Tuesday, November 17, 2009

- For those who haven't seen it...

...check this shit out. It's hilarious. Anyone who's ever worked at a company that does long distance transfers has had this scene play through their head at least once.








H/T AD and TOTWTYTR

-MM

Wednesday, November 4, 2009

-Night Shift

The old man wheezes, but it's a regular wheeze, a steady in and out, and I don't let it bother me. His television flickers. I've never seen a lot of these movies they're airing, and his mind has started to go just a little, so we watch together.

I'm tired, but not too bad. Nothing I can't handle. After the panic of the plane ride up to Maryland has subsided and the surprise our arrival has passed, he tired quickly.

He had called the day before and told my uncle he thought he just couldn't hold on any longer.
"I think he's going," my uncle told my mother. "I think this is it. I've never heard him sound so old."

I sit in the living room with my grandfather as old movies play on TV.

* * *
My father was not a part of my life growing up, plain and simple. The male I had the most contact with in my life was my grandfather, who all the grandkids refer to as "Big Daddy". He's a thin, olive complected man, classically Sicilian. He's always had a great, bushy white beard.

He was generous to his children. He served in as a Marine in the Korean War. He was at Chosin, and took some shrapnel.

"Coldest I've ever been," he would say. But that was about it. He didn't talk much about his service. Sometimes prone to depression, he threw out his medals one night in the seventies.

He's got CHF and pretty severe kidney failure. In the mornings, we take him to dialyisis, and I go to sleep. When he comes back he's exhausted, and sleeps till dinner time, when I wake up, and we watch those old movies. He doesn't talk much. He always sounded to me like Redd Foxx.

He coughs and rolls over in his chair.

My mother cries a lot when he can't see her. Her red puffy eyes tell the tale when she wanders in, blotting her make-up off of her cheeks.

My uncle moves awkwardly trying to help him out. He needs a hand getting back and forth to the bathroom and has had several falls. After a day or so they tend to let me handle the transfers, using the little tricks I've learned in my ambulance time. It makes things a lot easier and we're able to get there with less trouble.

After the military he started a career as a stylist, with his shop next to a dry cleaners. He dressed flamboyantly, and had a soft spot fnew immigrants to the States . He taught several hundred the art of hairstyling. One day, a giant mirror crashed down to the floor in his shop. Apparently the steam undid the adhesive holding it into place. He went next door and started to argue with the dry cleaner, who gave him a shove. My grandfather, decked out in a flourescent pink blouse with the sleeves rolled up a third of the way, proceeded to beat the ever loving hell out of the dry cleaner owner in broad daylight, after which he walked back inside, cleaned up the mess, and began cutting hair.

He was hilarious. He had a quick wit that even has not faded in the twilight of now. He relocated to Virgina where he had a beauty shop across the street from a resturant owned by Gen. Nguyen Ngoc Loan.

He had an "amicable" divorce from my grandmother and would later remarry a great lady who we all loved. As we all lived far from him, her children became like a second family to him and us.

"Son, ya dere?" He's awakened now. I help him to the restroom.

It's weird, this reversal. He always seemed to be at least ten feet taller then me. His voice would boom out into the house. Now his voice is barely a cracked whisper. He always was so vibrant, so alive, and to see him in this chair, brittle, tired, and weak...it's not him. I've never had to watch someone die before. Typically I'm pouring everything I've got into keeping them alive, pushing meds, intubating, running code. Here I provide a different type of care - fluffing pillows, helping him eat. Helping him get outside to the porch, fixing stuff in the garden that he used to tend to.

He had a chalet in the mountains we used to go to. I remember standing on the top porch, and the wind, and the fresh smell. He was so happy out there, moving the lawn shirtless, raising hell, living.

His chest rises up and down. He's lapsed into sleep again. I get up and eat a roll. When the family gets together we've always got plenty of grub at hand. Then I watch him.

I stay on nights the whole time I'm up there. We talk about a lot. I tell him about my life. More often I listen to him talk about his. The whole family makes it up to see him, and we celebrate his birthday one day while we're up there. He's the picture of his old self, cracking jokes, trading barbs and insults, yelling and talking as loud as possible, glasses of wine freeflowing - the way the MedicMarch family reunites.

We stay for a week, but my prior commitments force me to return. Hospice comes in the day we leave. He dies a week later, peacefully in his sleep, in front of his old movies.

I guess I've always idealized that in a normal father-son relationship, the dad tells the son all about being a man and what it means. I've never had that. Looking back, I don't think I need it.

I picked it up in bits and pieces from my grandfather.






I'll always think of him this way, smiling, in the mountains.

-MM

Thursday, October 15, 2009

- Exits

"That's a negative, Whiskey-6, fire on scene, saying it's going to be a DOA. Check your call notes, please."

I have just been denied a back up request, and toss the mic down in disgust. I've already read the call notes. Apparently the dispatcher on the phone with the caller asked if the patient was breathing. The response is quoted on our MDT screen:

*Caller states "His face is blown off"*


Ink is my new partner. He's young, and green, but he takes orders well, and we have the same sense of humor. We're on our way to a self inflicted gunshot.

"OK, Ink, I know you're thinking shotgun to the head, that pretty much erases everything right? The thing is, a lot of times, when they go to do the deed, they lean forward a little, and redirects the muzzle blast out instead of up. End up blowing off their face. It looks like they're toast, but every once in awhile, there's something you can save." (Jesus, I think, when did I become such a blow-hard lecture monkey...)

We arrive on scene to find several layers of police tape strung up. We end up having to park about a hundred yards away from the scene, out back of a trailer, adjacent to a bayou. Ink and I grab our gear and walk to the scene. There are still several layers of tape between me and the patient

A cop grabs Ink and points at me. "Just you back there, March. It's still a crime scene."

I look back at Ink. I do not like this one bit.

I walk pass the last layer. I can see a body lying out near a tree with a large pool of blood, uphill from the body. Hmmph. Someone moved it. Blood doesn't run uphill. As I round a picnic table one thing become abundantly clear:

Our suicide is still alive, and his body shudders as he tries to breathe.

The cops look at me expectantly.

"He's still alive, guys. I gotta work him. Get fire back here, now." I turn around and yell for Ink and grab my radio, requesting back up.

"Ink, grab c-spine. Let's get him on his back." We are delayed as fire runs up to grab the rest of the patient. We flip him on the three count. One of the firefighters, an older male, stumbles back and throws up.

Time seems to stop. His face is pretty much unrecognizable . I see, just posterior to the chin, the entrance wound. It is as big as my middle knuckle on my pointer finger. The flesh of the cheeks is displaced by the blast, rippled and stretched in an obscene perversion of a human face. His breath sounds labored, like he's holding a mouth of full of water and is trying to breathe through it.

Blood is pouring from his nose and mouth. It looks like one eye has been pushed into his skull but in reality the cheek and nose have been so displaced it's just an illusion. The other, I cannot see. The forehead is relatively normal, but immediately into the hair line and a little right of middle is a 4 inch diameter exit wound with flapped open skull and brain matter nearly protruding. Incredibly, I see a tooth sticking out from some of the gray. The blast must've carried it through.

I'm not to proud to say that I almost lost it for a second. I gag, but only once, and after I'm reaching for my airway equipment. Firefighters are now crowding in, and I send them back to my unit for the mechanical suction. One little girl, can't be more than 20, is right up in the mix. I open my medic bag and toss Ink a BP cuff and steth. "Get me some vitals, and let's get him spinaled. We're gonna shit and get."

I slip my safety glasses down and quickly prep my intubation equipment. I'm worried about what I'm going to find. I open up his mouth and the piece of the jaw I'm manipulating feels like a bunch of little Legos shoved into a latex sleeve. Opening the mouth, there are teeth fragments everywhere and a large pool of blood pooling at the bottom of the throat. I have already hooked my ETCo2 sensor to the end of my tube in anticipation of having to tube some bubbles and needing rapid confirmation. Luckily blood has only risen halfway up the cords, and they are plainly visible. I manage to pass my tube first try. I inflate and try a breath in. The ETCo2 value immediately jumps to forty and stays there. There is no resistance and I secure the tube.

In short order we finish spinaling and get vitals. Incredibly they're normal, except for a little tachycardia. My back up arrives and we get him loaded up. I wrap two trauma bandages around the mess that is his head. The tooth lodged inside falls down somewhere and hits my unit floor with a click.

Louisiana has recently instituted a trauma network where we phone in our unit number, patient's qualifying criteria, and location, as well as our resorces available. The medic at the phone then checks a board to see where the patient should be transported to. This enable the proper patients to get the proper care, as well as spread major traumas around the area so that one hospital doesn't get too busy. Since all the hospitals are with in 4-9 minutes of each other, the transport delay isn't too terrible. I actually know the medic who answers the phone personally, and give him a report of what we have. He whistles softly and directs to the nearest hospital that has 24 hour neuro surgery.

The medic I have riding in with me and I talk to one another, assessing. I got the tube, and we got off scene pretty quick, but I have kind of a shitty feeling. I look at the massive trauma to his face. I didn't go this guy any favors. I suction several times on the way in.

We hand off when we get to the hospital and I go and clean the blood out of my unit. Ink picks up the tooth from off the module floor and holds it up. I shrug, and he tosses it into the biohazard can.

A deputy would later tell me that the patient was sitting on the picnic table, and they find one of the patient's canines embedded in the door frame, twenty feet away. I restock my truck when we get back. The rest of the day is busy and I fall into a dreamless sleep that night.

* * *
I return to the hospital the next day. Our patient's parents are there. I go to check on him. He is still alive. The Louisiana Organ Procurement Agency has been called in. I confer with the nurse for awhile. Mercifully they have wrapped his head in large beige bandages to hide the trauma beneath. Only his mouth is visible, but they've cleaned the blood off of the sides and he lies under a blanket. The LOPA doc greets me cordially. He asks if I was the one who brought him in, to which I answer yes. He claps me on the back heartily, congratulating me on getting the intubation.

They take him on the vent that afternoon, and he breathes on his own for a short amount of time, but it goes ragged, and they let him fall into asystole. They tell me later that the harvest went incredibly well.

I take some solace in the fact that all though I was not able to save him, I was able to help other people.

But I still think about him a lot.

-MM

Tuesday, October 6, 2009

- Just a Note

You guys who're regulars may have noticed a new widgit down there on the right. I'm now a member of EMS1.com's new blog directory...what does this mean? Nothing, other than that I'm vain- this is going to increase my blog views, and you might even see an interesting article or two down there.

So anyway, entries coming soon....Shotgun blasts, MedicMarch's Helpful Medic Tips, and more sometime this week. Stay tuned!

-MM

Tuesday, September 29, 2009

- Boooo

re: Trauma, your new show

Dear NBC,

Really?

Thank you,
MM



-MM

Saturday, September 26, 2009

- Motivational poster



hats off to AD for the concept

-MM

Wednesday, September 23, 2009

- Secrets

I've must admit, I've been keeping a secret from you guys.

Shortly after Izzy got back, she got some great news. A recent premed graduate, she was notified by mail that been accepted to not just one or two but ALL THREE of the medical schools she applied to...which meant that our days as partners were numbered. She started at the beginning of the semester, and after speaking to her recently, she is having a ball, kicking ass, and to me sounds like she is already on the way to being a great doc.

It breaks my heart a little to see her leave. She and I and been through some rough calls together and you don't spend a third of your life in a cramped ambulance cab without getting close to someone.

In her own words, "it wasn't all rainbows and skittles. Although we did have our fair share of fun".

Truthfully? It's just weird not having her as my partner. Behind every good Paramedic is a great Basic, and I didn't know what the meant till I started working with her. Now that she's gone I realize what I'm missing.

She's the best partner I've ever had.

I won't go any further than that, other then to say...

Good Luck, Kid. Knock 'em Dead.

-MM

Monday, September 14, 2009

- MedicMarch's Observations on EMS #66

Dispatch is a lot like the inside of a porti-potti. It's not very bright, it stinks, and all the shit has floated to the top.

I am sure this is why at XXXX EMS, our communications center is located on the uppermost floor of the building.

-MM

Sunday, August 30, 2009

- Catcher's Mitt

The call notes pop-up on our laptop as we're trying to cross the river to get back home.

Notification - Caller can see head of baby.

Uh-oh.

Luckily, we're not the first unit going to the scene. Izzy guns it down the highway. We skirt across a gravel road that crosses a cane field, kicking up a rooster-tail of dust into the sky. I grab a pair of gloves and walk in as Izzy parks. Country and Floats are rolling the patient out from a back bedroom. Country looks like a piece of modern art: there is blood from his neck down to knees, a large smear going down his gown. Floats is sweating, her hair plastered to her forehead, and we load the patient and the patent's sister in the back.

I get the story from Country - apparently, the woman had an explosive delivery and tore her her self all the way down to her balloon knot. She's bleeding pretty good. The baby has pinked up, he says, and has a solid Apgar of around 9 now. I poke mom and get an IV running, and we pad up her tear. We are hot dogging it to the hospital.

Mom is 19 and is now G-4 P-4 (that is, for the uninitiated, 4 pregnancies resulting in 4 live births). She is missing all 4 front upper teeth. She gives off a distinct smell of unwashed body and birth shits. After the man with Melting Mouth, though, I've been immunized.

I ask her if she had medical insurance. She produces the state card, and I copy the number down. The sister of the patient has a huge grin on her face, and I see she has no more teeth then her sister. She says something unintelligible - "I'm At Ought Gen!"

I ask her to repeat herself, and again she says it - "I'm At Ought Gen"!

I look at Country. His eyebrow is cocked, and he looks at me and shakes his head.

"What did you say, Ma'am?" I ask the sister again.

She rolls her eyes and yells, as if speaking to a deaf, developmentally disabled puppy who has piddled on the rug - "I'M A TAUGHT UH GIN!" Finally I get it - "I'm a taunt again" - that is, "I'm an aunt again", for those of you still scratching your heads.

"Oh. You're an Aunt again!"

She nods and looks down with excitement at the baby. Now that I'm tuned into her patios, I can understand her a little better as she says "I wonder if mine gonna look like that!" Taking a look at her, I realize she too is pregnant, somewhere between 5 or 7 months along, depending on how much she eats.

"Maybe so!" I say. "Do you and your sister look alike as children?"

"Well, kinda. But I think they gon look alike cuz they got the same dadday."

"Oh." I say. "Maybe!"

* * *
Later I'm finishing up Country's paperwork as he cleans up. I ask about the smear on his smock. He looks around and lowers his voice. "Dude, there was blood and shit everywhere. That baby was greasy as fuck, and it slipped out my hands. I didn't understand until I looked around. Apparently mom had greased her works with Astroglide before the kid came out. It was all-fucking-over."

"You dropped the kid?" I ask him.

"Yeah, and then I picked it up. No one saw, and I was kneeling down, so basically the baby just slid down to the carpet. Do you think it's going to end up retarded or something?"

I look in at the toothless women. Combine their ages and they're not over 36, but they are only a few months away from having 5 babies between them. I turn back to Country.

"Naw man, I don't think it'd make a difference either way."

I slap him on the back and walk outside.

-MM

Tuesday, August 18, 2009

- Wash Your Mouth Out

Izzy and I are sweating. It is HOT outside, and the sun is beating me down like I'm a red-headed step child.

"I's sorry I said you wasn't my real pop, Mr Sun! Please stop a-beatin' me!"

Izzy looks at me sidelong from the driver's seat in the unit. Whoops. Must remember to keep internal monolouge internal.

We are on our way to a call in Backwater, a call for a 50 year old vomiting blood. I grab a pair of gloves and we haul out stretcher to the front door. The new power models are heavier, but going up and down stairs is a breeze. I complain a lot about working at XXXX but this thing sure is nice. They do take care of us.

Mostly.

We walk into the front and there is a skeletal, geriatric looking man staring blankly at us from a chair in the living room. Dispatch must've gotten the age wrong. He has the smell of someone who has not bathed in several days. I run through an exam. He has been vomiting for several days, and states he hasn't stopped drinking since he was 18. His stomach and throat hurt. I a little worried about the possibility of varicies. He states he is 52. I can't believe it. He is so emaciated, and looks like a concentration camp survivor.

I am kneeling, attaching wires and when I look up, Izzy's eyes are crossed and she is stepping back from the patient. She had been grabbing a BP for me.

She is quickly turning green, and as I ask another question and look at the man, I get a blast of his breath.

I thought I've smelled stank before. I've been around decomposing bodies. I've smelled a thousand nursing home rooms. I even smelled my own belly button, once.

But I've never smelled anything like this.

It makes my eyes tear up, and I come the closest I've been to puking while on a call in my whole EMT career.

Words can't describe the stank. They are too flimsy to encompass the enormity of the rot and gross.

I barely manage to keep my gorge from rising and shut my lips, and think to my self DONT PUKE DONT DO IT over and over again for 15 seconds.

When I raise my head, I motion to Izzy and we load the patient. After getting an IV going and running an EKG, I sit behind the patient for the trip to Metropolitan Hospital, with my face in the module window half the time to catch the fresh breeze. Normally I sit next to the patient because I think it reassures them with the added advantage that I can keep an eye on them, but the module smells like raw sewage mixed with carcasses. We transfer care upon arrival and I walk back out.

Izz is spraying down everything, top to bottom. I know we had just refilled the bottle but she is already a third of the way though.

"My God," I say to her. "That was horrible."

"Oh, I know. Worse than that poop waterfall."

"I've never seen someone's teeth actually rotting inside their skull before. Let's get the fuck out of here before they make us take him to the dentist."

"Lets."

-MM

Friday, July 17, 2009

- Fucktard Comment Round-Up

Analyst: Well, hey there folks, and welcome to another edition of Fucktard Comment Round-Up, the show where we take idiotic blogger comments and dissect them into easy to mock pieces for your viewing pleasure! I'm Roy Desoto, and this is my partner Johnny Gage. Looks like we have a pretty good match, Johnny.

Color Announcer: That’s right Roy, and boy do we have a humdinger of a fucktard today. Stepping into the spotlight is gjerry3. Although an obvious rookie with a join date of July 2009 he’s already come to our attention with some vicious attacks on perennial Duster Wrangler and hometown favorite AD, the paramedic behind “A Day in the Life of an Ambulance Driver”. The setup is basically that ole AD here brought his motorcycle to the shop “Cycles and More” and called several weeks later to find out not only had they not made the simple repairs to his motorcycle, they hadn’t even looked at it yet. As always we encourage our readers to review the original post and familiarize themselves with the history in order to more fully enjoy our…analysis. Please scroll down the comment section in the original post to review Gjerry's pitiful and amatuer attempt at flame in it's original setting.

Analyst: Here’s how to rules work. Spelling, grammar, and content of the offending post are left intact to illustrate the incompetence of the comment poster. I tell you, Johnny, it’s enough to make me want to don a Level 4 containment suit, because I’m embarrassed to even breathe the same air as the individual we are mocking today.

Color Announcer: And from the looks of it gjerry3 is lucky that breathing is an automatic bodily function, because if he had to do it on his own….yikes. Anyway, let’s get started.

I notice you took my comments off I guess the truth makes you run. Now for all your readers lets tell them the truth.

Color Announcer: Oof, not off to an auspicious start. Too bad they can’t lock someone up for raping the English language. I surprised he didn't spell "truth" with an "f".

Analyst: It would later be revealed that the comments were never deleted. Fuckface McGee was on a different entry and didn’t even realize it.

U live in the Oakdale are nobody in that area would work on your bike.

Analyst: What the hell?

Color Announcer: “ U live in the Oakdale are nobody”? That…that’s not even coherent. The whole sentence is one giant grammatical abortion. It’s like something someone on a 40-year drunk says whenever you’re putting him on a spine board. What is this guy’s problem? Is he just pounding his fists down on random sets of letters? I’ve seen cats walking across a keyboard that string together more cohesive thoughts then this moron.

Because they know you’re a douche bag.

Color Announcer: Ah yes. The thing you see every morning when you wake up, sir.

Then you found cycles and more they tried to help in every way possible your u cant be pleased.

Color Announcer: Tried to help in every possible? When? What document are you reading, gjerry3? I think you’ve gotten AD’s complaint letter with a self-help book of some sort.

Analyst: Perhaps, Johnny, he’s referring to a Cycles and More in some sort of BIZZARO alternate dimension, where up is down, black is white, and his man-package is actually capable of satisfying his seemingly endless parade of toothless, meth-addicted lovers.

So now u feel the need to blast them. And another thing if you’re going to post the prices at least put the correct ones on.

Color Announcer Well, we’re going to have to deduct some points here. If you’re going to drop flames on a blog entry, gjerry3, make sure you have the correct entry.

Analyst: A rookie mistake for gjerry3. I tell you, it’s been going dismally so far and this is going to hurt his chances to place in the final.

All u have left is Lafayette power sports good luck. You’ve burned your bridge in more ways than one stupid

Analyst: Just like the day you walked out of 3rd grade English in elementary school, eh, Gjerry? It would appear that you never met a piece of punctuation that tickled "you're" fancy long enough to use it more than twice in a paragraph. Does the part of your brain necessary for tact, reasoning, and intelligence even receive circulation? I submit that it does not. Johnny?

Color Announcer: I’m scared, Roy! I’m trapped in a black hole of stupidity and I’m about to cross the event horizon!

Analyst: Don’t try to touch the singularity, Johnny; it makes your fingers tingle. From my partner Johnny and all of us here at Fucktard Comment Round-Up, we bid you good night, and good luck!

(H/T To AD for the original concept.)

-MM

Thursday, July 9, 2009

- MedicMarch and the Volcano

Ms Boudreaux and I are on the same feeding schedule. I know this because I'm waiting expectantly in front of the microwave in the station. My small, hopeful face bathed in yellowish microwave light, nose up against the window, slave to the countdown timer, staring at my meal rotating in a tantalizing slow pirouette of deliciousness, and there's only 30 seconds left, and-

BEEP BEEP BEEP. BEEP BEEP BEEP. BEEP BEEP BEEP. BEEP BEEP BEEP. BEEP BEEP BEEP.

This is the not the happy mealtime chime you would expect to hear when your food is ready in the microwave.

This is the annoying insistent ear-needle that emits from my pager whenever dispatch gambles I will be too weak from hunger to actually kill the sperm-waste mouth-breather that has interrupted my mealtime and requested an ambulance, full code, to go and pick up a lady who has removed her own PEG tube.


You see, Ms. Boudreaux doesn't like to keep her PEG tube in. Invariably, after a period of, oh, 20 minutes, she realizes there's some sort of tube sticking out of her belly, and proceeds to start picking at it, until she worms it out. Then it lays on top of her, or on the floor, or wherever it happens to land, and then whenever the LPN or PCA or whoever goes to feed her at the next meal time, they find it and call us. We pick her up.

She suffers the bumps of an 18 mile ambulance ride, and I do mean suffers - even the slightest rock of the module makes her scream in terror, and the road between Major Metro Hospital and here is quite potholed. She gets her PEG reinserted, and than takes another 18 mile ride back, before being placed back in her bed...so she can start picking at her PEG again.

I know Ms. Boudreaux's paperwork by heart now. I should, after all. This is the 5th time one of me or my coworkers has picked her up this week....and the 3rd time I've picked her up in a 72 hour period. As a matter fact, I can carbon my run report from the shift before, except for the vitals. When we returned the last time, I asked the nurse to put something on the patent's chart - get an order for restraints, or tape a large dressing over the PEG so she can't get to it, or something. Izzy sees the name at the top of the chart and then looks at me and rolls her eyes.

I walk into the room, check on her as Izzy gets vitals, and step back out. I have to talk to someone. The ADON and the shift RN are all standing behind the Formica, intently staring into paperwork.

"Excuse me, ladies."

No one looks up. They are silent as church mouse.

"Excuse me, ladies," I try again.

The RN looks at me out of the corner of her eye, and then over to the ADON, who is still ignoring me.

After I don't go away, she looks up with a smile. "Yes, may I help you?"

Some thing's not right here, but I can't figure out what it is. The staff is at least looking like they're trying. The hall smells only faintly of decubiti and turds. The charts are stacked neatly. What the shit is going on?

" I just wanted to talk to you about Ms Boudreaux. She pulled her PEG tube out again."

The ADON looks up, and she looks PISSED. What have I stumbled onto here?

"The tube is out, which is why we called YOU! You NEED to take her to the hospital so she can get it PUT BACK IN."

"Did you guys try calling her doctor to get something to cover, like I suggested? Or maybe some restraints?" I ask back.

"No, but her doctor did say to TAKE her to the hospital so she can get her TUBE PUT BACK IN."

I don't know if it my blood sugar, or not. I don't know if it's the fact that Ms Boudreaux's room is DIRECTLY across from the nurses station and she should be the easiest to supervise. That I already tried to help by getting a doctor's order to cover that PEG. What I meant to say next was "This is ridiculous." But at some point between the signal from my brain going to my mouth it gets mixed up and instead it comes out

"THIS IS FUCKING RETARDED."

Whoops.

Izzy, the two nurses, and a PCA that was walking by all have eyes the size of dinner plates. It is very quiet.

Well, screw it. At least I've got her attention.

"I AM TAKING HER. I'M JUST TRYING TO SAVE ME, YOU, AND THE OTHER TAXPAYERS SOME MONEY. I'M TRYING TO MAKE THINGS EASIER ON THE PATIENT AND THE ER THAT HAS TO PUT THE TUBE BACK IN. I ASKED YOU NICELY LAST TIME I WAS HERE TO CONTACT HER DOCTOR ABOUT GETTING A PAD OR REST-" The ADON cuts me off, finally regaining her composure.

"For your INFORMATION Medicaid says we can't restrain patients. If you don't like it, they down the hall. Go ask them yourself."

That explains the cleanliness...Medicaid must be doing one of their inspections. She said this to try and intimidate me. It backfires. The ADON recoils as I get a gleam in my eye and a giant, manic grin spreads on my face.

"Down the hall? Oh, good. Which hall? I've got some stuff to tell them about the things I've seen here." I take off down a random hall at a fast walk.

Izzy would later tell me that right after I walked off, the ADON looked at her with the biggest "Oh shit!" expression that she's ever seen. Izzy just shrugged back, and after that, the ADON comes scurrying out from behind the desk.

"Sir! Sir! Sir!" she's screaming as she runs down the hall, adrift in my wake as a I storm down the hall. To be truthful, I'm bluffing, and can't think of anything immediately off the top of my head, but if I gave it five minutes I'm sure I can come up with something.

Just as I'm about to round the corner, she grabs my arm. I've never seen a 400 pound lady move that quickly except when there is a buffet involved. She's breathing heavily after her little 30 yard sprint.

"There's no need (huff, huff) for that (puff,puff). We don't (::minor pig grunt::) want anyone (::wheeze::) causing trouble (::fart::) (::wheeze::)."

There is steel in my voice but I'm no longer yelling. "Look, I'm taking her in. But you need to call her doctor and get some orders written so that she doesn't have to keep getting bounced around. She's terrified of it. It's fine if you can't restrain her - I don't know all those rules. All she really needs is a large trauma dressing taped over the site inbetween meal times, or something like that."

I walk off and load Ms Boudreaux up in my unit. I spent the rest of the shift waiting for a phone call from a supervisor that never came.

I've got mixed feelings. It was extremely unprofessional of me to talk to anyone, much less an ADON, with that kind of language. But I'll be god-damned if the next time we stopped into pick Ms Boudreaux up, it was for abnormal labs. And she had on a soft, vest-type apparatus over her abdomen, keeping her from picking at the PEG.



I won't say it justifies my actions or behavior....but at least this particular issue got fixed.

-MM

Tuesday, July 7, 2009

- Range Report

This will be a departure from my standard EMS fare.

Few of you, if any, know of my interest with firearms. My mother, raising me as a single parent, was decidedly protective of me (suggesting to my grandmother, at one point when I began walking, that I wear a helmet to prevent head injuries) and anti-firearm - when I was young she kept me away from firearm toys, nearly going nuts when my grandmother bought me a toy raygun water pistol at a young age. My obsession with toy guns and GI Joe, however, eventually forced her to cave, results being that I had quite a collection by the time I got to be too old to play with toy guns. When most other young tykes were reading Clifford, The Big Friendly Dog books, I had my nose buried inside a military issue manual on Jungle Warfare.

My uncle and grandfather had both served as Marines, and my (necessarily absent...but this is a post for another day) father was a police officer. In fact, until I graduated I had just assumed I would join the military or serve as a law enforcement officer. I was actually in the city police department's Explorer program before getting into a similar program in EMS. Part of the program involved a week long camp at a military base in Gulfport...where one of the segments was at a firing range. I will never forget exiting the class room and loading and firing a police issue .38 at a target. My shooting was horrendous but the excitement remained with me all day. My mother wasn't much of a hunter, though, and other than a few trips with my godfather, another police officer, I never fired anything larger than a BB Gun....but it was enough to fuel my desire.


Since that time my knowledge of firearms has been mostly from books and the Internet.

I finally decided that now, as an adult of 24 years of age, I would venture forth into the world of firearms and test my mettle.

Which why, about a month ago, I found myself in the 6th lane of a local shop and shooting range near my hometown. I had requested and received a safety briefing and course in range protocol (because if I had a misfire, I didn't know what the hell to do), and had a rented Glock 22 in .40 and two boxes of shining, factory fresh rounds laid out in front of me. I'm happy to say that my book knowledge served me well and I was able to load my own magazines and operate the pistol without further assistance. I slid my safety glasses down, advanced my paper target down the range, and it began.

I'm pretty comfortable in my own skin, and I wouldn't say firing a pistol made me masculine or powerful. But I definitely derived immense satisfaction from the flash and noise, the recoil of the grip, the satisfying snick as I slid the magazine and chambered a round.

My shooting was atrocious, and I could not get my hands to stop shaking the whole time. I fired a box to get used to the weapon, and my friend Courtney, who had accompanied me, and I had a little competition after, firing in the following sets at 15 yards.

Center mass, 5 rounds, x2.
Head, 5 rounds.
Torso, 5 rounds in under 4 seconds.

Below is the target I fired at. The grin on my face is unmistakable.

Lord help me, I think I'm turning into a gun nut.






- MM

Thursday, June 18, 2009

- Not Good Enough

A few months back the hospital here in Backwater Parish closed down. It wasn't much of a hospital...a few levels above above a band-aid station. About a year ago a new company bought it out, and basically ran it into the ground - trimming the daytime surgery and closing down the L/D section that was operating. They declared bankruptcy before, I shit you not, jetting off to Aruba, leaving the residents of Backwater Parish to the mercy of the gods.

The ER was small but it in a true emergency was great for quick stabilization before we choppered out the patient to Major Metropolitan Area. And for minor emergencies it saved everyone time, money, and effort.

Since the nearest hospital in my service area (around 400 square miles, give or take - largely rural bayou area) is now at least 18 miles away, we've been doing a lot of driving. My region is a busy one and though two units work my service area, we've been caught with our pants down on coverage several times.


My supervisor and coworkers all shared the same thing with our corporate management. "We're spread too thin, out here." "We need to rework our coverage policy."

We're too wide open, and this isn't good enough, I said. It's only a matter of time before someone dies.

Our complaints, advice and suggestions all fall on deaf ears. The policy remains unchanged.

* * *

Derry is a young, severely mentally disabled patient of ours. I've picked him up several times since I came to Backwater, mostly for minor, chronic care issues - fevers, peg tubes issues, etc. He house is a mere 5 minutes from our station, and the trips are usually to the hospital in Backwater. Easy trips, back and forth. His grandmother doesn't always remember my name right away, but she knows my face. She always makes a big show of reading my name tag, and we cut up on the way to the hospital.

We had picked Derry and his Grandma up earlier in then day for a doctor's office visit. He had a slightly junky breath sounds and pretty good fever going, and was tachy at around 130. I teched the call and kept him on my monitor there and back to his home. His other vitals were OK though, and I let his doctor know about the tachycardia. We both agreed that it was probably from the fever.

The doc gave him a pretty good checking out, was a little worried about a possible respiratory infection. She wrote a handful of scripts and advised Grandma to keep giving him meds to keep the fever at bay.

We tucked Derry back into his bed.

"Alright, buddy, behave," I say to him. I tip my hat at Grandma on the way out.

13 hours later we are down in deep Backwater, at someone's duck camp for an accidental fall. As we get a refusal we get paged for a code back in The Locks, the biggest city in Backwater Parish, where our station is and hospital was. The address looks familiar on the pager, but it's not until I get the call notes that I know who's house it is. No unit is around or even close to The Locks. As a matter of fact, no other unit is anywhere close to Backwater Parish. We are it.

I won't say what happened on the way over, only tell you that it was a good thing that it was late at night and the roads were empty.

It takes 18 minutes to get there. As we pull up the chopper is landing in the parking lot across from Derry's House. The chopper was the next closest unit, with a flight time of 10 minutes from Major Metro Area.

The fire department isn't angry when we get there, just confused, maybe even hurt. "Where were you guys? We've been doing CPR, but the AED advised no shock."

The chopper medic and I code Derry for another fifteen minutes. We finally get a PEA, that goes into fib, we shock it, epi it, get an ugly, bradycardic pulse that we pace and medicate, to no avail. We get on the road but Derry slips back into asystole 5 minutes away from the hospital. They call him moments after we slide him over.

I am sweaty and spent, angry at myself, the hospital, the system. A loud BANG as I slam down my clipboard with a curse and leave the ER room to get some fresh air.

I see Grandma on the way out to my ambulance. I guess the look on my face says it all, and her expression collapses. I wrap her in a hug. She doesn't have to read my nametag this time. "Oh, March, why? Why?" she questions me.

I have no answers.

After a while, I walk her inside to the consult room and sit her down.I walk back into Derry's room and apologize to everyone. They are understanding and don't hassle me any.

Although this happened awhile back I still think about it a lot. I am at war in my own head.

My head tells me that this is a blessing for Derry, that he is now happy and whole, living the life in Wherever It Is That You Go When You Die. It tells me that I did everything I could for him and that you can't save everyone. It tells me that even with the perfect setup you're not going to get every patient back, and that I'm being too hard on myself.

My heart seethes with rage at our response time, and the coverage situation. It is furious with the Buy n' Fly health care company that raped the hospital and the residents. Over and over in my head I see Grandma's face crumple, feel her tears on my neck. The look of the firefighters, hurt. Where were you guys? they asked me. What took so long?

Derry lived in the middle of the biggest city in Backwater Parish. It took only 3 minutes for fire and police to arrive but 20 minutes for EMS personnel.

Later, I talk to one of the firefighters I am friends with. He's kind of a big deal in backwater Parish. "I know it wasn't yall's fault," he tells me. "I know it's dispatch. But they've got to do something."

Yesterday, we are twenty five miles away for what began as an asthma attack and ended up as a repository arrest.I don't know how the long the patient has been down. I medicate, intubate, and pass an electric current through her to bring her back to life. She gets choppered over to Major Metro Hospital. Last I heard she was still alive although not doing to hot.

I stock my bag and and replace the items I used, and only one thought burns in my head.

Corporate policy and Politics are all being placed ahead of the patients in Backwater Parish, and I'm mad as hell.

Because whatever the fuck the higher ups are doing, people are dying, and It's Just Not Good Enough.

-MM

Thursday, May 28, 2009

- Collisons

Blacktop shines slick with rain as we race towards the strobes in the distance. All the sugercane has been cut and we can see the wreck, even though it is two miles away. There has been a car accident at a local intersection, with an entrapment.

We arrive on scene to find three teenagers trapped inside a crumpled mess of a late model sedan. The driver is the most seriously injured, disoriented with a large avulsion to the knee. He took most of the impact and the door he sits behind is deformed. He's going to have to be cut out. I'm surprised he doesn't have an humerus fracture. Fluids have been leaking from beneath, and there is a slight stench of radiator juice and gasoline. I don't jack squat about how flammable what I'm standing in is. This is not safe, but we can't leave the patients, and the fire guys don't look that concerned.

After quickly assessing the other two teens, both stable and complaining of minor neck pain, but neither need to be cut out. I call over the radio for back up and look to find Izzy, tell her to grab the spine boards, and braces. When I look up, though, she's already on the far side of the car with the equipment. "Those two out first, in our unit. The driver goes in the backup unit."

Izzy simply nods an affirmative, and I don't look up again...because I don't have to. Izzy functions on her own, and as I climb inside with the driver, I can hear her giving firm but polite orders to the Vollies out on the wreck with us. By the time I've got the driver collared and IV'd, she has both patients in the back of our. Less than a minute after the Vollies pop the door on the car, our backup unit is on scene. I do a quick handoff, and walk back to my unit to find Izzy ready with a set of vitals for each patient.

Our transport to the hospital is uneventful, and, as just about always, our unit is cleaned and ready to go back in service by the time I finish with my paperwork (I try to finish as fast as I can. I hate the she does most of the clean-up of my messes). In the back of a unit she anticipates my next move with near psychic comprehension. She's got an incredible work ethic.

The truth is working with Izzy has me spoiled pretty well. Days when I work overtime or with a different partner, it's apparent to me how well we work as a team. I'm not sure how much of it is chemistry or if she's just that awesome. For all you EMTs out there, remember this: most of the time, a Paramedic is only as good as the Basic backing them up.

Izzy isn't just coworker... a coworker is someone you work beside. She's someone I work with.

A partner.

-
MM

Wednesday, May 6, 2009

- John Lennon

Izzy and I have been busting hump all day, a common occurrence since they've switched dispatchers in our area recently. The new guy is, to be kind, a complete ball-lick. Actually, I take that back. A ball lick, at least is useful or fun to at least one person. This guy is more like a herpes lesion - no fun for anyone. Whatever. Dispatch is dispatch, and you're going to get crapped on eventually. It's just seems like it's been us...every shift.

Anyway, we are paged out for a transfer from a residence to a local hospice. We make our way over and arrive at the residence. I'm a little gun shy. The last hospice transfer I had was form the hospital to the patient's home.

The patient passed on in the back while we were en route. The partner I was working with that day had never had anyone die on her before, and it was an (understandably) emotional time when we arrived at the residence. They didn't understand that the patient was gone, and the granddaughter actually requested to work the patient until his wife managed to come over. She put her hand on her granddaughter's shoulder and pulled her into a gentle hug and said "No baby, its OK. He's gone." They started crying, my partner started crying, etc.

Back to the present, we walk inside where we meet a lady I will call Delores. She's sitting in her bed, in the back bedroom. She's in a hospital bed, with oxygen cannula attached, watching Judge Judy. A recent "Glamour" magazine is sitting on the nightstand.

It's obvious from the start this lady is a card. She looks at me and cocks an eyebrow. "And who is THIS gentleman?", she asks her hospice nurse.

I introduce myself. "I'm March, this is my partner Izzy. We're taking you over to the hospice".

'Lord, I don't even have my face on. Well, OK. Let me get my purse."

We chat and joke for a little while. As it turns out, Delores grew up in the 1960s in London...and she let us know all about the wild parties she attended. She worked as a model before falling in love with one of her photographers and lived allover the world before immigrating to the US and settling in the South, where she and her husband did charity work for a children's hospital and raced hot air balloons. The nurse gives her some pain medication before we leave.

We get her loaded up, and I hop in the driver's seat. "What kind of music do you like, Delores?" I call out through the window.

"Well, I was always a big John Lennon fan." Oh crap. I was hoping she'd give me a genre, not a specific request. I put on the local classic rock station and pray for a miracle. Unfortunately, it's a Fleetwood Mac marathon, and we listen to that as we drive over.

We are getting pretty close to the hospice, and I switch radio stations on a whim, and incredibly...

...I hear the opening melody to "Imagine." Chills run down my spine. I turn my head to the window and wave to get Izzy's attention, and then point at the radio. which I turn up. John Lennon's voice blares beautifully from the speakers. The song ends just as we pull up to the entrance of the hospice.

I pop open the back doors, and Delores has a huge smile on her face. We bring her inside and put her in the other bed. "Light as a ballerina!" I say, a line I caged from Peter Canning's book. She gives us each a hug and tries to tip us, which I decline, saying the pleasure was all mine. She then looks over at the male hospice nurse that has entered. "Oh, lord, two strapping young lads! I had better watch out for my purity!" and we all crack up.

She is still smiling as I walk back to the hallway where Izz is making the stretcher up. Izz tells me apparently, when the song came on , the lady got all excited. It was her favorite song.
We load the stretcher in the back and I put my sunglasses on, still wearing a smile.

I don't want Izz to see that there is something in my eye.

-MM

Monday, March 16, 2009

- Izzy Tales

I was off the truck over 10 days recently on a minivaction for a friend's wedding. This meant my partner, Izzy, was working with a swing medic, who for clarity shall hence forth be referred to as "Swingy" . This is one of the adventures she told me about.

Also, it's pretty gross. Don't read if you have a weak stomach.

* * *

"Oh, god, March, I wanted to DIE this weekend."

"What happened?"

"Well, Swingy and I had gotten our butts kicked all night. We were just about to head home and get off shift when they gave us a Critical Care call at Incompetence Memorial Hospital coming back to Metropolitan ER. We get there to find this massive lady intubated with all kinds of medicine flowing into her, still on a spineboard. She had a history as long as my arm. Apparently she had coded and they brought her to IMH where they got her back. We load her up and drive over to Metro to drop her off."

"When we get to Metro, the hallway is full of every doctor, nurse , and tech that can be corralled. We transfer her over, and I'm standing down at the end of the board. I don't know why what happened next happened, but I'm so thankful it happened."

"I'm down at the end of the board and step to the side a little bit. I don't know why I stepped to the the side, I just did. There was no reason for me to. "

"All of a sudden, the most rotten, disgusting, and vile stench that has ever passed these nostrils invades my sinuses and will NOT GET OUT. I look at where I was just standing and there is a brown waterfall spewing from between her legs, flowing down the board, splattering onto the floor. "

"Everyone starts gagging. The room is silent except for retches and a doctor at the head of the bed who says 'Um, I believe that is feces!' (at this point I want to yell 'no shit, Sherlock'! but I'm gagging too hard)."

She looks nauseous at this point. "One of the nurses was hunched over a trash can vomiting and crying, crying and vomiting."

"It smelled like every single piece of bacteria and rot that had been lodged in this woman's body in the past 60 years all of a sudden exited her bowels...explosively. It was the worse thing ever."

* * *
Apparently here People start leaving the room in droves, but the Critical room at Metropolitan is really crowded, so a bottle neck forms at the exit. People could not leave fast enough to escape the poo.

* * *

"Swingy comes out of the ER later and sits down. He's all sweaty and kind of pale. 'Izzy,' he goes, 'that is the worst thing I have ever smelled. Worse than any decubitis, any GI bleed, anything. Ever."

Izzy looks a little green around the gills.

"Horrible. It was a brown waterfall of death." She swallows heavily.

"Glad I was in Lake City!"

"Asshole."


-MM

Friday, March 6, 2009

- Close Calls

Getting up at my girlfriend's house this morning, I scratched myself and walked into the bathroom, about to do my morning duty when all of a sudd-

HOLY SHIT THAT THING ON THE COUNTER LOOKS LIKE A PREGNANCY TEST

OH MY GOD OH GOD GOD OH MYGOD CRAP CRAP CRAP

MY MOMS ARE GOING TO KILL ME
OH SHIT MY GIRLFRIEND'S MOM IS GOING TO KILL ME
OH MY GOD MY GIRLFRIEND'S GOING TO KILL ME
OH GOD HOW IS MY GIRLFRIEND

I'm not smart enough to be a dad! I'm No Ambulance Driver! I can't even beat pre-k students at Wii bowling and now I have to raise a whole baby?!

Holy crap what if it's all hairy like me! Oh god.

OK, MM. Just relax. Just take a deep breath and press the button and check it...just press the button.

You've picked up people's body parts from the side of the road, this is nothing, simple, just a little button to press.

::a minute passes::

You Can do this, March. C'mon.

::another minute passes::

C'mon. Knowing is better than not knowing.

::another minute passes::

At this point, my girlfriend walks in, and I love her, but she looks like hell, all sweaty and puffy. Oh, god, I think. This is real. Well, she's a solid chick. If she's the mother of my child, OK. Let's do it. I just hope the kid takes after her side.

"Baby, I-"

She doesn't stop, heading directly for the pregnancy test. Uh-oh.


She picks it up and waves it at me. "DID YOU SEE THIS? IT'S HORRIBLE"

"Well, baby, I don't think so, I th-"

"It's bad, MM! I already feel like throwing up!"

"Well, that's part of it, I think." I don't know, the only thing I have to go off of is Father Of The Bride movies!

With that, she slides the pregnancy test into her mouth. Hmm, that's new. I didn't know you excreted hormones into your saliva, but fuck, technology is amazing.

It beeps after about twenty seconds - holy crap, that was fast. Technology IS amazing.

"Look!" She extends the pregnancy test out to me, so I can read the results. And there, in the little window that says "Pregnant or Not Pregnant" it says "SZOI"

"'SZOI'? What the fuck is 'SZOI'?"

CRAP. Is this bullshit in Russian or something? GODDAMIT I NEED TO KNOW IF I AM A FATHER, NOT WHAT YOU'RE NAMING YOUR FUCKING SPACE ROCKETS.

"Oh, wait, sorry babe, it's upside down." And with that she flips the test to show that it reads:

102.5

What the fuck?

Wait.

Oh.

It's a thermometer. Oh. Wow. Wow.

Girlfriend looks at me. "Baby, you're kind've pale yourself. Are you getting sick too?"

"Nope! I'm Good!"

-MM

Monday, February 16, 2009

- A bit of a detour...

Ok, for those of you who don't know I'm a fan of coffee. Was perusing Keep Breathing's blog and caught a link here to Tom Bibey, MD's bluegrass-and-medicine page.


Seems ole Doc Bibey composed some lyrics, and I felt the musical bug bite me on the ass, so I went ahead and laid it down on my laptop.


EDIT: Here is the working link to COFFEE SONG. Check it out!


And now he's got a song writing contest going! Check it out!

-MM

Thursday, February 12, 2009

- For everyone who wanted to see what I really look like...


...it's like this. Coming to a newsstand near you!


-MM

Saturday, February 7, 2009

- Lies

Izzy and I were in the unit one day last year. It was a beautiful sunset, the kind that makes cinematographers have to adjust their underwear, and we were deciding on what we wanted for dinner. In our small town, this consists of three options.

1) Wal-mart
2) Chinese
3) Fast Food

I believe we had decided on Chinese when we get a page for an overdose...at a dentist's office?

"A dentists office? Too much toothpaste? What the hell?"

Traffic parts in front of our siren as we speed over. We arrive 2 minutes later (small town, remember?) and get out, ready for action.A cop is standing outside, and as we walk through an open door, we see three large women clustered around the door to a patient care room. It smells like a dentists office, and my teeth ache slightly. I step past the ladies at the doorway to find a perhaps forty year-old female curled, fetus like, around a nitrous tank. A firefighter is poking her in the stomach.

"Look out, bud. You're doing it wrong." I kneel down to the lady, and poke continuously on her forehead.

"Hey. Heeeeeeeeeeeeeey. Hey. Wake up."

My technique works, and our little nitrousnaut's eyes flutter open.

"Wh....where's...Tooktook? Where's...bali??"

I shoot a sidelong glance at the firefighter and Izzy, who's trying to suppress a smile. Bali? Wow.

"Ma'am, I'm a paramedic with XXXX, my name's March, what happened?"

She's starting to come around now, and looks at the tank she's wrapped herself around.

"Oh, uh....I...was....um. I work here."

"Oh, ok. Izz, can you get some vitals?" I turn around and look at the three pack of women at the door to the office. They can barley fit all of their faces inside. "Do any of ya'll know what happened?"

One of the pack looks at the other two, "Well, we left the office around two today, and went to have an after work lunch. She said she had to finish some paperwork. We all went home and got dressed, and when we drove back by on the way to the restaurant, I noticed her car was still parked out around the back. I didn't think it was a big deal and we went and ate. When we got done, we were driving by, and her car was still here. We went inside to check her and found her like this, and then we called you."

I check my watch. It's a little after seven. These woman ate "after work" lunch for 3 hours. That's close to my personal record! But, more importantly....a woman has been huffing laughing gas for 4 or 5 hours.

Now, pharmacologists, you may be able to educate me on the particular kinetics of nitrous, but as I recall, it's premixed, and you can't dose yourself too high without dropping the mask. So I'm not to concerned with the potential of this individual to go into respiratory arrest. At worst, she'll have a shit-ass headache. I walk back to the woman, who is now awake enough to communicate effectively.

"Oh, look, I was just feeling...short of breath, so I decided to um...breathe some oxygen. I feel...better."

I bet so.

The dentist shows up, and decides not to press charges.

















For dinner, I have chicken on a stick with steamed rice.

It is delicious.

-MM