Backwater Parish Hospital. "Um, hey, March, the nurse said to come and get you and the doctor. Some lady pulled up with, uh, a dead baby, I think."

Yeah, I woke up pretty quick.

A quick snapshot as I step out into the bay. As it turns out, no, the baby is not dead. Barely. The two nurses and ER tech are clustered around the passenger side car door. Sitting there are a mother, who looks...calm. What the hell? She's covered in blood and just self-delivered.... somewhere. No emotion really, just sitting there, blinking at the nurses. Wait a minute...half lidded eyes...slow reaction to stimulation...

Jesus. She's high.

I pop my stretcher out from my unit, conveniently parked 15 feet away, and together Bossman, who's shown up from God Knows Where, and I physically lift mom and baby out of the car and wheel them in. The baby had been wrapped up in a comforter and is cyanotic, but I hear a weak cry. We pull mom across, and Doctor Dickhead walks in.

Normally, this is where I give you an extensive list of why I've bestowed this nickname on this individual, but here it's unnecessary. The name's got it all. He's a dickhead.

We get the cord cut and I get an IV in mom. There was blood everywhere on the car's seat. There's going to be hefty cleaning and detailing bill that medicaid is not going to cover. I walk into the other room, where baby is getting warmed up under a heating lamp. Dick is hunched over the patient.

"What's he doing?"

"Trying to sink an ET Tube," stage whispers BossMan. "I guess stimulation and blowby aren't in his playbook."

BossMan has already been given specific instructions not to argue with Doctor Dickhead from our higher ups. I guess he sees my lip twist in disgust and before I can talk he pushes me with his elbow. "Go Help with Mom."

I glare at him. As I was taught when it comes to neonatal resuscitation you follow a kind of inverse pyramid. A lot of times kids just need a vigorous rubdown (don't go all British Nanny, but get the job done) and some blowby O2. If that's not working, Bag 'em, and then so on down the pyramid till you get to cardiac drugs and electricity.

Well, fuck it. I'm not a doctor. Maybe he's doing something I'm not trained on or don't know. I walk out to the lobby where the driver of the car is waiting nervously.

"We're working on mom and baby right now. What happened?"

"Well, the power is still out over at their house, and I was sleeping in the other room. She was crying out that she delivered into the toilet. She thought she just had to go to the bathroom."

"Does she take any medicines?"

"Well..." She looks at me guiltily. "She gets bad anxiety and takes Xanax. She takes the boyfriend's medicine. He ripped his knee up and takes, um, vicodins, I think. She smokes weed too. She's not due for another month!"

I nod and thank her.

Back in the ER lab has come back with the screen results. ER Nurse 1 holds up the results. "You wanna guess?"

I hold a hand up to my forehead and shut my eyes in intent concentration.

"Opiates, benzos, and marijuana?"

"Ooh, not bad, you forgot barbiturates!"

"Well, I cheated and asked the family or friend or whatever outside. How's she doing?"

"She's pretty spaced." The phone rings, and ER Nurse 1 picks it up. It's the local NICU, telling her they're sending a team to grab the baby.

"Well, at least she's not hurting." I look through the observation window. Mom is passed out in the bed, even snoring delicately. Zonked.

I'm pretty worried about what could be floating around in the baby's lungs. Born in distress, mom's high as a kite, delivered into a toilet? Ick.

The neonatal team arrives in short order, and get the baby packed up. Doc was unable to get a tube in place, and they put the baby inside the plastic box, and head for the hospital. We're going to be getting off late, but I volunteer to bring mom over to the other hospital.

We transfer care and we go up to visit the baby. After some suctioning the baby has cleared up considerably. She's sitting under the fry light, getting her tan. I touch her foot lightly, and she opens her mouth for a second before closing it again.

"Happy birthday..." I say, and walk out to my unit.


Tuesday, October 14, 2008

- The Hot Seat

OK, so my Welfare Sterilization Incentive post ("Get Smart") from a few posts back is getting interesting. You can click on that link to read the original story, my post, and the comments. I'm made a new thread to respond to everyone's comments.

Annie: While I definitely agree with you - having kids you can't afford is a stressor on the system - I disagree with out and out mandatory permanent sterilization. What if the $1000 (permanent sterilization) offer was kept on the table with no strings attached and the rules were changed to mandatory Depo shots or something like that necessary so that for those who are using this as a stopgap measure aren't permanently sterilized because they needed help (ie, Tony's situation).

Bernice: Good idea. We'd save on the tax breaks those potential children would be providing, as well. More money would stay in the system to go to other stuff. But I think the incentive should remain in place for those on welfare, and we could make it free for everyone else. What do you think?

: What if it was simply free with no incentive? Also I've asked around - it seems they are reluctant to sterilize someone with no kids (on the idea you might change your mind later) - I don't believe you have any. Would you still go for the procedure?

Elizabeth Bryant Alexander: I agree. There seems to be a lot of support for this from the people who work in public services and health care. Even if that's $400/year for each person on that, if it keeps the individual from having one kid they cannot support, it pays for itself.

ChuckR44 - from what I can determine in my state you lose your medicaid if you test positive for drugs - but no one really does any testing (most of the time it's in the ER - the doc can contact the state about yanking the person's medicaid, but nothing comes of it)!

NewGradNurse: I'm not suggesting we go all the way and make it so that you are permanently sterilized while on public assistance. What do you think about temporary sterilization?

And where does race play into the picture? No one has made this a racial issue or mentioned race (georgeh said I might be called racist, but that's it)

Bianca: Thank you for commenting. I may be making some awful deductions, but I'm interested in hearing what you think about the proposal :)

Alright! Fuel on the Fire! Thanks to everyone for participating!


Saturday, October 4, 2008

- He Doesn't Look Too Hot

Sometimes I can tell just by looking that we're going to have a rough call.

We pull up next to a cane field. A man lies crumpled at the edge of the field.

"Shit. He doesn't look too hot," I say as I get out.

One of the fire fighters yells at me that the guy's having trouble breathing.

"OK," I yell back. "Let me grab my bag!"

As I open the side door I hear a curse. "HE STOPPED BREATHING!"

"OK." I hop the ditch with my bag and run over to the guy. AS stated, he is not breathing. I reach down to check for a pulse.


"He's a code. Start CPR, Let's get him loaded up."

We are only one mile away from the hospital and I'm thinking he would benefit more with me transporting than if I worked him here in the mud and sun. As they load him into the back I slap on the pads. The guy is already in PEA. We get him to the hospital in exactly one minute. I'm not getting good compliance with the bag and as we hit the brakes I quickly try to tube but the guy's incredibly anterior. I can't get it and we wheel him in. It's only been 3 minutes since I pasted the pads to his chest but he is already asystole.

They quickly IV him and push round after round of drugs, but to no avail. 20 minutes after we've gotten the call the man is dead on the table.

He is an immigrant into this country, working illegally, and through a translator we learn his family is all back in Mexico. There is no one to come and take responsibility for the body.

Later I get his medical record bounced back to me for not providing a social security number or address with his billing information. I fight with the billing department for three days before they have me contact my supervisor to write off the call.


EDIT: Please welcome PARACYINC and VOODOO MEDICINE MAN to the Blogroll!