Meat in The Seat

- Obstructed

2011-08-05T06:27:00.006-05:00

The room is hot. I guess the patient didn't like having the AC on so much. She's been here for days and recently returned from having a pacemaker put it. When we walked in, one nurse has her brow furrowed, attempting to ventilate the patient, with difficulty. She has no airway in. We were paged out for a respiratory arrest. The other nurse stares at us.

And that's all they're doing. I look at the monitor they have the patient hooked up to- an ugly complex obviously being fueled by the new pacer marches across the scene. I check a pulse.

"I don't feel a pulse. Start CPR," I tell Benni, my partner.

"Wait," says the nurse, grabbing Benni's arm. "She's got a rhythm. You don't do CPR with a rhythm. We just need to bag her and send her to hospital."

"You don't do CPR with perfusing rhythm," I correct her. "I don't feel a pulse. Go ahead, Benni."

The nurse gives me a dirty look that lights a rage in me so hot my eyeballs steam. "How long has she been like this?"

I guess the anger carries in my voice, because the nurse flushes and scowls at me. "Ten minutes."

"So she hasn't had a pulse for ten minutes?"

The nurse's face breaks and a look of fear flashes across it "She had a rhythm. We didn't check. "

I sigh and grab an oral airway from the bag, gently grab the BVM from the nurse, and try to insert the oral airway. She's got a lot of emesis, which I suction out. I then hand the BVM back to the nurse. I'm mad at myself. I probably could've made that a teaching moment and instead I let my anger get the better of me.

The BVM nurse is having problems, so after I push an epi through the conveniently preplaced IJ I have a recently arrived firefighter take over compressions and direct Benni to bag. I thank the nurse through clenched teeth.I can tell Benni is having a pretty difficult time trying to ventilate, even with the airway in. The patient's rhythm is unchanged, still a PEA. I grab my intubation equipment and, with the firefighter still doing compressions, intubate. The angle is horrible, but I can see the bottom of the cords and manage to slip my tube in. I watch it pass, but when I attach the BVM to the ET I can't bag, not even a little a bit. What the fuck? It's like there's no outlet for the air.

I pull the tube and reinsert the oral airway. Benni tries the BVM again, and now she can ventilate with no issues. What the hell is going on? I look back at the monitor. The patient's pulse ox is now picking up, holding steady at 79. I shake my head. At least air is going in. I push an epi and plot my next move. I as I'm disconnecting the prefill I look at the tube I pulled. At the bottom is a massive wad of blue gum, lodged in the tube. Oh.

I successfully intubate shortly after and about thirty seconds later, the patient's pulse ox goes to 100 percent, with a ETCO2 of 102. I go to check a pulse and realize I don't have to - I can see her carotids throbbing in time to the now organized sinus tach marching on.

We package and transport to the hospital, where I mention the gum and turn over care. The patient's pupils are large and nonreactive, and seem to stare up at me accusingly. But she doesn't blink, and when I move away, she stares lasers into the flourescents.

-MM

Soaked

2011-05-19T05:39:00.006-05:00

There is so much blood on the bed I can't believe it - the sheets are saturated with all hues of red. You can even see blood on her hands, darker than that on the sheets, where I'm assuming she was trying to hold pressure on the quarter-sized hole on her thigh before she went so hypovolmic she went unconscious. She breathing agonally, about 4 times a minute. I'm glad I told Fabio to grab an extra handful of 4x4's and Kling, and he is rapidly taping up the leg wound.

"I called as soon as she axed me," says the son, in the door way. "She gon be aright?"

"We're going to try. She's lost a lot of blood." I open her airway and slide in an OPA as I hand a BVM to a firefighter standing next to me. Her mucous membranes look like black and white photos of an airway.

I knew we were in deep shit when one of the firefighters, who arrived 45 seconds before us, came running back out. "STEP IT UP, GUYS! SHE AIN'T DOING TO HOT."

"Understatement of the Year," I mumble to myself, reaching for a pulse. Nothing at the wrist. A carotid is present, but so faint I can barely feel it. Fuck it, it's there, that's good enough for me. Fabio's pressure comes back as 70/30 and I immediately reach in the ALS kit for our EZ-IO and drill. I love this thing. Fluid is soon being pressure-infused as I take another look at the EKG. Her sinus rhythm suddenly gets squirrelly and I actually feel her pulse getting fainter as I recheck her carotid. She's going PEA. I've got the most likely cause being treated as well I can right now but the situation has some unique challenges. There's so much blood on the bed, but we can't do compressions on this mattress anyway.

We pull her off towards me, on the side of the bed, and a literal wave of blood accompaines her of the sheets, fanning out all over the floor and onto my pant knees. Fuck. Stupid. I should have backed up a little more. Nothing to do now but roll with it. Fabio starts CPR as I fire an epi down the IO. We've already got around 200mL of fluid in. Our backup arrives and I tell them to set up my intubation equipment. It's foolish to do all this, I think, her entire FUCKING VOLUME is spread out on the sheets, bed, and my pant knees. After slipping on a procedure shield I open the airway with the scope and am greeted by a wave of pale yellow mucus and emesis against what looks to be a waxwork replica of an landmarks and vocal cords. I suction and go in again, looking at the bottoms of the cords. The backup medic applies pressure and they drop.

I sink and secure, and hook up our ETCO2. The value is only 20, but at the very least confirms I'm in.

The whole neighborhood is outside, and I hear some curses about our response time. Fuck it. I did the best I could. We're not even really supposed to go to this area of town with a police escort.

We secure to a spinebord and push another epi. In the truck she briefly regains a pulse but looses it again. We can't find anywhere to stick an IV...it's all scar tissue and tiny pipes. We fire more epi in and even a bicarb.

It looked like all the blood she had was on the mattress, I tell the doc. The family told us prior to departure that she had a large aneurysm in her leg that was supposed to be operated on later in the week. They hang blood and put in a central line. They too get temporary returns of pulse and pressure, but it's to no avail. Nurses leave the code area an hour later, dripping with sweat.

I look at at our Alert and On Scene times. 8 minutes apart. She went from conscious and talking to completely vampire'd in 8 minutes.

I got blood on my shirt at some point during the run, and I toss it in the washing machine along with my pants. The detergent lifts all the blood as cold water pours in, washing it out to the sewer, and then to the sea.

-MM

- Wow

2011-04-18T05:16:00.007-05:00

Fabio and I are blazing to the scene, a gas station off of the main drag in our company's hometown. I've been working here for about a year, following my departure from Louisiana DOC. We're en route to an "Unknown", so that means when we get on scene, it's going to be something ranging from a stubbed toe to multiple shotgun homicide.

Ah, the life of a paramedic. At least I know my new haircut kicks ass.

There isn't a mutilated body upon our arrival on scene, just one man sitting in the driver's seat of his SUV. A drunk bystander comes up to us as we get out of the unit. "He wuz pumpin' gaz, and he drop da pump and walk back to hiz truck," he says. "When he dint get up for 20 minnits and wooden talk to us, I call 911."

"Thanks."

He stumbles off as I walk to the driver's side of the SUV. The man is older and slightly out of shape, but doesn't seem to be in any phyisical distress, until I see his eyes. They have a look of pure panic in them, and when I introduce myself and take his wrist I can feel his pulse pounding.

"Sir, my name's March, with XXXX Ambulance. Can you tell me what's wrong?"

The man swallows, and tries to respond, but all that comes out of his mouth is a salad of mismatched vowel sounds and hard consonants. He stops, swallows, and tries again, but experiences the same result.

"Don't try and speak sir. Can you squeeze my fingers? Tightly, like you're trying to crush them."

The left hands squeezes my fingers tightly, but the right barely manages to keep grip on my hand.

"Open your mouth wide and try to show me your teeth." The right side of his face seems frozen while the left is normal.

"Sir, I suspect you might be having a stroke. We're going to assist you out the vehicle." Fabio grabs the man's legs and I get underneath his upper body, and we carry him out to our stretcher and lay him down. We load him up quickly and I get his vitals as my partner secures his vehicle. He is slightly bradycardic, but his twelve lead and CBG are normal. We rush him to the hospital. Dr Mick does an assessment and sends the man to CT immediately.

The staff are a little shorthanded, so I go upstairs with the nurse, a lively lesbian whom I've become chatty with. As they are cranking through the CT, she notices my new haircut.

"Does your girlfriend dig you hair?" She asks.

"Nah. We broke up ages ago, El."

"...So you're not seeing anybody?"

Uh-oh, I think, I dont want to be some 35 year-old lesbian's one last reassurance she hates dicks.

"Nope."

She has a gleam in her eye. "Seriously, no one? No girlfriend-"

"Nope."

"-or Boyfr-"

"NO. GODDAMMIT. IS IT THE HAIRCUT?"

"No! No,' she says. She turns a deep shade of red.

"What?" I say.

"...are you interested in being a sperm donor?"

to be continued.

-MM

- Damn

2011-01-28T00:11:00.004-06:00

(This whiny, selfserving post deleted by the author. You guys don't need this bullshit)
-MM

- For those of you under a rock...

2010-12-30T15:18:00.001-06:00

....Confessions of an EMS Newbie, featuring my bloggy daddy Ambulance Driver, is a GREAT podcast that covers a rookie's journey through Basic and Paramedic Class. Check it out!

-MM

-Self Defense

2010-12-14T17:15:00.004-06:00

We have been called out to a domestic dispute between a father and his 16 year old daughter, where the daughter apparently made some sort of threatening gesture after an argument with her dad. The deputy meets us outside.

"He took away her cellphone after an argument. She got pissed and went home, and when he walked by in the hallway she shook a bottle of Aleve at him, and he freaked out and thought she had taken them. The bottle is still full."

"What an idiot. Jesus."

We go inside and get the story, the daughter still simmering with anger and crying. She raises her voice at the dad and yells at him a couple of times. The dad refuses to send her to the hospital, saying he would take care of the matter himself. The daughter's vitals check out and Dad signs the refusal, even after I explain that it may be in her best interests to get checked out at the ER. He still says no, and I get my supervisor involved, but the supe tell me to let it slide.

Everyone is out of the house now except for me, the daughter, and the dad. Apparently their screen door sticks if it closes wrong and is now locked in to place. The dad gives it a solid kick, but it stays stuck in its frame.

The daughter steps out of the hallway at this point, looking at her father. Her frustration is evident on her face, and tears are still drying on her cheeks. She walks into the kitchen, opens a drawer, and pulls out a large steak knife.

Then she starts walking towards me and her father with a determined look on her face.

Her father is still facing the door, preoccupied with getting it unstuck. A quick look around shows no other exits. The girl is still walking towards us. I think I could break through the frame of the screen door but I have to get through the father, who is maddeningly still hemming and hawing at the stuck door. The daughter still advances, feet whisper soft on the carpet, knife in hand, staring at her father's back.

7 feet. Definitely no way out now. My butt sucks up about half my underwear. She's big for 16, rivaling Serena Williams in musculature. She can probably get some serious torque on that stabbing arm.

4 feet. She's almost in range. I plant my feet shoulder with apart.

3 feet. Go.

I grab her knife-wielding arm as she walks by me, twisting at the wrist and squeezing, stepping into her with my hip and pinning her upper arm between my arm and chest. The knife pops out and, still holding the girl's arm, I trip her down onto the carpet, where she lands on her back with a confused look on her face. I kick away the knife behind me, towards the wall and near the dad

'WHAT ARE YOU DOING?" I yell directly into her face. A sheriff's deputy had been on the other side of the door and saw the whole thing, his pistol out and pointing over the dad's hunched form, trained on the daughter.

"It's for the door!" She yells.

The dad, incredibly, finally notices all the commotion, and turns around and stares at me and the daughter, who is sitting up and rubbing her wrist.

"Oh," he says. "Thanks, babydoll." He then picks up the steak knife and uses it as a wedge along the interior side of the screen door, which pops open deftly after he slides the blade down the length.

"That thing always sticks. Sorry, sir, thanks for the help this evening."

The deputy on the other side of the door is bent over laughing.

"No problem at all, sir," I say to him. "Have a good night."

-MM

- Numb

2010-12-01T17:22:00.005-06:00

The carnage is amazing for only having one vehicle involved. The car has flipped multiple times - that much is obvious, from the impact marks in the grass trail of car parts from the roadway. To top it off, the car, which was now skidding on it's driver's side, slid roof-first into a large, sturdy oak. The passenger compartment is like the inside rim of half a donut, with the trunk of the tree filling the donut hole.

The driver is sitting on the ground next to a cop car. He has a lac on his head but is awake and talking, so I downgrade him to "Can Wait a second" as I walk over the car. It's pretty rough.

"One inside," says the fire captain who is prepping his extrication gear. "He's hurt pretty bad."

"Breathing?" I ask.

"Yep. Twisted around in there pretty good though. We're going to take out the back window to see if we can slide him out."

"Sounds good."

I crouch down to the back window where a firefighter is reaching inside maintaining immobilization. This patient isn't going anywhere for the time being. A quick look in the back shows most of his body lying along the interior driver's side of the vehicle, along the roof. His right leg looks wrong, but I'm not sure why yet.

"Can you hear me, sir?" I ask the the young man. "Are you hurting anywhere?"

"No, not really. My nose kind of itches."

"Ok. Do you remember what happened?"

"Uh.....no?"

"OK man."

I walk back over to the driver and do a quick assessment. He has a small lac on his head. My partner, who has been prepping immobilization equipment, takes over. I walk back over to the smashed car as the extra unit pulls up.

The car is actually leaning against the tree it hit, allowing me access in through the rear driver side window. When I wedge my hefty frame inside, I am a mere foot away from the entrapped patient. There is plenty of blood on the roof from what looks like a lip laceration, but nothing else seems to be actively bleeding. I ask the patient his name. Now that I am inside, I can see that his right leg is covered by jacket, obscuring my view. I pull it aside and find out why it didn't look right.

The femur obviously has at least two fractures - it's bent in the shape of a "C". There is a large lac below that. And there is an ominous bulge in the front of the patient's loose gym shorts.

Fuck.

I grab the patient's hand.

"Hey, bud, can you squeeze my hand?"

There is no squeeze.

"Bud, squeeze my hand"

No squeeze.

"Tell me when you feel my pinch." I pinch his fingernail. Hard. Hard enough to make someone
pull away and yelp.

There is no reaction. He just stares up at ceiling. I take my pen from my hip pocket and drive it into his palm.

There is no reaction.

His eyes dart over to me. "When are you gonna pinch, man? Don't leave me in suspense."

Well, that's why his leg isn't hurting. He's paralyzed.

I do a couple of tests. He's numb from the navel down, and shoulders out.

It takes 35 minutes to extricate him. When we get him out he's starting to get shocky. The bulge I saw earlier is priaprism, an indicator of spinal injury in this case - I don't think the kid has had time to pop a Viagra with all the commotion. The chopper is fogged in, and our limpdick dispatcher is waffling about sending me some more back up. Our third and fourth trucks in the service area have both gotten emergencies on their way to the wreck scene, he says, and he can't spare anyone. It's going to be at least a 30 minute drive to a real hospital.

Tired of his jabber on the main radio, I pick up the 800, and lean forward into the cab, so the patient can't hear me. "Listen B, I don't care who you send me or where they come from. We can do an intercept. But I'm going to need someone soon, or I'm not going to need anyone at all."

I get my back up about 6 minutes later.

We manage to get some large IVs started, and hurry the kid to the hospital. He's starting to go in and out on me, and I have my intubation equipment set up, but a gentle verbal command perks him up and gets him breathing again.

We transfer care.

At home, in the shower, I wash broken glass out of my elbows, and try to wash the exhaustion off of everything else

-MM

- Medals

2010-09-23T23:06:00.003-05:00

I am not in the line of fire, although most shifts I encounter life-ending contagious diseases. I am not a hero, but most shifts I help save a life. I'm not a rich man, but I help enrich lives. I'm not a counselor, but I've comforted more grieving family members then some psychiatrists.

I'm not much. I'm two years of crunch medical training inside a delicate fleshbag that's as susceptible to the trauma of everyday life as anyone else.

I don't have a gun or handcuffs.

I don't have flame retardant clothing or a breathing apparatus.

All I have is a stethoscope, a bag of salt water enhanced with chemistry, and my own assessment skills to keep me ahead of the game and to help save your ass.

I don't wear my medals. I don't take them. I'm doing my job.

I am a medic.

And I am proud.

-MM

- Ventilated

2010-08-06T10:06:00.004-05:00

I step under the yellow police tape. The young man is lying there, bleeding, on a pile of towels the people who's threshold he had fallen across had grabbed from under a sink. The towel givers are all in the same room as him, but pressed up against the walls, present for the action and at the same time wanting to be as far away as possible. He is lying on his left side looking face to face with Snoopy. Woodstock, farther down the towel, is turning an ugly orange as blood seeps from the gunshot wound to the young man's chest.

He had tried to break into a home several blocks over from where we are standing (or laying, in his case). The old man in the house had already been robbed twice this month. As our hoodlum slid open a window the old man, sleeping on the floor, silently rose up. He fired at the shape as soon as a clear silhouette presented itself.

The .38 hits about two inches of the midclavicular line at the 3rd intracostal space. The young man sprints across two yards, jumping fences, before I imagine the fact that he had been shot made itself present to him. He crossed over another a fence and limped, then crawled to a door - I can see the drag marks and impressions in soft earth where he went to his knees. The residents opened the door, fetched their old and ragged washcloths.

He looks up at me feebly as I step over him, assessing the damage. The slug went all the way through, a slightly larger exit wound out of his scapula. His hands are cuffed behind his back. I give him the once over as I place a collar. He has no other injuries. As we load him up in the back, a large, bloody bubble pops from hole in his chest. In the good light I can now see the bullet has almost perfectly bulls eyed a large cross tattoo the young man has on his chest.

His pressure is 100/60, but his heart rate is relatively steady at 100 and he is breathing with only a slight extra amount of effort.. As my partner affixes an oxygen mask and opens the tank, I slap dressings on. We are only 6 minutes away from the hospital. His left lung sounds about a third full. This kid needs a chest tube. I quickly call the state response network and the hospital and sink a large bore IV. It's all I have time to do - we are only 16 minutes from going on scene to transfer to a trauma bed. The doctors remove my dressing, now soaked, and another large ruby bubble pops out of the hole on the chest.

They stick in the chest tube with barely any warning. A torrent of blood splaches onto the floor and the doctor steps away, cursing. In his haste to insert the tube he neglected to wear shoe covers. The young man yelps. Eventually they sedate him and in short order intubate and ship him up to surgery.

I walk out of the room and throw my bloody gloves in biohazard on my way out.

In the unit the young man, a boy really, weakly asked me:

"Am I gonna be OK?"

"Yes," I tell him. "Don't worry. You're going to be fine."

I read his obituary three days later.

-MM

- State Job

2010-04-16T01:25:00.002-05:00

Well, I've been a paramedic with Louisiana DOC for about 2 months now, and I am not impressed. Although I find the expanded medical practice extremely satisfying and rewarding. Jumping through all the bureaucratic hoops is starting to drive me nuts. Add in the 1.5 hour commute? Eccchhh....

Pros:
Extended practice
POST certification
free certs/recerts
I can tell someone "NO"

Cons:
Shitty pay
micromanagement
Spend a lot of time cooped up in the ER

New Hotness:

www.emssaudiarabia.com

I put in my application. Let's see what happens.

PS - everyone still alive? Drop me a comment, folks.

-MM

- Horizon

2010-03-13T22:43:00.003-06:00

I'm having a conversation with the Office Czar.

"No, I didn't check."

"No. I just said I didn't check."

"Because I was off duty."

"Well, I work 60 miles away from where I live."

"No."

"No."

"Seriously?"

"Fine."

I hang up. Ink raises his eyebrows. As I finish my run report the pagers go off again.

"Another fucking BLS transfer. You've got to be KIDDING me. I swear to God, Ink, I'm going to kill someone."

My unit, a 24 hour truck, is running BLS transfers while one unit sits in our base town. Now, from our base town, we cover a large rural area. One ambulance is not enough to cover it - if they get a call, the next closest unit is at the least 15 minutes away, and more likely 20-25 minutes away. And if they're responding to the eastern part of our area, which is bordered by the America's largest swamp, it's a 45 minute response time. That's a long time to wait when you're seriously sick.

To add to this, XXXX EMS has also been becoming more corpratized. When I started 5 years ago, the company was very employee oriented, really taking care of us. Since then the benefits have started to fade, and the company has in my opinion put profits ahead of patient care. Moral has dipped severely and not a lot of the EMTs and paramedics are very motivated. The call load has increased because they've cut units to save money. It's not unusual to run 10 or 12 calls in a 12 hour shift. The pay for a paramedic in my area is laughable - one parish over, they pay 7 dollars more an hour for the same job.

My personal job satisfaction has plummeted.

So when a friend mentioned that a state prison was hiring paramedics for its fledgling EMS program, I took them up on their offer.

Stay tuned...

- Walk Up

2010-03-04T18:56:00.003-06:00

Dispatch has trapped us in Major Metropolitan Area and has us, a Specialty MICU ambulance, running a routine BLS transfer.

As Ink is unloading the stretcher, a silver sedan pulls up. A guy gets out and asks us where the nearest walgreens is. I give him directions and he thanks us, then he asks us for a piece of gauze.

"Sure Man, no problem. You OK?"

"Oh, yeah man. I'm fine I just got shot."

Ink and I look at each other.

"What, with a gun?" I ask.

"Yeah."

"You mean, like, just now?"

"Yeah." He points to his leg, where there is a through-and-through wound just above his ankle, oozing blood.

"Oh. Dude. You need to go to the hospital."

"Well, it really doesn't hurt that much. Are you sure?"

"Yeah man, let me call it in. Ink, help him into the back and get me some vitals. I'm going to call it in."

The silver car's driver asks what hospital we're taking him to, and I tell them the nearest, only 4 blocks away.

I call dispatch over the radio. "Papa Lima 2 to dispatch."

"Papa Lima 2, go."

"Put us out at this location for a walk up patient with a 58G" which is our code for GSW.

Dispatch doesn't respond immediately, and when they do, it's in a questioning tone "Uh, did you advise a 58G?"

"Yes ma'am."

"Uh....standby." I climb in the back and begin in assessment. Remarkably, the wound isn't bad, there's no vascular compromise. The bullet doesn't seem to have hit anything important.

About two minutes later she comes back.

"Uh, Papa Lima 2, police, fire , and City EMS units enroute.Supervisor wants to know if the shooter is in the area."

Shit. I don't know. "Uh, I don't think so. Pt is completely stable, one gsw left lower extrimity, GCS 15"

"Copy that....uh....I'm still going to need you to handle that transfer, so transfer care to City EMS."

Shit. I thought this might have been our ticket out.

About thirty seconds later 4 police cars come screaming up, as well as a fire truck, City EMS supervisor, and City EMS ambulance.

I shrug at patient. "Sorry bro, didn't think it was gonna be such a big deal.

Two City paramedics bust ass with 30 pounds of equipment leaping into my unit ,BSI'd to the teeth. "What you got?"

"GSW to the leg, no other complaints. I got it bandaged and an IV in."

"Oh." They look crestfallen.

We transfer care.

As we drop off our BLS patient, Ink looks over at me. "That was weird."

"Yeah. Yeah, it was."

-MM

- Scalped

2010-01-19T05:41:00.006-06:00

I'm a city boy. I'll cop to it.

I work a rural area, however. This has its advantages - there's a slaughterhouse near our station that THE freshest meat I've ever had the privilege to eat. Ink pan-fried some burgers the other day and proofed them in the oven. I've never had a burger that satisfying. Ink and I sat, faces greasy, bloated on delicious cow flesh. AMAZING.

Disadvantages are present too. The area around our station is primarily agricultural - sugar cane fields. They just got done with the last harvest, leaving wide open plains with no wind-blocks. Sometimes the breeze feels like a low-grade hurricane. Plus, there's the dirt.

This isn't normal dirt, mind you. This is vitamin rich, well tilled, 100 percent pure-dee GROWING dirt. Which is great, if you're a farmer.

But if it's been raining for a week? All that dirt turns into the ickiest mud I've ever encountered. It's like cold, wet, napalm. It sticks to everything, it gets into equipment, and it tastes horrible.

And then someone runs their car into one of the ten foot ditches at the surround these mudflaps, and we have to rescue them.

The mud is most of the way up my boot ankles with each step. The patient slid off the road going about 60 and flipped into the ditch, up the other side, and then cartwheeled across the cane rows until coming to a rest on the driver's side. There's no chance we're getting the unit back here. We're either going to have to carry the patient out on the board or figure something else.

I've been working out in Backwater for quite some time and know the firefighters pretty well. They are clustered around to the left of the car, kneeling and standing adjacent to the roof. They wave me over. I shlosh to the front of the vehicle.

If you've never smelled it, large wounds have a smell all their own, which I call "The Gore Smell". I've never been able to smell it anywhere else. It's kind of flat, maybe a little coppery. I can smell it now even though I'm ten feet away. Once I reach the windshield, I pop a squat. Inside is an older man, maybe 50 or so, rotund, and bleeding, sitting on the drivers side window.

I introduce myself. "I'm March, with XXXX Ambulance. How are you feeling?"

His eyes flick up to me, and what he says next drops my internal temp by around 30 degrees.

"Man...I feel like I'm gonna die." His face is so pale, he looks like a black and white photo come to life. He coughs a clot up and spits it at the console, which is level with his head now that the car is on its side. I can see that he's missing three teeth on the bottom. The seat behind him is simply painted with dark crimson. The firefighter holding c-spine is pale. He looks pointedly at me and then down at the back of the guys head, then back at me. Message received. Big boo boo.

"Well, I'm gonna do my best so that you don't. We're going to get you out of here. Let me take a look at your head real quick." I lean over and look.

There's a chunk of flesh and hair the size of my hand on the back of the man's head, flapped over like an open book. I can clearly see skull. I gingerly reach over, and flap it back, and adjust the firefighter's thumbs to hold it in place. I wink at him, and step back.

"Sit tight. We're going to have cut you out of the car. I'll be right back. Someones right behind you, keeping your neck still as a precaution, OK?" I hate to leave the guy, but I need to get things rolling on the medical side.

I stand back up and start giving orders, politely but firmly, with my paramedic face on. My preceptor, Spiderman, once told me that as the paramedic, you need to be cool, even when you're scared shitless. If you stay cool, it helps everyone else stay cool, and things will for the most part run smoothly. Stay in control, but don't get bossy. Take care of your first responders and they take care of you.

"Genetleman, we need him out, ASAP. Maintain c-spine, O2 on him at 15, and keep him warm. If you please, can you send one of the fellows out to the Ag center to set up a night landing zone for the chopper." I get on the radio and request the chopper. They will arrive in 15 minutes.

At this point, an off duty deputy runs up to me through the mud. "March, my truck has 4 wheel drive. I can back it up over to the access road, and you can put the spine board on it."

I look at the mud on the ground. Even with 6 people carrying this is going to be incredibly rough terrain to get across.

"OK, sounds good." He scampers off to get in and pull around.

I go back to the front of the car with a c-collar from the bag I left near the car, and call for the KED. The man, however, has so little neck that not even the shortest setting on the collar will fit him. Fuck it, I think, I'll just do a really good tape job.

A blanket covers all of us as I assess more injuries and the firefighters take out the posts at the top of the roof. A ton of sensitivity on both ribs, and when he breaths, I feel a large section just below his nipple moving out of sync with the rest. I've never actually gotten to feel paradoxical motion. His lungs sounds are slightly diminished just underneath that area, as I expected. The right side is OK. In addition, his left shoulder is dislocated or fracture. I start to sweat a little bit but manage to keep my cool.

His BP (136/84) and pulse (104 and regular) are ok, but he's breathing around 24 times a minute and his room air sat is 90%. I put the oxygen back on. I here a wrenching of metal and the blanket is pulled off. The whole roof of the car has been pulled down from the side of the car, an eerie mirror of the man's head injury. They lay a board down, and we grab the handles on the KED, easing him over.

Quicker then quick we get him into the truck bed and drive out of the field. We load him in the unit and drive the short half a mile to the Ag center. I expose him completely but find no more injures. As the chopper's landing I attach a bulky dressing and make a little bastardized sling/swathe for his shoulder. His lung sounds aren't getting any worse, and his color has returned with the O2. As the flight medic pops the doors open, I'm the phone with the Trauma Hot-line, who gives me a destination. We get him loaded up.

I look down as I walk back to my unit. My boots and cuffs of my pants look like someone rubbed chocolate covered cherries over them - mud and congealed blood all over. Damn.

Ink does a great job getting everything cleaned up as I phone in a report to hospital - the Trauma Hot-line should've let them know, but I want to make sure the hospital knows he's coming.

It takes us over an hour to get the mud off of everything. My boots simply will not get clean. One of the firefighters, Slim, stops by and laughs at me. "Jesus, how long have you been out here, March? Don't you know how to clean cane mud off of something?"

He takes a bottle ofIvory out of his truck and sets to work. Within ten minutes my boots, although damp, are mudfree.

I take them back from him. "You know, you're not too bad for a fucking country bumpkin, Slim."

"Ahhhh...go fuck yourself. I'm gonna tell Mom not to sell you any more ground beef at the slaugherhouse." He walks off laughing.

"Slim, I was only joking. Slim? Buddy?"

Shit.

-MM

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

2009-11-17T10:19:00.003-06:00

...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

-Night Shift

2009-11-04T14:05:00.008-06:00

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

- Exits

2009-10-15T02:32:00.010-05:00

"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

- Just a Note

2009-10-06T02:01:00.003-05:00

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

- Boooo

2009-09-29T12:43:00.001-05:00

re: Trauma, your new show

Dear NBC,

Really?

Thank you,
MM

-MM

- Motivational poster

2009-09-26T17:28:00.001-05:00

hats off to AD for the concept

-MM

- Secrets

2009-09-23T22:14:00.004-05:00

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

- MedicMarch's Observations on EMS #66

2009-09-14T18:36:00.002-05:00

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

- Catcher's Mitt

2009-08-30T23:57:00.005-05:00

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

- Wash Your Mouth Out

2009-08-18T20:13:00.006-05:00

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

- Fucktard Comment Round-Up

2009-07-17T13:57:00.006-05:00

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

- MedicMarch and the Volcano

2009-07-09T13:45:00.006-05:00

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

- Range Report

2009-07-07T23:52:00.006-05:00

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

- Not Good Enough

2009-06-18T23:24:00.005-05:00

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

- Collisons

2009-05-28T03:38:00.003-05:00

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

- John Lennon

2009-05-06T20:52:00.003-05:00

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

- Izzy Tales

2009-03-16T15:34:00.003-05:00

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

- Close Calls

2009-03-06T15:37:00.002-06:00

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

- A bit of a detour...

2009-02-16T21:18:00.005-06:00

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

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

2009-02-12T18:49:00.004-06:00

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

-MM

- Lies

2009-02-07T14:38:00.005-06:00

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

- Holiday Times

2008-12-31T14:58:00.003-06:00

For some reason, everytime it's the holiday season, all I can think of is that great Monty Python Song and Dance Number.

Happy New Year, you guys.

- Updates

2008-12-26T10:15:00.004-06:00

All my best laid plans to screw with FNG are all screwed up because he turned out to be a sly and crafty learner, sparing him the brunt of my mindgames, but I got moved to the Critical Care unit at our station...

...leading to what has been a 6 week death spiral of every new employee we've hired. I don't mind teaching someone, but having to go through the same stuff every shift was wearing me thin...

...really thin. And even though I only have to see her for twenty minutes a week, tops, the urge to strangle Lazy Paramedic (formerly partner) is so intense my eyeballs bulge 6 or 7 centimeters from their sockets every time I see her. I also was turned down for a promotion...

...which kind of works out though, because I'm enrolling back into school to finish up my little punk-ass associates degree. If I nail straight As, I'll go premed, and if not, on to Nursing...

...and apparently The Higher Power has decided to award me for not going ape-shit on anyone because guess who's coming back to be my partner until she gets into medical school?

That's right. Izzy.

Merry X-mas to me! And Happy holidays to all you guys!

-MM

- 2x4

2008-12-18T14:49:00.007-06:00

There is a large crown of perhaps forty people clustered around the three cop cars and rescue truck. It is four AM, and we've been, well, we've been getting hammered. No, not hammered, where you wake up with a screaming brain next to some girl who's name you can't remember and oh God you're wearing her underwear again oh God oh God what is wrong with you.

No, we've been dick-scratches favorite nail this evening, and although I would like to try and look interested in this patient, I cannot.

"Why are you crying?"

"I (wuuuuuuuaaahhh) ba...ba...broke my nail! Wuuuah!"

I look at my partner, who looks like shit. He looks at me.

"Wow, yeah. I'll grab the trauma bag."

I turn back to the patient, and squat down to her level, and take a deep breath.

"Wow," she says, "that's a mighty big vein you've got throbbing in your forehead!"

"Yeah," I say. "It comes and goes. How'd you break your nail?"

"Sumdood was swinging a 2x4 around in the club."

"Oh." This, at least, is marginally interesting. I gamely try to engage my brain into full interrogative mode. "What...uh...where...where was this at?"

She points toward the RR tracks. There's a club, not too far away. "Over dere."

"Oh. Ok. You want to go to the hospital. You're hand could be fractured." It wasn't. It wasn't even close to being fractured. Nothing was wrong with her. But they don't let me tell that to people, so instead I lie. "If it's bothering you , you need to see the doctor."

"No, I'm fine."

Silently, I thank providence. Maybe I can get a whole 45 minutes of sleep before waking up to clean the station and wash the truck.

"Uh, March?" says one of the cops. "We've got another one here."

This patient is a young man who's been struck on the head with the 2x4. He has a minor lac, and also does not want to go to the hospital, even when I tell him that he could be seriously injured, slip into a coma, or die, if he does not want to go to the hospital.

"Fo' Real?"

"Yeah, man. Fo Real."

"Well I'm just gonna get my cousin to take me to BackWater Hospital."

I'm too tired to argue. He's awake, alert, oriented, and vitals check out. I'm too tired to argue (although somewhere in the back of my head, a little voice says I should never be to tired to argue.)

"Yeah, man, sumdood was going CRAZY with that shit. Swinging it around like he was fucking Sammy Sosa or shit."

"Sign here." Well, at least I can get thirty minutes of sleep.

A girl walks up, with pain in her shoulder.

"He caught me on the backswing, it don't hurt though."

Then why the fuck are you standing here?

I give her an icepack after assesing CPMS, and get another refusal.

The ink isn't dry before a Firefighter walks up, a young lady in tow.

"What happened?"

"Some guy were swinging, like, a stick! He hit a bottle, and it hit me! He were crazy! He was a meaniac!"

She has some minor lacs to the inside of her right leg. The only thing hurt here is my eyes - I mean, I'm no prize, but she is absurdly too large to be wearing shorts like this. If she would've worn some proper sized and fitted clothing, she would've escaped with no scratches.

I obtain the last refusal, and grab the PA of the ambulance and address the crowd.

"Attention, Attention. If anyone else has been struck by the 2x4 wielding psycho, please report to the back of my ambulance for treatment. "

Forty or fifty pairs of eyes turn and look at me like I'm crazy.

postscript: instead of sleeping for 7 minutes before having to get up again, I watch an infomercial for Shamwow!...that thing is awesome.

-MM

- Gang Bangin' (Holy shit!)

2008-11-28T20:02:00.005-06:00

We're paged out for a shooting at around 3 in the morning - not to say this wasn't expected.

There has already been a shooting tonight, and it seems that retaliatory gunfire has been mandatory. This time it's a little different, however - someone has loaded up a shotgun with slugs, and opened up on the supposed shooter's (from the first murder tonight) house.

Well, the shooter wasn't home, but his 61 year old mother was. There are at least three holes in the door and front wall of the house. I can actually see light coming through from inside. Shotgun shells are scattered allover the driveway, circled by little orange hoops of spray paint to mark them as evidence.

"It's kind of messy in there," says one of the cops. "I was like, 'Holy Shit!'"

I walk in and look at the scene on the floor in front of me. "Holy shit!" I whisper to myself.

Apparently when the shooting began, the first slug - the one that punched a hole through the door, also punched a hole through her, entering through the rear of her left calf, through what I can now see is an inch wide ragged hole. If the front of your foot was 0 degrees, and the read of your calf 180, the slug has entered at a 225 degree angle.

Traveling through the lady's calf, it burst out of the front right side of her shin and continued on though the home. The exit wound is about 4 by 5 inches, about as big of the top of my fist, and is bleeding venously. It looks like someone dumped red paint allover the floor, where it has started to clot already.

If this wasn't enough, the whole neighborhood is out to watch. They sound like a whole zoo, packed into a 100 yard area. The cops are running around everywhere, only a wink at crowd control, and We are forced to park about 50 yards back from where we should be due to improperly parked first responders.

And if that wasn't enough, my partner this evening? Why, it's old Cutsy, every one's favorite Goth wannabe. She's a real mess this evening, and I am entirely unsympathetic.

Hey, I'm kind of an asshole sometimes. I've worked pretty hard to try and help her out but it's like trying to get blood from a turnip. On the usefulness scale, she's falling somewhere in between A Monkey Fucking A Football and a Starfish.

At least If I got mad at a starfish and ripped it to shreds, it could regenerate.

Cutsy manages to drag her ass through the door. "Holy shit!" she yelps.

There are no pulses on the foot no matter how I manipulate it. I tell Cutsy to bandage it up. A ragged chunk of bone visible in the wound and NO WAY YOU CANNOT BE SERIOUS Cutsy is just starring at it as I'm trying to get this patient squared away.

"Cutsy!" Nothing.

"CUTSY!!!!"

She blinks her self awake. "Huh?"

You need to turn down your fucking Cradle of Filth, you superfluous waste of genetic Material. You're going to blow out the tiny little remnant of brains you barely manage to hold on to if you don't lower the volume, you vacuous fucking mouth-breathing hell-spawn sent here to make my life miserable.

That's what I want to say.

Instead I say "Bandage the Leg."

"How?"

I'll be honest, I wasn't expecting that one. She caught me flatfooted, and now here I am, staring across this old black lady who is bleeding allover the floor, trying to figure out what to say.

Finally I grab the bandage from her, wrap it, and secure it. "Like That," I say gruffly. "Go spike me some bags in the back, please." I look away from her and I can hear her start to cry as she walks outside. It bothers me for nearly a whole second before the anger boils back. How can she not know how to bandage something? She had to have seen that at least once or twice in Basic class. HAD TO. Had to pass it for national registry. All that shit should be fresh in her head.

That's how I used to know you were mad at me, Lazy Partner told me after we stopped working together. You get real polite, and you don't smile at all. That's how I used to know.

Well, I still hate Lazy Partner, and Cutsy is climbing higher on the list.

We transport the lady to the nearest hospital. I can't get a line in her at all - her veins are nonexistent, and if she passes out on me, I can drill her, but I'm betting that the ER might be able to succeed where I've failed.

"Holy shit!" Goes the ER Nurse, when I unwrap the wound. "Call the resident, now!"

"Holy shit!" goes the resident, when he sees the damage. "Call a Trauma alert, now!"

"Holy Shit! Look at the that! The Tibia and Fibula are completed shattered! You can see!" says the Trauma surgeon.

* * *

I walk out to the truck, and sit down next to Cutsy, who is not cleaning, just sitting there shell shocked. "Hey."

"What?"

"Look, I know you know how to bandage someone. You had to have done it at registry, at least."

"Well, yeah," she concedes meekly. "But I didn't want to hurt her."

"Huh?"

"Well, that was a big wound on her leg and she was already hurting. I didn't want to make it worse."

"Sometimes, that part of the fucking job, Cutsy. You need to get used to that. If it's ever just the two of us on scene, I need to know that I can count on you, hopefully as an independent EMT, but barring that, at least as someone who can follow my orders. The lady needed that leg bandaged immediately. You could see how much blood she had lost."

She starts crying again. I whip out a post it and write a phone number on it.

"Here's the number to CISM. Call them right now."

This is the extent to which I will help her.

* * *
So I show up at work the other day and who should I see as part of the off going crew?

Lazy Partner.

Only, now? She's Lazy Paramedic, here to do some ride time to clear as a paramedic in her own right.

It's going to be a long holiday season.

-MM

2008-11-25T14:26:00.004-06:00

Take that nature!

Real Posts coming, I swear.

-MM

- Hey Yall

2008-11-23T09:36:00.000-06:00

Coming up - pictures of our new property in Summit, Mississippi, and of me with a chainsaw!

Ladies, prepare your panties for disintegration!

-MM

- Headin' Up The Country

2008-11-15T09:18:00.003-06:00

Hey ya'll, blog is going to go silent this weekend - heading up north to do some camping!

See ya Monday!

PS - I Got Tagged - Rules:Pass it on to five other bloggers, and tell them to open the nearest book to page 56. Write out the fifth sentence on that page, and also the next two to five sentences. The CLOSEST BOOK, NOT YOUR FAVORITE, OR MOST INTELLECTUAL!

Yes, Satan?
"Unit Two, go ahead," Bobby awnsers, groaning.

Life, Death, and Everything In Between: A Paramedic's Memoirs, by AD. BUY IT!

Don't have to time to spam it on!

-MM

- Confessions of A Weird Guy

2008-11-10T16:11:00.003-06:00

I think I'm weird because I get a lot of pleasure out of these and I don't think other people do. Maybe I can get away with "Delightfully Eccentric" instead of "Full-Blown, Mouth-breathing Whacko":

1. Vacuuming - I like to vacuum the house. I don't know why. I like the way the rug looks after the vacuum runs it over. It may be the noise it makes. (others noises I like - the ambulance siren horn, the sound the phone makes when you call someone and it's ringing)

2. Driving with the window down - I'll even put on a jacket and knit cap in the winter just to drive with the window down. I like the breeze! I always get out with a smile on my big dumb face. I sleep with 2 fans going, even in the winter (yes, I have a CPAP too)

3. Folding My Clothes - I get a little excited when my laundry gets done because that means I get to fold everything! It all gets put away in its neat little box or hung up in the closet!

I know, weird, right?

-MM

- 007

2008-11-03T18:04:00.006-06:00

Well, it was bound to happen sometime. They've finally put a new person in Izzy's spot (insert sad MM face here). It was bound to happen sooner or later - we've gotten a large hire of EMT-Bs since a class just let out.

Our company has a clearing process that new employees have to attend - 3 weeks, roughly, although the first week is purely paper and book work. That leaves the rest of the time for 5 (or 4, if they really need you bad) orientation rides and a clear ride (unless the supervisor is busy) and then the employee is considered "Cleared" - ready to operate as a normal employee.

Yeah.

My new partner shall be referred to as FNG.

Actually, I'm not being fair - he wants to learn. Sure, we had to go to the gas station again last night (wait? There's TWO diesel tanks to fill up?), but hey.

I'm not really much of a teacher - I'll make sure they know how to do basic stuff, like spiking a bag or attaching the heart monitor, and then as things come up in the field I instruct as I go. To me it seems to work better then me telling them fifty things at the beginning of the shift, and then expecting them to just recall everything I said.

So I'm showing FNG how to assemble a prefill syringe and of course, our first call is a cardiac arrest.

Bulldog and Stanky, working the other unit, beat us to the scene, and the fire department and they are working the patient as we walk in. I grab a tube and tell FNG to start compressions.

"Hol up, " says Bulldog. "You don't need it."

I get a good look at the patient. Dead Right There.

"Ok, you want me to call it in?"

Stanky, Bulldog's partner, is doing his last clear ride for his paramedic. "No, no, I got it." He calls it in to dispatch.

FNG has his eyes glued to the body on the floor.

"Hey, FNG."

He does not move. I poke him. He looks up at me, looks a little sick.

"Hey. Good Job."

"Huh?"

"Put a notch in your stethoscope, buddy." Fire, Stanky and Bulldog are suppressing their giggles.

"Huh?"

"You got a kill on your first call. Strong work. Put a notch in your stethoscope." I hand him my pocket knife.

He just stares at it. I walk out of the room, whistling a jaunty tune.

This morning, when I told him he was but a pawn in my master plan, he laughed, but when I didn't, he stopped.

I'm going to have FUN with this one.

-MM

- Gol Damn

2008-10-29T22:30:00.003-05:00

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.

Bravo!

CHECK IT OUT AND BUY THAT SUCKA!

-MM

- Crossing The Line

2008-10-28T16:33:00.003-05:00

"March, you are way too inappropriate."

"Huh?"

"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!"

'THEY WERE LAUGHING BECAUSE THEY WERE IMAGINING MY SANDPAPER COOTER EXFOLIATING MY BOYFRIEND'S FACE INTO GOOP, AND IT'S ALL YOUR FAULT!!"

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!
FRND: AUUGGGHHHH LLALALALALALA NO NO NO

-MM

- MedicMarch's Baseball Mitt (Gustav: Aftermath)

2008-10-22T08:41:00.000-05:00

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.

-MM

- The Hot Seat

2008-10-14T14:54:00.005-05:00

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?

DetailMedic: 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) except...you.

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!

-MM

- He Doesn't Look Too Hot

2008-10-04T14:17:00.004-05:00

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.

Nope.

"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.

-MM

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

- Get Smart

2008-09-26T07:01:00.004-05:00

Ok, at the risk of starting a political firestorm from all 2 people who read this (Thanks, Chris and Bernice!) I wanted to tell you guys about something I saw on the news the other day - A representative, John LaBruzzo (R-Metarie), is toting an idea that would pay individuals below the poverty line 1,000 dollars to get sterilized. I don't usually get into politics on my blog (it's a personal matter) but I wanted to hear what you all had to say, especially people that work on the emergency side of the healthcare field.

Tentatively I'd say we need to include sterilization for males and females, and put a cap on the age (no reason to sterilize a 60 y/o woman). I know it's not just going to cost just the payout of 1,000 dollars (you have to pay the doctor, the hospital, etc) but I'm under the impression that vasectomies and tubal litigation's aren't that rough, so does anyone know the average cost for a sterilization procedure?

I believe this would save us taxpayers a lot of money in the long run. Am I wrong? Am I right? What do you think?

Also, please note the new poll off to the right - I'm going to go one a medical Mission for a month or two next year (through Institute For Field Research Expeditions) and am taking suggestions on destinations

-MM

- Compelete and Total Humiliation

2008-09-23T18:54:00.003-05:00

So whenever I got myself cleaned up last year something I started doing was running 2 miles every day. I actually dropped about 20 pounds over the course of 7 weeks. It felt pretty good but once I came back down and started back to work I slacked off - 10 hours a day, 5 days a week ambulance shifts wore me down pretty well. I had joined up with at a Snap Fitness before I moved to my new house 3 weeks ago and haven't made the time yet to rejoin somewhere yet - but when I was a member I did go - sometimes even at 3 in the morning, if you'll believe that.

I've was watching the Olympics during the triathlon - it looked rough, but I said - man, I could do that. I could DO THAT.

So As it happens they're having a triathlon at the end of October.

Coincidence?

That means I've got about 5 weeks to get in shape for a 400m Swim, a 9 mile bike ride, and a 3 mile run.

I'm pretty sure I can run it out of sheer tenacity and cussed-ness, but I still need to do a little prep work, otherwise I'm going to cramp out. So at the end of the week it's back into the gym. I've got great legs and used to be on the swim team, so I'm not going to sweat the swim much and put sometime in on the bike. I need to be able to run at least 4 miles on the treadmill before I enter so it's going to take some ass-busting.

I'm sitting with Izzy one day. "Oh, wow. A triathlon? I was training for one of those once."

"Really? How was it?

"Oh, March, it's not fun. I didn't smile once the whole time."

"Fuck. Thanks for those words of support."

-MM

- Gustav, II

2008-09-22T11:27:00.003-05:00

It's the day Gustav hit. I've gotten to the hospital with Nurse 1 and 2 and thrown on a pair of scrubs to help out - technically I'm an employee of the hospital as an ER Tech although I've never been placed on the schedule. There's water everywhere; part of the roof of the hospital blew out. A team of Evac paramedics from New York and Boston (never seen a guy wearing a Yankees cap and a guy wearing a Red Sox cap work together that well) evacuate the hospital so all that's left are ER staff, my self, and our two Backwater crews, the guys ahead of me on the shift. I hit the wall around midnight, and pass out in the back of the ER. They have the AC on the generator, and when I sleep it is dreamless.

I awake the next morning to relieve the crew from the night before after showering by flashlight in the staff lockers.

We pretty much get our asses hammered. That's what was expected though - I've got a bag full of beef jerky, and I'm ready to go. Later Bossman swings by.

"How Long? For the station?"

"Well, right now, 6 weeks. I'd say two months. The electronics are all fried, the furniture is a write off. The appliances are a write off. Roof is trashed."

He looks emotionally and physically drained. It's not until later that I learn his house had gotten torn up and he had been up for about 48 hours at headquarters, getting us temporary housing and grub lined up.

* * *

They just turned the power back on at our station (where we've erected temporary housing - we're Trailer Trash Paramedics!) yesterday. The infrastructure is pretty trashed but they're making a lot of progress. We ran off generator power for 3 weeks - I feel like a man when I do things like operate giant pieces of equipment and refuel them. Local ER still is open but since the evacuation they have not admitted a patient. Everything's been shipping out to SmokeStack City. We've been burning through a whole tank of diesel every shift, sometimes twice.

What I'd really like to see at the end of this is a bonus on our checks when FEMA shells out. A token of the Company's appreciation - I know it's impractical, but sometimes, you need something a little more tangible then a pat on the back and a "Get your Ass back in the cab, we've got more calls for you."

Hey, I can dream.

-MM

- Gustav, pt I

2008-09-17T17:38:00.007-05:00

There is shit everywhere on the floor. If I was a betting man, I would bet that in the end it's going to be cheaper to rip out the carpet and lay down some more than to try to shop-vac the poop out of here. I don't know much about home restoration but based on the glimpses I've seen on the Home and Garden channel these guys are BONED.

Then the smell hits, and WOW. Even those jackasses from Extreme Makeover: Home Edition might have to chalk this one up to the game. It almost becomes necessary to wade through it physically as we approach the bathroom in the back of the patient's little assisted living apartment.

Our patient is sitting down in his closet size shower, looking deflated (I mean, considering the amount of shit smeared around on the carpet out side, he'd almost have to be). He glares at us as an eel might glare at an invading fish. "we can't get him to get up or do anything. He says he just wants to lay there. We washed him and he just wouldn't get out of the shower." Well, at least he's not smeared in shit...anymore.

I'm working with Cutsy today, a new EMT with a myriad of self inflicted cuts to the insides of her arms. She did her first ride time with me. She does not handle criticism. Period. She can't even take coaching. We were in a Wendy's earlier that day and she just broke down and started crying when I was telling her about how I like to run my calls - I do patient interview, you get a manual BP, hook up the EKG, pulse ox, and tell me if the numbers are out of whack. I use a standardized approach. I had already taken care to use a gentle tone of voice, trying to make it obvious that she wasn't in trouble, I was just giving her some information to help, and GUSH - sobbing in the middle of Wendy's, standing between me and my bag of food on the counter.

I guess I could've been a little more supportive than throwing up my hands, stepping past her, and walking out of there with my cheeseburgers, but hey. Whatever.

I mean, Jesus. We were at Wendy's.

Taking hold of his shoulders (and sticking Cutsy on the business end - hey, Rank Hath Its Privilege) we throw him on the stretcher. I recognize the sudden bulge on his cheeks. "Fuck, he's gonna puke." I scuttle sideways and use a trick I picked up from one of the LifeFlight medics - I grab a biohaz bag from the back of the stretcher and make him a puke bib. He's starting to go out on me, I think, so we rush him to the hospital. My 12 lead is negative, but his heart rate drops into the 50's and I cannot believe this guy has anything left anywhere in his digestive system. I manage to push some fluid in and we drop him off.

I come back out to find Cutsy crying in the module. The module has not been cleaned. The stretcher is dirty. He face is in her hands.

"What? What is it?"

"I got puke in my hairrrr! Wwuhhhh! (I can't accurately reproduce her keening wail in text, so just imagine you fed a whale a bunch of helium and sped up it's bellow, and that's kind of what I was dealing with.)

I shake my head and walk to the cab.

* * *

The wind is really starting to pick up. We've just run our 4th evac transfer. They've put together a large evac shelter down in my part of Backwater, in a deserted store. I'm in the back, rerolling my EKG wires, when we get a page. "Wind speeds unsafe for operation". OK. Back Home we go.

We swing by the ER and I'm talking to a couple of the ER nurses. I tell them I'll probably end up crashing at the station, because I have to drive 20 miles home through Gustav just to come back to work the next day. "Well, shit, March, come stay with us at my house."

I raise my eyebrow. Both of these nurses are very attractive, recently divorced, well proportioned, and you know, they're ER nurses - kinky!

They must see the look on my face cause they start laughing. "Easy, March, I've got 3 bedrooms. We're not going to have to shack up."

"Oh, I know, but man, this is going to be so awesome for my blog."

* * *
Of course, dispatch doesn't care that we're not supposed to be running, and after my second argument with the dispatcher we find ourselves in the middle of a rainband, the unit getting tossed around pretty solid. But nothing bad happens, and I pack up at the end of my shift, and go home with ER Nurse 1 and ER Nurse 2.

The power goes out at house at 10 O'Clock in the morning. We can't sleep in the house so we're sitting together in the living room and I pick up a newspaper. There, on the coffee table, are not one but TWO of those "Love Positions" books (you know with the pictures, and diagrams? Yeah. Sexy!) and a book entitled "Tickle Your Kitty" - a guide for the ladies to, you know...yeah.

Jackpot.

I raise my eyebrows and hold up all three. Nurse 1 blushes heavily. "Look, I got those at a fun party."

"Fun Party? What the fuck is a fun party?" I believe I actually might have heard of this before, but I'm a dirty pervert, so I press for answers.

"It's like when a bunch of girls get together with wine and stuff -and one of them is a sales person and has like books, creams and oils, shit like that. Fake Wieners. Girl stuff. And she tells you about them, and shit."

"Holy shit. Basically it's like 8 drunk girls and a literal bag of dicks? This has AMAZING marketing potential."

"Uh-uh, hotshot. No boys allowed. And uh, actually, it was a giant Rubbermaid full of dildos, not a bag....uh, are you ok?"

"Sweet Jesus!" I say, tearing up a little. " A giant box of latex dongs, a barrel full of drunk girls, and a whole evening to test the wares...it's...it's BEAUTIFUL."

"Dude, March. You're freaking me out. "

* * *

We sweat our asses off for a little while longer and it's time for the Nurses to go back to work, so I put some scrubs on and tag along. Backwater is trashed. I did not think that there would be this much damage. Hundreds of feet of line are down, debris is everywhere. As we pull past the station I cannot believe my eyes. It's totally trashed - it looks like Godzilla put his foot through the roof. The carport is in the driveway. Inside it's a mess - rain water is everywhere. The station is totaled.

I shake my fist at the clouds. "Gustav, you motherfucker!"

-MM

- Patience is a virtue, and besides....

2008-09-16T14:55:00.003-05:00

....laziness is comfortable.

Blog Posts currently in my "Drafts" heading:

-Gustav, pt 1
-Gustav, pt 2
-Gustav - Aftermath
-Softball Face
-He Doesn't Look Too Hot
- The Tempest

I swear I'll come out with at least one by the end of today.

-MM

- Gustav, you Mother Fucker.

2008-09-02T13:07:00.002-05:00

I made it through the storm ok, everyone.

Unfortunetly, our station was not so lucky. Our whole carport came undone and smashed into the rest of the station....

...estimates are 3 weeks to 2 months for repairs.

Go back in tomorrow and get some more. This isn't over, not by a long shot. I'll post my hurricane story in a moment.

-MM

- Please Stand By

2008-08-30T11:09:00.005-05:00

Hey guys, going off the air for a moment while Hurricane Overtime chugs its way over here. Wish my ass luck! And to all my broskis down here, see you in the field!

-MM

EDIT - If you guys check out AD I'm sure you saw his VP Palin post. Anyway, check this out, from Vpilf.com

I mean, c'mon, was anybody really surprised that an old, ailing, white man picked some young foxy thing to stay at his big mansion? Really?

- A Love Song for Izz

2008-08-24T08:48:00.004-05:00

First off, a bit of blog maintainin'-cleared some deadwood from the links column that were no longer active or deleted (relax, AD, you're still number one, on my blog and in my heart).

I haven't really posted about my new partner, Izzy - afraid I'd jinx myself, and they'd stick me with some mouth-breather with no sense of humor or personal hygiene. All good things come to an end, however, and she's leaving me anyway, to go back to finish school.

It's been an unusual experience for me, not having to worry about WHAT THE FUCK ARE YOU DOING doing while I'm trying to provide patient care. I know that sounds pretty stuck-up and egotistical, maybe even para-godish, if you will-that I can't trust someone else to function without micromanaging them- but I've seemed to have been paired with a string of idiots who barely know their way around a stethoscope and apparently think that the best way to operate the ambulance is to hit every pothole on the way to the hospital. I thought maybe, after one particular string of stupid, that maybe my standards were too high or that I expected too much from someone barely making 10.00/hr. I consider myself a patient person, and after crappy partner #3 resolved I needed to take more of a coaching approach. Cause, maybe it is possible I'm overly hard to please.

Then I got Izzy.

I was worried initially, because she was BRAND NEW to the company and to EMS in general. I had formulated plans based on my past experience of what we were going to work on. Imagine my sup rise when she showed up on the first day on time and knocked out her inventory, and then came to me what we needed and we were missing. I know that sounds like, Hey March, the only reason you like it is because she's stroking your ego, but I mean, shit. Us not having a stair chair is shit that I need to know, son.

Let me Tell you:

She drives like magic - unless it's 4 AM and we've been getting our asses kicked, then she can be a little rough, but shit, so am I -

She does her inventory.

She learns from call to call and anticipates what I'm going to ask for. Or, when I give a string of orders, does them quickly and efficiently.

She bought me lunch a couple of times.

She has no fear or hesitation - if I ask her to stick her hand in something gross, or do something that involves nastiness, she ovaries up and fucking handles it. No pause, no bullshit. I know I can count on her to handle her bidness when the shit hits the fan.

She asks questions.

She has a sense of humor.

She's not afraid to call me on my shit.

She can actually lift (she's maybe 5'7 or '8 and weighs like 115? If that much? She's tough!).

She handles all the mundane shit most people don't think about when they get into EMS - station duties, washing the truck, etc - with the same enthusiasm of running an emergency call.

I think that last one says it all - that's the hurdle, I think, for a lot of new employees - when they realize it ain't all cardiac arrests and catching babies, that 90 percent of our call volume is routine bullshit. That we have to wash and clean and be maids in addition to being lifesavers and heartbreakers.

Yeah, it doesn't hurt that she can handle her beer like a pro, either.

But, like I said, all good things come to an end. So tomorrow when I show up to work, she will be reporting to class. As I'm tucking in a dialysis patient, she will be studying the microbiology of organisms. As I run a code she will be running from one class to the next. As I return from yet another BS call she will be doing homework.

So Izzy, my hat's off to you. It's been an incredible two months and I wish you luck in your future endeavors. You've restored my faith in new people to the company, and you've taught me a lot about myself. I'm going to miss you.

-MM

- The Intoxicated Avenger

2008-08-12T15:45:00.004-05:00

wThe sun shines down in Backwater Parish as Dirty D and I hop into the unit. Quick behind us are the other crew at our station - we've gotten two calls at the same place, which to me says that they're probably the same call, but hey, what do I know?

Sure enough, as we pull up to the Public Services building, I see a deputy wave to us, and then give the other truck a confused look. "Why they here?"

"We got two calls. Just one patient, right?"

"Ayuh." (This deputy is a transplant to Backwater Parish from one of the Great Lakes states) "Seems this young man in there had a bit too much too drink today....and, you know, every day this week before today. Seems he's making his inspection on the PS Building today and decided this would be a good place to take a nap. "

"Well, shit. Ight."

We drag our gear into the building, wear a ring of public servants are gathered around, eyeing our patient. It looks like FD has already spinaled him, and there he lies in all his glory, babbling obscenities. When I kneel down next to him, he tries to swing at me. Luckily he's neglected to remember his arm has been placed in between the top and bottom of the the spineboard strap , and actually end up losing control of his arm and punching himself on his chest. His arm then flops back down, and I make the mistake of getting within a three foot radius of his mouth. His breath is...tough. I mean, I've smelt some rough stuff in my time, but this guy could probably contract his halitosis to the Department of Defense. I can't imagine a prisoner at Guantanamo would be able to stand to more then 30 or 45 seconds of direct exposure before succumbing and telling us where Osama really is (oh man, just now I typed Obama instead of Osama. Wow. That could've raised some hell).

The answers all of my inquires with obscenities. He's about as drunk as I've seen someone be and still be conscious. I know long term alcoholics can usually tolerate pretty high Blood Alcohol levels, and I'm almost sure the will have a pool running after they draw labs at the ER.

We load him up. He's not going to like this IV much, and I ask Dirty to hold the patient's arm while I mess with it. I thread a 16 into the guy's hand (honestly, I could've started this IV with an Ink Pen if I had needed too - it always blows my mind that the hardworking mother-of-three, member-of-the-Ladies' Aux, productive member of society, who just got T-boned by some drunken jackass and can't hold a pressure, will have tiny, rolling veins, and that the other other driver who will be fine except for being drunk, will have pipes. Sometimes it's not fair) and do a quick blood draw. This is when it happens.

Apparently Dirty had undone the top strap when I asked him to hold the guys arm. Drunky realizes he's got mobility again, reaches across his body, and takes another swing at me. I see it coming out of the corner of my eye and manage to take it on my shoulder instead of my face. The cop reaches in and, pretty forcefully, drags the guys arm back down. Luckily I've managed to hold onto my IV, and finish taping it down. Time to go. I do not want to have fisticuffs with Drunky.

Dirty gets us to the hospital pretty fast, and after calling a report I try to get some information from the guy. He responds only with curses and petty vulgarities, which I will not sully my blog with (yeah, right.).

We wheel him into the ER and the Charge Nurse comes over to me. "What's his name?"

"Motherfucker."

"Heh, yeah, I know, right? No, really what's his name?"

"I'm serious, he told me his name is Motherfucker. Ask him."

"Sir, what's your name?"

The man eyes her speculatively, then back at me. He lets out a small belch.

"My name ish...motherfucker!"

Impressed by his own rapier like wit, he dissolves into cackles.

"Allright, I'll get the rest from you," Charge says. "Hmm. What's his DOB?"

"He said it was the 1st of Bitch, Nineteen-Sixty-Fuck-You. And before you ask, his social is Kill Whitey."

Charge nurse looks at him dubiously. "What's that smell?"

"A new weapon for the War on Terror. "

-MM

- Down Time

2008-07-26T02:16:00.008-05:00

OK, I know I bitch a lot, but one of the things I do like about EMS is that off-duty, we know how to have a good time. No where else really comes to mind when I try to think of where the amount of drinking I do is not only socially acceptable, it's encouraged! ( I guess it's actually not that good of thing, but shit, most of you guys are too drunk by this point to even remember that you originally logged on to check out porn and not my blog).

Going through rehab made me really take a look at the amount of alcohol I was consuming. But whilst I know I'm a drug addict, I really don't think I'm an alcoholic. Granted, those in the program (and all you bastard tee-totalers) might beg to differ, but I don't care, because by this point I'm too drunk to remember that I logged on to check out porn and not post a blog entry.

Look, there's some seriously rowdy language in here, so if you don't like that kind of thing, it's a good idea to go somewhere else.

So without further ado, I give you:

Down Time.

AC/DC is cranked, and the window on J-Lo's truck is rolled down halfway, pushing a fresh breeze into my face. We are rolling into New Orleans on 10, the sun is out, and a plane is taking off from the airport. Our hotel room is going to be right off Bourbon Street. He gives me a big ole smile. "This isn't going to end well," he says. "I know it."

Arrival and check-in is arduous. I realize our hotel is very highend - luckily it's J-Lo's sister's B-Day, and his mom is picking up the tab for the hotel rooms. I step out onto our balcony. Intelligently, J-Lo's mom had saved a bunch of the nicer beads from Mardi Gras. It is getting to be 5 o'clock, and as J-Lo and I crack our beers and toast. I watch as a nice looking young woman jiggles down the street and disappears into the cabaret across from us. Inspiration strikes me.

"Hey J, let's play a game."

"What? What game? We're drinking, I don't have time for this."

"No, c'mon, you'll dig it."

"Fuck. What is it, March?"

"We're going to have an exciting round of....'Walking, or Working.'"

"You're not nice."

"C'mon."

"I'm not going to degrade women like that, March. You're a chauvinist ass."

"Oh, when did you trade your testicles in for that purse? C'mon. C'MONNNNNNNNNN. Do it!"

"I hate you."

A moment passes by. Then J-Lo points to one. "Working."

The lady is decked out in skintight leather pants, a corset, heels, and a yellow boa. She disappears into the door of the cabaret next to the other cabaret. "Drink!"

I glug at my beer. "Oh, like that was a hard one, you jackass."

"Fine," he says, eyeing another woman speculatively. She's a cute redhead (Rrrrow! Me likey redheads!), but is conservatively attired in shorts and a blouse. "Working."

"What, her? No way. No wayyyyyyyyy."

"Working, I'm telling you."

"Dude, no. The one in the leather? Totally. There's no way this one is. Walking."

The girl enters the door to the first cabaret.

"No way."

"Drink!"

"No! This is a setup!"

J-Lo is suddenly enraged. "Drink, you dirty fucker! Do it! You, sir, are a bastard and a limp-dicked tittyfucker if you do not drink right now!"

I wither under his outburst. "Granted, you miserable pile of festering dogshit, I am actually a bastard, but I'll be DAMNED if I'm a tittyfucker. I concede, sir, and drink." I tilt back my beer, and empty it.

And with that, we finish our first beers. This is not going to end well.

We are down a 6 pack an hour later as we head downstairs and pass a group of formally attired older ladies. They are clustered together with champagne glasses. It looks like an advertisement for how much fun you can still have if you take Medication X to jack with your hormones because you don't get your monthly cycle anymore. "Working!" I yell in their direction as we walk out. They look less than amused.

We meet up with Chris and Kay, J-Lo's cousin and fiancee, and start out at a Fahy's, an Irish pub. The beer selection is incredible and the prices are awesome. The barmaid has truly righteous cleavage displayed, and a dog is chilling near the door. It is good times. We down several adult beverages and laugh and joke.

We walk down to Bourbon. Even though the sun is set, it only cools off about 2 degrees. Welcome to New Orleans.

We sneak into a bar advertising 3-for-1. There is karaoke going on and we watch as people make asses of themselves. We all vow we will not get on stage and make asses of ourselves.

Two hours later, after several shots and beers, the karaoke announcer, who I now am making wedding plans with in my head, calls for the three hottest girls in the club to come and shake their stuff. Two run up immediately, one of them running into Kay and spilling her beer. They jiggle up onto stage.

Kay looks down at her spilled beer, and back up at the stage. I think, maybe, at this point, if we has said "Fuck it", paid our tab and gone home to bed, we would've been OK. But hell, that wouldn't have been any fun. J-Lo, Chris, and I are pretty good. I don't claim to be a power drinker, but I am a stamina drinker, and the speed at which we've been putting them back has left feeling an inch past buzzed. I am determined not to give in, because Chris has just the teeniest slur, and Jeff is having slight balance problems. Not bad enough for drunk yet.

Kay, on the other hand, has been keeping pace with us, despite the fact that we all outweigh her by at least 90 pounds. Kay's good, but over the past twenty minutes, she's been declining. And she suddenly realizes that she is not going to take having her beer spilt by some clap-infested two bit skank. I know that because those were her last words as she pounded up the stairs to the stage. And now we are caught in the grasp of the black hole, and are heading irrecoverably towards the Event Horizon.

Dance off! Yells the karaoke goddess.

The first girl begins her dance, and is quickly obvious she's done this before, probably for money. J-Lo and I look at each other and immediately yell "WORKING!" as she struts her stuff. Being on the front row, I get a healthy view of her business. Purely from a medical standpoint, I'm just going to say, she was in danger of catching a cold. She finishes up, and the second dancer begins. I think she works at the same place as her friend, and apparently they follow the same fashion advice when it comes to panty wearing. I am happy to report, however, that the carpet did indeed match the drapes.

Kay has watched these two dance, and now it is her turn. She mouths "Silly bitches. Move!" and takes the stage.

I'm not really sure what happened next, but suffice to say that when Kay is drunk she has the ability to channel the top 5 erotic dancers in history, all at the same time.

When she gets done, they line the three girls up side by side. The applause for the first two girls is loud, but when they get to Kay, the house goes RABID. She is the clear and obvious winner. She steps down from the stage, grabs Chris' beer, and takes a fierce swig. Chris is goggling at her with raised eyebrows and a surprised expression on his face.

"What?!" yells Kay. "Bitch spilt muh beer! What was I sposed ta do?"

Awesome.

Well, almost awesome, because next, the Karaoke Hostess yells, "Guys, your turn!"

I'm having a good time until I realize that J-Lo, Chris, and Kay are all looking at me expectantly.

I stare back at them. "No."

"Yes!" They all say.

"No, no no. No."

"YES!" They say more forcibly.

As we have established, I'm not the most...attractive male specimen in the human race. While God didn't see fit to bless me with looks, smarts, or charm, he did not skimp when it came to the body hair, and my belly is the victim of an ongoing romance with cheezeburgers.

But goddamit, this is America. I swig my drink one last time, step up on stage, and eye the jacked, muscular competition. #1, who I will refer to as Bronx Bombshell, introduces himself, saying he is from New York. #2, Tall and Tanned, introduces himself as "Professor Love" and I have to change his name to Tall, Tanned, and Australian, because his accent makes the girls scream. #3, I will refer to as Kenmore on account of his washboard abs, states he is from Cali. And then, when Karaoke Goddess, love of my life, gets to me, her eyebrows knit in confusion. I do not belong up here. Maybe I'm the butler for one of these other guys or something, or maybe some poor disfigured sot who is Making his Wish that he come to Bourbon Street and see Larry Flint's Hustler Club before he dies of Terminal Ugly.

Regardless, when I don't step off the stage, she gently thrusts the microphone my way and manages not to vomit upon looking at my face. "Uh, I'm March, from Louisiana. Woo!"

There is scattered applause, and more laughter. The format is different for the Men. We will all dance simultaneously. The music begins, and suddenly, I am motivated. I dance like I never have danced before. I get a Lucky break when Bronx topples over a railing, but TT and A and Kenmore are dazzling the ladies with their flat stomachs, and I am flagging behind in the competition, fading into obscurity.

Unbeknowst to them, I too, can dazzle with my stomach. I tromp to the center of the stage, and lift my shirt. There are gasps of horror as everyone views my hairy and pale fish belly.

Until I bust out my secret weapon. In front of everyone at the bar, America, and God, I use my go to move - The Truffle Shuffle. I nearly black out, I Truffle Shuffle so hard.

When I come to again, it is voting time. Tall, Tanned, and Australian gets moderate cheering. Kenmore gets more rowdiness and catcalls. But when it comes to March?

The house comes down when the Hostess points to me. There is cheering everywhere. The Hostess gives me light peck on the cheek and whispers "Good job. Please, get the hell off the stage!" seductively into my ear.

I walk off the stage, victorious, and sip my beer.

A girl walks up to me. "That was hottt. Where ya'll from?" Her accent is so thick that I'm pretty sure I get a complimentary 3-pak of Skoal just for listening to it.

"Louisiana, hot stuff. What say you and me get a drank?"

She complies.

I could go on from here, and tell you about me getting kicked out of the Hustler Club (don't ask the strippers if they take rolls of coins) or ditching Miss Assippi (peein' your pants doesn't do much for the hotness, ladies), but instead I'm content to let the story fade into obscurity here, my steam successfully blown off and in the company of good friends. All in all, a good night, well played.

Oh yeah, when we got back to the hotel room balcony and started tossing beads, I got to see BOOBIES!!!!!!!!!!!

-MM

- Douchebag ho!

2008-07-09T17:03:00.005-05:00

Let me preface this with the following - 95% of the RTs I know are about awesome at thier jobs. A lot of time I'd rather have a solid RT at my back as opposed to some of the ER Docs I've seen...understand, this RT I discuss is NOT one of you.

It's another day in Backwater Parish and I am cleaning my pocket knife. Just as I dab a tiny bit of oil onto it the phone rings. It is Terminally Anxious Dispatcher.

"You're not going to like me," she says. Fuck. This is going to be retarded.

"We got a call at MRSA Manor for a breathing problem...looks like it's in the vent wing."

"They're already at the gold standard of care for the patient!"

"I know, I know. I told you you weren't going to like me."

We make the drive over as we get notes. I tilt the MDT toward myself, and sigh in disgust at the display:

-PT HAVING AGONAL RESP ON VENT-

Wow. Sure, the patient may be having breaths in-between the mechanical respiration, but hell, you just turn the fucking knob to SIMV instead of A/C, right? Problem solved. We get called out to the vent farm at MRSA Manor pretty often. I'm not sure if being incompetent is a prerequisite for getting hired, but I'm almost positive that at some point Satan is involved.

We bring all our gear in and walk to the back. We are stopped by the RT at the patent's door. The RT's at MRSA manor are usually at least baseline competent...except for this one. She's infamous in Backwater Parish, but I've yet to tangle with her.

"She gon need a treatment and they cleaning her," she yelps in a shrill, annoying tome. My ear bleeds a little. "She messed herself!"

She takes a closer look at our stretcher. "Where ya'll vent at? The patient gotta go out on a vent!"

We have this problem at MRSA Manor a lot. They don't understand that taking the time to set up our vent, connect the patient to it, let the patient have the recommended time to get adjusted, transfer them over to our stretcher and then take them the short distance to the hospital takes about 10 to 15 minutes minutes longer than it does for me to hook my BVM to oxygen and ETC02 and leave. By the time I get done setting it all up the patient would already be in the ER, on the other vent.

"We're going to bag her."

She blinks, then repeats, in EXACTLY the same tone and rhythm as before, "The patient gotta go out on a vent!"

A headache is beginning to crystallize. "No, she doesn't. We're going to bag her. It's a lot faster. If she's sick, it's the best way to get out quick."

She does not flinch, but rather leads us into the room. There is water all over the floor from a leaky air conditioner, and two tired looking CNAs are eyeing the RT dubiously. She points to the patient.

"See, she's on a vent. The patient gotta go-."

"I know she's on a vent. I see the vent. The big, loud vent, that is beeping."

"It always beep!"

The RT leaves. I get vitals. The patient is satting ok, but the lungs sound like someone just dumped a few gallons of Steen's Syrup (shit, I guess that would be Ms. Butterworth or something, for all you Yankees) into the trach just before we got there. The patient sats are in the upper 80's.

My partner finishes making preparations as I review the paperwork and call the hospital to tell them to get ready. Apparently, at some point, the RT comes back in to give the patient her breathing treatment, because when I look up again the patient's pulse ox reads less than 50. Silent terror makes her eyes bug as her lips begin to turn ever so slightly blueish...my partner doesn't even talk, just hands me the BVM she has just connected the ETCO2 to. I cinch it down onto the trach and bag.

The ETCO2 reads 79.

The RT looks up. "What you doin'!? I'm about to give them a treatment!"

"YOU FORGOT TO GET SOMEONE TO WATCH THE PATIENT!" I say back. "LOOK AT HER SATS!"

My monitor is still reading a sat of fifty-ish. The RT goggles at me, then at the monitor, then back at me. She opens her mouth, and the biggest chunk of stupid I've heard so far this day clunks out into our world: "Your machine WRONG."

To my credit, I do not hand over the bagging to my partner and cudgel the RT to death with the oxygen tank. I just give her enough rope to hang herself.

"Hook her up to your machine."

"You machine is wr-!"

"HOOK HER UP TO YOURS."

She stares at me sullenly, and grabs her portable sp02 out of her labcoat, putting it on the patient.

It does not even pick up.

"Let's go." I began to wheel out of the room, and brush past the RT, who stands there glaring at us. With some good ventilations from the BVM her sats rise instantly and the CO2 drops to a lower level of 58...not the best, but good enough for now.

5 minutes later I am at the hospital, and the patient is on their vent.

Keepbreathing, where the hell are you when I need you?

-MM

PS - I know I've all this serious bullshit up here lately, so I promise my next post will be the tale of my misadventures out in New Orleans last weekend. Ok? Is that ok? OK.

- Arrest

2008-06-28T12:39:00.003-05:00

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

- Rebel Without a Clue

2008-06-22T12:15:00.010-05:00

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

- Occupied

2008-06-15T22:22:00.003-05:00

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

- A little pimpage

2008-05-31T18:50:00.002-05:00

I don't do this sort of thing often but just wanted to pimp out my roommates' band STEWART STREET. Go by the myspace spot and give 'em a listen. They even wrote up a song about the struggles of Ole MedicMarch - it's called Better Now. Give em a listen!

-MM

- Attitude

2008-05-29T23:07:00.005-05:00

I had had a cough for the most of the week, and while lifting a patient into the unit, I started coughing again. I felt something pull pretty good in my upper back, on the right side, and when the pain didn't go away immediately; I called the Supervisor and told him I needed to be replaced.

They sent me home, and I went to the doctor's office where I peed in a cup and was told I had a thoracic strain - no heavy duty lifting for a week, heavy being anything more than 10 pounds. I advised everyone up the chain about my restrictions. "Well," they said, "maybe we can find something here for you to do that's light duty." They haven't let me know anything yet, despite my repeated attempts to contact them, so today I stayed home. I've also come down with some sort of intestinal virus, which has been not fun so far.

Earlier in the week, I was relieved to receive a phone call from the office. Maybe they had come up with something for me to do! I stepped into the main office to find one of the Veeps sitting there. He is a small man, and he has a moustache the twitched like mouse whiskers. I have trouble lifting my eyes from them to meet his gaze.

"Hey, MM. How are you doing? I heard you got hurt. Tell me what happened."

I give him the rundown. He steeples his fingers and appears to listen, and his mouse-stache twitches only once or twice when one of the other medics walks by with some Burger King. But when I finish, he looks up at me.

"Oh, ok. Well, I just wanted to make sure of what happened. You're going to be out for a week?"

"Light duty, for a week," I nod. The whiskers twitch.

"OK. So, if you start feeling better, I need you to head down to the clinic. Tell them about the workers comp case and let them know what's going on with you, that you're feeling better, and they should release you to come back. That way we can get you back in."

I get the sinking feeling he did not listen, really, to anything I said, except for the part where I'm out for a week. But then I realize what really happened - he's trying to find out if there was something I screwed up on, that they could pin on me. Paranoia? Probably, but this would be more par for the course for someone from upper management deigning to grace me with their presence.

He looks at me, smiles an empty, watery smile, shakes my hand. I can look through his eyes and see the gears spinning in his head. Then his whiskers twitch again, his eyes light up, and he walks into the next room. A few seconds later, someone walks in carrying a big cake.

He left me sitting there. Maybe it's do to my recent low morale, as evidenced by my last post, but I felt more than ever like I was just a number to this company. Profit X will be affected by MedicMarch not being able to come in, so let's fix that problem.Well ya know what? Profit X will also be affected by MedicMarch if he permanently injures himself and has to go on permanent light duty. Asking me to come in early from a back injury is short sighted - yeah, I may be back on my truck again for a couple of weeks, but if I get hurt, you'll have to fill the spot again.

This injury was preventable as well. We were in someone else's unit, not ours, because they do not have enough spare units to cover when one of the contract units breaks down in an outlying area. The truck we were in was broken down too (but not enough to render it unusable, apparently) in that the air ride would not drop. This is not that big of a deal but lifting that extra bit of height contributed to me hurting myself. Also, my truck, even though it is a full time truck, does not have a power stretcher, even though the area I work in makes 1/3 of the division’s profits, the largest by any area in my division. The next closest area makes 28-30 percent. They have several spare units in their area, and all units are equipped with brand new power stretchers. They also all have new ALS bags that sit better on you shoulders and don't pull you to one side. Most of the units are widebodies with extra room in the back, and with new modules with decent lighting.

They told us this year we didn't do so well with our corporate stock, that we only had a 2 percent increase. I tell you, I would much prefer to have new equipment on the truck and only have a 1 or .5 percent increase. I don't see much of the stock money at the end of the day. I don't really have much motivation to keep lining the pockets of the corporate higher ups when we get smashed into the ground every day.

And I know they didn't use to have power stretchers in the old days. They used to have more back injuries, though. It bothers me that we have a soloution now to a problem but it's not getting used. It's like having someone in V-Tach but not shocking them! I'm too young to pop a handful of Ibuprofen every day just to make it through. More and more it looks like I'm going to jump the career tracks. I can't slave away for the next 40 years on a unit, and I'm not selling my soul to go into a support department or dispatch.

I guess that toasty smell is all the burnout inside.

This place is turning into Office Space for me - I have 8 bosses: four field supervisors, a station supervisor, a paperwork supervisor, an operations supervisor, and my Mouse Boss veep. And 6 of them (the original field supervisor I reported the incident to and my station supervisor) have called me to find out if I was "feeling better". I think the only reason the other two haven't called yet is because they haven't been exposed to the dark side of the force yet - neither of them have been in supervisory roles for more than 6 months. I've got TPS reports, too - the company paperwork scores I mentioned in my last post. Guess who calls me when something is out of whack - all of them.

And I guess what I would've liked to have heard from the Mouse Boss was something more like this:"Hey MM, look, man, sorry you got hurt. Let's talk about what happened and see if there's room for us to change the way we do things to make it safer. Tell us if we can help you with something. Also, if you feel like you can handle it, go ahead and get checked out by the doctor again, and if it's ok with them AND you, we can get you back on a unit. "

One thing I want to point out is where I want him to say "to make it safer." It seems to me like most of the changes we get have a motivating focus of "to make more money". The way he asked me the first time had the air of trying to find out if I had been negligent. It felt like I was getting blame pinned on me. Now granted, this is just my perception, but dammit, that's what it feels like.

Way back when - when I was just March, not MedicMarch, I was discussing going into the EMT class at the local college with a paramedic who worked for the company. She was a friend of my mom's and we were out at the lake, rasising hell, drinking. We had a small dip in the conversation and she said "Yeah, you got to watch for the Company, though. They chewed me up, spit me out. It started off good, but in the end, I was just Meat in the Seat." This lady didn't know who I was, where I was from, where I was going to school at, or anything. She told me that, unsolicited, after I stated that I might deicide to go to Basic school.

Not that everything is all bad. One shining point this week was AD contacting me by company email to inform me that he had been assimilated into the hive min...Uh, I mean, hired for my company. Welcome to the Club, Big Guy! Your purple robes are here, and if you give me your shoe size, I can get you some white Nikes. And tell me something else - how do you feel about kool-aid?

Sigh.

-MM

-The Interesting Art of Career Suicide

2008-05-18T16:15:00.007-05:00

This post was not the original I planned on posting. I was going to comment on my somewhat childish penchant for what I refer to as "Le Sabotages" in my head. Lately this has consisted of me, while at a red light, stealthily opening the window the back of the ambulance, turning the fans in front on 'high', and passing all the gas I can muster before the light turns green. I then stealthily close the window, and then put on my concerned, good partner face when Red tells me she can't figure out why all of her patients smell like they're coming back from the 24 Hour All Bean Buffet.

That's what I was going to post on.

But instead Ambulance Driver's column at EMS1.com caught me eye and got the old gears turning. I want you guys to head over there can read the damn thing. Don't just skim it. I'll wait.

While I can't comment (except some light snark) on Le Drama ala Fire and EMS, I can comment on something I have had some experience with - his mention of for profit ambulance service, like AMR and Rural Metro.

Have you ever heard the saying "The Road to Hell is Paved with Good Intentions?"

Yeah, I know after that it's hard for me to convince you I can look at this at an objective point of view, and maybe I can't, but god dammit, I'm making the effort. It's really not that bad working for one of these companies, as long as I keep my thoughts locked in a box all day.

Companies like this, I feel, mostly started out as concerned efforts by community minded citizens that were concerned with their neighbors as much as they were with profit. But once they got their services up and running, the Companies, like any good capitalists should, began to look for ways to improve profit. My company is very fond of mentioning to us that if each unit got one less refusal per week, it would make a one or two million dollar impact in our bottom line. This money, they are then very quick to remind me, would then be available for things that us day laborers might like - raises, new equipment, and things of that ilk.

Well, one might say, that makes 'cents' (oh, MM, you so punny!). Why not motivate your workers to that end? It seems like a win win for everyone.

The thing is, I don't get refusals for funsies. I get them when I and the patient agree that said patient doesn't need to go to the hospital in the ambulance.

"Well, we understand that," says Company. "But how can you be sure that something isn't wrong with that patient, and the doctors could find it if you took the patient to a Hospital? (Hospital is always said with a near mythical quality- to get the same ring at home, I recommend you repeating 'hospital' to yourself in a reverent and hushed tone while making jazz hands). Besides, MM, you're not a doctor, LOLZ!"

That is correct companies, I am not a doctor. Very astute observation....although....Dr Medic March does have a wonderful lilt to it.

No, I am not a doctor. I am a medic. But I am a medic that you have trained to be able to assess for injuries and to look for the whole picture of this patient's emergency. I do not think this patient needs to go to the hospital. The patient agrees and is willing to sign away any right to legal recourse.

"But MM, our company survives on its profits LOLZ!"

And there is my sticking point. The line about finding something wrong with the patient I might have missed is just cover for that.

Somewhere along the line, patients became only cosmetic - all it seems we care about, sometimes, is that 3 inch by 8 inch flap of leather in the patient's back pocket.

My company introduced a way to track us though stats, telling us it would help develop us as medics and give us feedback about our performance-funny thing is, the categories are things like how many refusals we get, how often we make billing mistakes. There are about nine different categories and only one of them has anything to do with actual patient care - our time on scene with extremely sick/injured patients. The rest, variously, all have to do with how fast our reports get processed and whether we have collected insurance information.

If this was the end of the line, fine. But now, during raise time, the numbers come back out, and low and behold, some people didn't get a raise they deserved because of an arbitrary set of numbers a bean counter out back who's never had ANY Field experience decides we can squeeze a bit more money out of the system.

I wish, I wish, I wish, I could make my company put patient care and their medics in front of the profits.

Remember earlier, when they said the money we would make could be used for raises? In the two years of having this system, the only raise we've gotten was on to bring us to the minimums of industry standards and to comply with federal minimum wage law.

Oh, and the reason I've titled this entry "The Interesting Art of Career Suicide"? The employees at my company are not allowed to have any sort of online profile, blog, or entry that says anything about the company.

Basically, if they trace this back to me, I'm a done tom turkey.

But to me, it's worth saying and getting out, and letting the consequences fall where they may. I'm not going to compromise myself anymore for something I shouldn't have to compromise myself about in the first place.

I'll expand on this latter. I'd love to hear what you guys have to say.

Deuces.
-MM

- Second Verse, Same at The First

2008-04-29T20:13:00.002-05:00

I wasn't going to post about it. I swore up and down I wouldn't, that I wouldn't drag y'all down with me into this murky, rotten abyss. But as they say, misery loves company. I need to vent.

Since coming back to work and getting assigned to my new truck I've been assigned to the partner FROM HELL. She makes Lazy Partner look like Basic of the Year.

I'm not sure how often she bathes, but it is not often.

I'm not sure how much deodorant she uses, but it is not much.

I do not believe she washes her uniforms more than once a week - ie, Monday's Pot Roast stain will still be there on Thursday.

She apologizes when I coach her - at first I thought it might've been my tone or my delivery, but it wasn't. She just cringes like a beaten puppy.

She's handsy - she reached to get my pager one time, and the hand lingered on my crotch. I told her never to do it again, and to her (dubious) credit she has not.

But the worst part is her face - the bovine, mouth breathing look on her face, as she watches me lecture again about not running red lights while going code - twice she has nearly killed me. The vacant gaze as I remove the empty oxygen container and remind her the importance of changing it out when it gets low. The mind numbing, brain dead zombie stare, follow by the reflexive "IT'S NOT MY FAULT!" as I ask her why we have no spineboards.

I sat down with our supervisor, intent on having a serious talk with him. Before I opened my mouth, he says "I know. I know. It's PFH."

I nod.

"Well, I've got to hand it to you. You went the longest."

I have been working with Partner From Hell for 2 months.

"Look, we're changing some things around. You won't have to work with her anymore."

I nod again.

* * *

I tried a different approach this time, than I did with lazy partner. I learned from that I need to more of a coaching role than an authoritarian one.

I actually pity her. I tell you, I think she's just so gunshy after being split and replaced from so many partners she doesn't even know what to do anymore. I really don't know what to do. I feel it's a cop out that I'm going to a different truck, but I absolutely can no longer expend my time or energy.

On a lighter note, she did ask me what a falafel was the other day.

"I don't know...it's...it's like a terrorist hotdog."

And with that, friends, good night.

-MM

- Hey Kids, Remember - it's Down the Block, Not Across the Street

2008-04-26T12:28:00.001-05:00

The man, finally letting his sister in the door, says, "It's all over. Sorry about the mess."

I arrive at the home about 12 minutes later, slipping through fire fighters. The man is curled up on the floor, not responsive. The man's sister thrusts an armload of empty bottles to me.

"He took these!"

Oh. You're kidding.

I do the paramedic thing - the usual stuff with all the initials - BSI, CBG, EKG, ET, IV - and as we're rolling to the hospital and I'm calling in my report I suddenly feel like I'm having an out of body experience.

When did this become comfortable for me? I remember starting out last June I thought I was going to feel brand new everyday. I'm glad I've finally gotten use to this nonsense.

Of course, by saying this, I'm now tempting fate.

WHY DO I ALWAYS HAVE TO STIR THE SHIT?

-MM

PS - If you're going to kill yourself it's really hard to screw up jumping off something tall.

EDIT - Ok, now on the newswire some guy survived a 500 foot fall, so I guess that's out too. God damnit.

- B(M)SI

2008-04-20T00:37:00.004-05:00

It is a typical night in Major Metropolitan Area. The young college students are out in force, and the freshman are really making a showing of themselves before the summer semester begins and the new students begin streaming in.

"Wow," I say. "She's pretty drunk."

A young lady is sitting on the concrete outside of a bar, in her own vomit, trying to text her friends to pick her up. I lean over her shoulder, and look down at the words on the screen, which consist of this:

H3fo gsad I nee ri pick me 4j0 9.

Outstanding.

I step back as she begins to retch once more but luckily she has emptied everything in her stomach and only a few lines of drool spill from her lips. I look down, and realize that her little sundress is hiked up far enough for me to see...well, it's not important, but suffice it to say that she decided to avoid that whole "Always wear clean underwear in case you get in a wreck" issue by not dealing with underwear at all, this evening. A puddle of something has formed underneath her.

Her friend stands next to her, a concerned look flashes across her vapid features. "I think someone might have put something in her drink!"

"I agree!" I chime in. "They put alcohol in it."

The young lady reaches out with her other hand and gives the campus officer next to her something that looks like fishing line with a bit of fabric attached to part of it. Aha! Her underwear! She followed directions after all. The officer absentmindedly takes the underoos and helps the young lady to her feet. When she stands, the officer, myself, my partner, and the 50 people gathered around us realize something: they young lady has, at some point, shat herself.

Slowly, agonizingly, the officer opens his hand with the young lady's undergarments in it, and pure, unbridled horror registers on his face.

The young rookie suddenly realizes what he is holding in his hands:

Poo Drawers.

Yeah.

Another day in paradise, folks. God Bless the USA.

-MM

- In which shit hits that fan

2008-03-30T00:32:00.002-05:00

Dear Taxpayer (bonehead):

Enclosed is your economic stimulus check! 300-600 dollars! Go on out and spend that shit!

-George

So while I was in rehab (read: under a rock) apparently the Big Bosses came up with this little scheme: everyone gets a check to spend on crap!

Has anyone seen that episode on futurama where they do the same thing, and everyone gets 300 dollars?

Surely someone has.

By the way, if you're not reading www.marriedtothesea.com, you need to be.

Ya jerks.

-MM

- Cut your damn hair! And get off my Lawn!

2008-03-22T16:07:00.003-05:00

I really miss my mohawk.

Back when I was a young March, not yet a Medic, fresh out of high school, I got one shaved into my head. I was in a punk band at the time, but that really didn't have too much to do with the decision. Really it was all my teenage immaturity - the rebelliousness, the shock factor, the attention it drew. Boys, if you're thinking about getting one, let me tell you one thing I think it's very important for you to know - Chick LOVE the 'hawk. They like to look at it. They like to touch it. Instant cool.

But luckily that all faded away once I was no longer a teenager.

Yeah. That happened.

The thing is, I'm still kind of immature. So at a point in time last summer, I got my hawk cut again. I even brought in my company hat and the back end trimmed to fit in, so as long as I'm wearing my cap, no one could tell it was there. Alas, having three quarters of a hawk wasn't working for me, so I shaved my head. That was fun for a while, but I decided to let it grow out into my big Italian pompadour I have now-really a cross between a rockabilly type thing and the spike up strands of the guys in this video. But I like my haircut.

The lady we've just loaded up is very upset with me. Typical butterfingers (really, I don't know why XXXX Ambulance Service trusts me to hang onto a handful of air, much less an IV needle or a slippery, freshly crapped out newborn - it really boggles the mind. Also, 'andy tip for all you newbies - If you drop a baby, pick it up.) I've dropped her wig on the dusty ground. I pick it up and dust it off, hand it back to her, and apologize.

She's in a foul mood already, which is understandable, cause I know that if I couldn't poop, I'd be upset too. Anywho, she makes the comment that I probably wouldn't like it if someone dropped my hair on the ground. I told her she was absolutely correct, and I meant it, though technically it wasn't her hair, even though she owned it. Unless she shaved her legs and braided it into a hairdo. When we picked her up last week (for constipation! Imagine that!), her gams looked like two uncooked chicken drummettes that had come out on the losing side of a fight with a five gallon jug of UltraStrength Rogaine. The reason I agree with her is because my hair is connected to my head still (Hah! Take that, old people!) and dropping it would involve said head striking the theoretical ground which is something I try to avoid...in theory and in real life.

Uh, I digress, and suddenly realize I'm not going anywhere with this post.

Also, I've got a girlfriend. Woo!

-MM

- First Day

2008-03-09T00:12:00.004-06:00

"He must be nervous as hell," says Cool Old Medic,"the way he's going through that bag. Hell, MM, you only been gone 3 months! It's just like you been out for a few days!"

"3 and a half. "

"The bag's fine! Here! Take the damn narcs so I can get out of here!"

Cool Old is messing with me, playing, but I really am nervous. Scared I'll miss something stupid, something I take for granted because I would do it all the time. I've been out for a while. I run through the normal inventory, recount my narcs. I feel like it's my first day again.

We get our first call and I still feel nervous on the drive over, as I walk in and glove up.

I immediately slip back into Zen as I step in the house. I can remember it all.

The call goes smooth.

The day goes smooth.

I'm back, and it feels good to be sober, happy, alive and a paramedic.

Then, towards the end of the day, my boots fall apart.

I've had these old Bates for 3 years and they finally gave it up today. I had to run my last call with the shank of my boot taped to the tread and sleeve.

It was bittersweet - what kind of jackass gets emotional over a pair of boots? But all the same those stupid, well priced boots have protected my feet for three years of blood, sweat, and tears and I'll miss them.

They went back into their original box, and were deposited, with full honors, into my garbage can, layed respectfully as I placed them on top of a pizza box.

So then, wiping a tear from my eye, I found myself in the boot aisle at Academy.

And I was looking at a pair of the same, wistfully, and then, out of the corner of me eye, I see these puppies.

I bought them. I couldn't deal with some more Bates. I HIGHLY recommend and endorse them - I got 10 times the use from them than what I paid. Comfy and tough.

So I'm officially a weirdo.

Yeah.

-MM

PS - Please welcome Guitar Girl RN to the link list. Funny and in the medical field, and a musician! Go Girl!

- Suiting Up

2008-03-05T17:15:00.002-06:00

I step out of the shower, wrap a towel around my waist, and step out onto the carpet. Opening the cabinet I grab my bag and in short order have my face and neck slathered in foam. I shave quickly and throw on some aftershave, briefly doing the Home Alone Face Slap as I always do. Teeth get brushed.

I quickly put on my jockey shorts and uniform pants, pressed straight. Socks go on next because I never remember to put my socks on before I put my pants on. I slide my feet into my old reliable Bates zip ups, freshly polished. Undershirt is next, followed by belt and a quick trip back to the bathroom for deodorant and hair gel (I'm Italian - it's a rule, okay?) and then back to my closet for my shirt. It sits quietly on the hanger, my disco patch staring up at me from the sleeve: Let's go, it says. Let's go save some lives today. What hell are you doing staring at me when we could be out there working?

I put on my shirt, button it, and tuck it in. Pen, sunglasses go into front left shirt pocket. Pocket knife into right pocket. Cell phone into left pocket. Unit keys clipped onto my belt, Id tag into my shirt. Walking out to my car, I see my reflection in the window. I haven't worn this uniform in over 3 months. I take a deep breath and step into my truck, grab my sunglasses and put them on. My clipboard, steth, and vest are resting in my back pack next to me.

Game Time.

* * *
Well, I finished up my treatment and have moved into a recovery house in Metropolitan Area. I finished my checkout with our FTO today and should be back in action Saturday.

Look out, America! MedicMarch is BACK!

-MM

2008-03-04T10:01:00.001-06:00

'What" will your obituary say?' at QuizGalaxy.com

Porketta, my tollbooth angel, our secret love shall never be consumated.

No content today because I'm moving!

-MM

- We've Got to Stop Eating Like This

2008-02-24T09:43:00.007-06:00

Scene: 10:30 PM. Two EMTs sitting in the cab of a unit, sweaty and tired. They've been on for 17 hours and are outside of a large hospital.

Eating Partner: "What are you hungry for?"

MM: "What. Are you serious? No. We just had a cheeseburger."

EP: "I know that...but...Popeye's Chicken has that 99 cent chicken sandwich...we could make it, it's in the coverage area."

MM: "No! I'm not doing that! You and I both know that those employees keep getting 'spider bites'. How many times have we've been over there for 'spider bites' for some chickenslinger trying to strike it rich with a law suit? HOW MANY TIMES, DAMN YOU? HOW MANY?!"

EP: "Just one chicken sandwich, then we can go to sleep."

MM: ::sigh:: "Fine."

---
(later, in the drive thru)

Voice Box: "Fvvvshhg?"

MM:"....Uh, yes I'd like a Chicken sandwich, no may-"

Voice Box: "NKFJENKF?!"

MM:"What?"

Voice Box:"NFJKNEJKE!"

MM:"Uh....CHICKEN SANDWICH. NO MAYO. ROOT BEER!"

Voice Box: "CJNFIRSJVKSH!BNTY! BTNY! BTNY! JJJJnnngh."

MM: "Screw this. Let's go inside."

---
Register Lady: "Welcome ta Popeye, I can take yo order?"

MM:"I'd like to congratulate your company on it's progressive attitude, letting a deaf-mute work the drive thru. That's mighty ambitious!"

RL: "Huh?"

MM: "Nothing, I'd like a chicken sandwich, no mayo, a Bar-

RL: "You gon et that sandwich dry?"

MM:"It's not for me, I'm getting it for my par-...why am I telling you this? Yes, dry. No mayo, and a roo-"

RL: "-You wanna a drink?"

MM: "Yes. Yes, I wanna a drink. A large Root Beer."

(The Register Lady, easily close to 400 lbs, waddles across the greasy Popeye's Fried Chicken kitchen floor, my cup suffocating in her dainty, sweaty hoof. I'm thinking if she falls in here, we're going to have to call in and get lift assistance, tell everyone what happened, and probably never be allowed to come back to this chicken restaurant again. "Skate across the tile, my chicken angel! Skate like a Kwan!" Somehow, she manages to get there and back without falling.)

RL: "Der go yo rootbeer!" My sweet brown nectar slops over the side of the cup and onto the counter.

MM: "Thanks. No triple axle? You could've nailed it."

RL: "Huh?"

MM: "Nothing."

I notice suddenly Register Lady has been sizing me up...whether to ask me out or make me a meal. I am not sure. "So you an bambulance driver?"

MM: "What, are my antlers showing again? This damn cap..."

RL: "Huh?"

MM:"Nothing. Yes ma'am, I'm a Bambulance driver. I drive the Bambulance. I enjoy saltlicks, and getting shot by men wearing neon orange. I love it."

RL: "Huh?"

MM: "Yes Ma'am, I'm an EMT."

RL: "Oh, ok. Dere go yo sand-itch." Her hand leaves a sweatprint on the bag she hands me.

MM: "Thank you. Look, before I go, could you say 'Jeenga Nert Do, Solo! Hah hah hah hah!'"?

RL: "Huh?"

MM: "Thank you."

---
EP: "What the hell? This has mayo on it."

MM: "THEN PUT ON YOUR BIG GIRL PANTIES AND DEAL WITH IT."

EP: "Well...it's not that bad....and we do still have half of that pizza we got at lunch."

MM: "Argh. I'm going to bed. I'm getting an antlerache."

EP: "Huh?"

MM: "Nothing."

See ya'll next weekend.

-MM

- Just a shout out...

2008-02-17T12:37:00.004-06:00

...to all my homies huddled around the single computer in Visalia, CA - just remember this simple rule while working in the medical field.

(puts on gieco gecko voice)

Air goes in an' out, blood goes 'round an' 'round. Any variation on this is a BAD.

Should be getting a longer pass next weekend so I'll be able to throw up some new posts. I'm still alive!

-MM

- Still Here!

2008-01-26T12:05:00.000-06:00

Let me tell you story. A story about a scared boy was getting to the end of his rope. He didn't handle his problems well and had problems with drug abuse before he got cleaned up and got a job he loved. He thought he was getting his life back together.

Well, the boy never did how to learn pressures and stress. He liked working, he liked working hard, and he liked playing hard. But eventually, somehow, an insidious disease snuck past him and roaring, grabbed control of his life without him ever realizing it. When he did, he was crushed under so far he didn't know what to do, and was going to end his life. But instead of picking up his knife, he picked up a telephone, and called some one. He went to treatment. He's getting better, so much so that now they let him go to town for a little while.

Do you know who this boy is?

It's me.

I've been in rehab, folks. I've been in treatment the past 60 days and am getting better all the time. I should be back out soon, and don't worry, I'll definitely be back. Maybe round the end of Febuary. So keep your eyes open and your boots dry, and you'll see me soon.

Stay safe!

-MM

- Sorry, Everyone

2007-11-25T18:05:00.000-06:00

For personal reasons hiatus is in effect until further notice. I'd like to thank all of you who stop by.

In the words of the immortal Gen Mac: I shall return!

Remember, there ain't no Meat like Meat In The Seat!

-MedicMarch

- Your Attention, Please

2007-11-18T18:25:00.000-06:00

So, are there any readers in the house from Guildford County, NC or the surrounding area? If so, drop a comment or an email, because I need to know who you are! Important stuff!

I can be reached at medicmarch@gmail.com .

-MM

- To Infinity, and Beyond!

2007-11-17T12:42:00.000-06:00

As told to me by SpiderMan, my preceptor, yesterday:

"So we get this call out for a guy complaining of weakness and syncope. We get on scene, and this guy looks completely spent - like, totally drained, can barely move, etc. Complaining of head pain, says he can barely move his legs, and is really tired, that he just wants to lay on the couch. We finally manage to get out of him that he had taken some Cialis, and that he thought that it reacted with some of his other medication, but he wont tell me anything else.

Finally we get him loaded up, we get over to the hospital. We note that the only other medicine the guy is taking is Augmentin. Anyway, we look it up in the drug book and it says that Cialis has been noted to react with Augmentin in a very unusual away - it potentiates the feeling of orgasm...by 1,000 times.

Yeah.

Apparently the guy decided to check the equipment, so to speak. When he "peaked", he had a climax 1,000 times greater than his usual one. The guy totally lost it - it just blew him away. No wonder he couldn't walk and was feeling dizzy."

We better keep this a secret. If the teenagers ever find out it's going to be a disaster.

-MM

- 10K Hits #1

2007-11-17T12:34:00.001-06:00

In lieu of making an entry here, I'd like to post a clipping off a message I sent to my best friend and what he wrote back. This was in early 06, when I was going through some pretty tough shit, and had reverted back to my old partying ways, and when I got done with that I found out who my friends really were...

anyway:

I was just looking at the old photos of NGS (MY OLD BAND-ED.) playing together on our old webpage that's still kind of up. It made me think of NGS and the early days before kyle joined and it was just you and me and Thomas running around in his Eagle and going to wal-mart. I'm kind of nostalgic for those days...I miss them. I miss drinking sodas out of your mom's fridge and hanging out with you and the gang and pegging the fuck out of each other with air soft guns. I know we're pretty busy and I also know that it's no one's fault but my own. I've been a real shitty friend for probably the past couple of years now but you still come out and listen to me at the shows and call me up every once in a while, and when I do get back to you I know I can be short and kind of an ass and I don't talk much. You've been a much better friend then I deserve. I just wanted to thank you for that and let you know how much of a douche I've been. I think our friendship is one of the most positive things that's ever happened in my life and I never have put into it as much as I got out of it. So I'm sorry, and thanks.

His Response:
Know what you mean man, I look fondly back on those days too. I don't know what it is but things were just really fun back then. I realize everyone gets busy. Over the past couple of years I've realized that everyone eventually goes their separate ways, and that's fine ya know, just still got to find time to be friends. Dude, I've never thought of you as any less of a friend because of anything you ever did. i might not agree with everything you have done, but hey that's me. I'm not going to let it mess up a friendship that has lasted this long. Sometimes i feel like i can't hangout (as much) with a lot of my friends because i don't really like to go out to bars, or drink that much. but dude, call me anytime when you aren't working. Ok shit I'm rambling now. get back to me on this, or something. talk to you later man.

Robby and I hooked up in eighth grade and started a punk band. Although that has since faded he's been the one constant friend I've had throughout the years, the one who I can call and would always call me back, the one who calls me if I don't call him, who's content to hang out and listen to me bitch, play music, whatever. I don't think I'll even be half the friend to him that he is to me, but I'm gonna goddamn well try.

Sorry for the serious stuff, folks. Just working around a little writer's block.

-MM

- It's the time of the season.

2007-11-06T14:22:00.000-06:00

I wont give in to the temptation to blog about the oncoming Christmas blitz - it's pretty much been covered. As a lark, I've decided to blog out each entry in the 10,000 hits post...look for that coming soon!Haven't had much motivation to write lately - as AD pointed out it's still beautiful down here, and I actually went for a walk the other day. And not just to McDonald's! It was at the park!

This fellow, by the way, is MedicDog...handsome, aint he? He stays with MedicMom since I have no backyard...and he's pretty god damned smart. Loves squirrels. Loves barking. Loves bacon. Loves sleeping. Not too different from MedicMarch, actually...MedicMom is not pleased that I've been tying to teach him how to open the front door. I don't think it's fair that she was so behind him getting taught how to fetch the paper but is upset about this. I'm just trying to give him a good education.

What's going on in my life? Hmm. The latest applicant for MedicGirlfriend and I have parted ways. We were working opposite shifts and...well, she wasn't too sharp. Granted, I'm a pretty unusual feller, but after the fifteenth or sixteenth time I've had to explain a reference...well, it gets old. Cest la vie. To quote The Oblongs ..."Love is a joke with no punchline."

Uh. Except for AD's and Babs's. Cause AD pretty much knows where I live and too many places to hide bodies in the swamp. And Babs can almost certainly kick my ass. So, uh, only the best, guys. Please don't hurt me.

I was passed out dreaming yesterday, seducing Civil War era Southern Belles as a dashing blockade runner - "Oooh, March LeFitte, you are positively giving me the vap-uhs!", when MedicMom called me and woke me up to tell me she had booked me a day at the spa.

At first, I was confused ("MedicMom, didn't I just say MedicGIRLFRIEND? I don't want to prance around in a skimpy towel"). This gradually gave way to elation - I was imagining cute, giggly Asian girls with only the shakiest grasp on English. I'm an evil man, and I decided I DO want to prance around in a skimpy towel. But again, this gradually gave way to another feeling - suspicion.

"Wait a minute. You've got that tone in your voice. What's the catch?"

"Well, I actually just scheduled to get your back waxed."

Allow me to paint an image in your mind. Imagine, if you will, a large gorilla. Now give him a fancy Italian haircut and a stethoscope, and you've pretty much got a rough idea of what I look like. Naked. With a stethoscope. I am, needless to say, less than thrilled with the idea of getting my back waxed.

"Don't be a sissy," she tells me. "Plenty of guys do it all the time."

"MedicMom, they're YANKING THE HAIR OUT OF MY BACK WITH HOT WAX. No! I'm not doing it."

"Call J! She's the one who's going to do it."

J is a friend of ours who runs a spa here in town. I call her up.

"Hey there, MedicMarch. You ready to get your back waxed?"

"No! It's torture. You can't even do that shit to the prisoners at Guantanamo!"

"It's not that bad! You've had your eyebrows done, right?"

I have, in fact, had my eyebrows waxed in the past. Not to get them all shapely and feminine, but just to keep it from looking like someone had underlined my forehead with a big ole 44 magnum permanent marker. I didn't care for it much at all. I really don't understand how someone can have a bikini wax ::shudders::. The eyebrows nearly put me over the edge. It's not the pain so much as it's the sensation of having the hairs yanked out of my face.

"Yes, I've had it done. On the pain scale, what do you rate getting your eyebrows done?"

J thinks for a moment. "Hmmm. I suppose that's about a two."

For one brief glimmering moment, I am hopeful.

Of course, if you read this blog at all, you know that This is a mistake.

"Well, that's not so bad, I guess. What would you say getting your back done is?"

"Well, I've never had it done myself, obviously, but from my customers reactions, I'd say...hmmm....probably a six.

"A Six? A SIX?! Are you serious? That's three times the pain of getting my eyebrows done on an area that's two feet by two and a half feet! I'll never be able to sleep on my back again! You might accidentally rip out my spine!"

J eventually got me calmed down and told me when I was ready to give her a call.

Le sigh. I do not look forward to this.

-MM

- God Laughs At Me

2007-10-30T11:00:00.000-05:00

I had written down what I wanted to say. It was about two pages long, and I had it memorized. I carpool with Lazy Partner, so I was going to have a captive audience. It detailed why I'm unhappy with her performance and why, even though I thought she was nice enough, I'm giving her this talking to. That she needed to mature as a person, as an employee, and as a medic. That she gets paid a lot more than I did when I started as an EMT although she's not doing half the job. That she needs to work on every area of her job performance. That she needs to listen to my orders and obey them, and if she has questions, to ask me after the call. That she needs to learn how to work a god damned mop.

I had written all this out in the nicest manner. It was ready to go for our ride to work later that week.

I arrive to work to find someone different at the station.

"Didn't you hear?" She says, when I question Lazy Partner's where-a-bouts.

Hmmmm. "Nope."

"She's working with Redhead Medic now, on the other shift. She says she thinks she needs to work with someone with more experience."

I am, as always, the last to know. Apparently last shift when I was outside washing the unit by myself, she was inside with the oncoming crew, telling me she wants to work with someone who can teach her better. They told me as much when I mentioned to them this morning that she was switching - Ice Cold Medic tells me "Oh, yeah. That's what I heard. She mentioned that Friday."

What Lazy Partner apparently does not know is that RedHead Medic is a lot less patient then I am, doesn't help out with the driving, and has no tolerance for any bit of BS. This will be...entertaining.

All that effort for nothing.

-MM

- Hollywood.

2007-10-23T15:37:00.001-05:00

Terminally Anxious Dispatcher can't keep the worry out of her voice. "They're saying 5 kids involved, blood everywhere. I'm going to send an additional unit. AirLife 1 and 3 are responding.d"

We are hurtling down Big Road. We are going to have to go down to the next highway exit and loop back to get to the crash site, where a single car has careened off the road into the forested median. As we pass from the other direction I can see smoke rising up through the trees. I swear there is a flicker of yellow. I want to stop here and just run through the forest, but the trees are too thick. We have to go all the way around.

"Unit X."
"G0 Ahead, X"
"If you don't have them coming already, get fire department rolling. The car is on fire."
"They've been toned out, March, coming from around the river."
"-4."

We take a shortcut I know about. Lazy Partner is scared about crossing the opening, stating that it rained a couple of days ago and the ground is probably still too wet. I can see anxiety in her eyes.

"Just do it. We'll make it."

The ground holds, and we quickly get on scene. Our field supervisor comes over the radio as we pull up, establishing incident command.

I leap out of the truck, double gloved, ready for action, and say the line every medic has said a thousand times when they get to a scene.

"What we got?"

"6 vics, one critical, the rest all need to be collared and boarded."

"No one still inside the car, huh?" I can see the smoldering wreck in the trees. All the foliage around it has been burnt away. The car looks like it's been inside a compactor, with the front compressed to an average length of two feet. The windows are all broken but I'm not sure if that's from the wreck or the firefighters.I finish sizing up the scene. All the vics are sitting or laying on the grassy hill next to the wooded median. The VFD Paramedic is with the critical, and that's who I go to first. I turn to our Sup. "Ok, this is what I think. Crit out first on Airlife 3 (who is closer), we get the rest boarded, and decide if another needs to go out on Airlife 1. Sound Good?"

"Exactly what I'm thinking. I'll get in touch with dispatch."

Technically since I'm the first "Real" unit on scene, this is my scene, but since a supervisor is here I'm content to let him make the calls. He's got a lot more experience and I'm not going to get into a pissing contest over stupid shit like who's in charge when people need help. It is, however, very reassuring to hear him echo my exact thoughts, that we've processed the same information and come to the same conclusion.

Maybe I should go help this critical patient before my head gets much bigger and I cant fit inside the back of my unit.

I make eye contact with my partner, who has parked the truck at the front of the scene, put my hands around my neck, hold up the number 5, and yell "Peds!!!". Mom, I can see, already has a collar on, and one of the firefighters had bandaged her hand. I kneel down next to the critical. She has swelling to the right side of her face, and her left arm is swollen, definite fracture. Her vitals are stable, though, and she's talking to us, remembers everything that happened. I grab my partner. "Collar her, board her, she's out first, I'm going to check the rest."

I quickly assess the rest. No one is really hurt, but one of the other kids has a goose egg on the noggin and is complaining of abdominal pain. The kids are 3,4,10,11, and 15. I decide to fly out Goose egg and drive the rest.

Airlife 3 comes in low and fast, buzzing the scene. They troopers scramble to shut down the interstate. After giving instructions to the VFDs to finish boarding everyone, Supervisor and I grab my stretcher and load up the critical. Airlife has set down, and the flight medic takes my report. They lift off.

Our other medic unit has arrived at this time, and in short order, we get everyone loaded up. Airlife 1 sets down a mere 50 yards from my unit, kicking up dust, and forcing Lazy and I to lean over our patient, the Mom, to protect her from debris. Lazy sets me up an IV as we put Goose egg in the chopper. Airlife 1 takes off again, low over the scene, the rotor wash battering my unit.

We transport to the hospital uneventfully. Mom is feeling a little chest pain but it is consistent with injuries from where her seat belt would've been. I shoot a 12 lead for posterity that comes back negative. From our supervisor getting on scene to us, the last unit to leave, the whole call has lasted 27 minutes, including the time for to board 6 patients and two choppers to set down and load up.

Later, when we're restocking, Lazy partner can not quit smiling.

"What?" I inquire.

"That was so cool, with the choppers flying around, and the smoke, and the chaos. It was like I was in a movie!"

-MM

PS - Scroll down to read my 10 percent post - I'm going to blog on a topic of you're choosing, so leave your vote in the 10 percent comments section.

- 10 percent of 100 grand

2007-10-23T00:23:00.000-05:00

I guess you guys might be paying attention after all.

Wretham, MA, thanks for being #10,000.

As way of compensation for all you guys putting up with me, I want you guys to leave a comment on this entry of a subject you want me to blog on. the only thing I'm not willing to blog about is politics or the war, so other than that....shoot.

-MM

- DNR

2007-10-23T00:19:00.001-05:00

After I get over the lungfunk I always seem to pick up from this time of year, posts are coming.

-MM

- It's Not Getting Any Better

2007-10-15T09:26:00.002-05:00

This morning I:

Made Truck Soap
Made Mop Water
Cleaned the Stretcher
Sprayed the Back
Mopped the Back
Mopped out the Cab
Disinfected Cab
Wet the Unit
Washed the unit
Rinsed the Unit
Shined Unit tires
Windexed the Glass
Rolled the Hose
Made Mop Water Again
Swept Station
Washed Dishes
Lysoled All Bathroom Surfaces.

My Partner:
-Washed one Ambulance Wall
-Told A Ghost Story
-Ordered Makeup From TV
-Complained about being ordered to Mop the Station
-Bitched when I was finishing up a run form that I was taking too long (we carpool)

Did I mention that she's not allowed to tech calls, because all though she's been hired for three months she has yet to complete our EMT-B "Boot Camp"? I. Run. Everything. Granted, it's not been a problem lately as we've had slow shifts...also, she did not stock paper towels on the unit, forcing me to clean up a guy who mud all over with 4x4s.

She also got mad at me last night because I told her she needed to do the full inventory every morning. She always seems to have an excuse when I ask her about whether she's performed her job duties.

Whenever I took Driver's Ed, I took with my football coach. I would make an excuse every time I messed up, and after three or four go-rounds, he said "Dammit, March, Next time I correct you I just want you to say 'OK, COACH, SORRY, I FUCKED UP.'

I missed a turn, and when I started to open my mouth, he gave me a look - the same look he gave the O-Line after we had -3 yards rushing after the first half, one game where he told us that if we didn't get it together, that we were going to go outside and hit the sled till we quit the team.

So I said, "OK, Coach, Sorry, I fucked up."

I'm glad my Coach made me do that. I now own up to my mistakes and try to learn from them, something I don't often see in other people.

Especially not in my partner.

Le Sigh.

-MM

MedicMarch, Your Lord and Savior

2007-10-09T12:45:00.000-05:00

I'm sleeping happily at the station when the call comes in. It is Terminally Anxious Dispatcher.

"Hey, MedicMarch. Priority To Mosquito Bayou for an Unknown. 54 yo male rolling around in bed."

"Maybe he's trying to get comfortable?"

"Ha. Just get in the unit and run the call."

Sigh.

My partner is hauling ass. I believe we've gone plaid.

"Where do I turn? Where do I turn? I don't know where I'm going!"

I'm trying to coach her.

"Slow down, slow down, slow down, CAR CAR CAR! CAR! CAR! Turn Left! LEFT! LEFT LE-shit."

"Where, up there?"

"No, the road you passed."

She is not applying the brakes yet. "Huh?"

"The road was back there. Turn around."

"Why didn't you tell me earlier to turn?"

"If we weren't traveling at ludicrous speed, we would've been OK."

"What?"

"Nothing. Turn Around."

We make the turn and head back towards the scene.

"This is the house. The House. HOUSE. THIS IS THE HOUSE. STOP, STOP, THIS IS IT."

We have issues.

A man in a wheelchair is worriedly waving us in from the drive way. "In heah, In heah. He sick."

We roll our equipment inside to find a man rolling around in his bed, back and forth. His wife is holding his hand, kneeling by his bedside, crying. Pages are ripped out from a bible, scattered all over the room. I'm trying to remember our protocol for demonic possession as I introduce myself.

"I'm MedicMarch with XXXX EMS. How long has he been like this?"

She looks up. "He like this since I got home!"

My boot kicks over an empty bottle of SoCo.

"He have any medical problems?" I ask. "Or has he been reading the Necronomicon?"

"He has back problems, and he's got the pressure. Oh, and he got the sugar."

Aha. Most likely our culprit. His CBG is 28.

The man in the wheelchair has managed to wheel to the threshold of the door. "My daddy! My daddy! What's wrong with my daddy? Oh Jesus, help us! My Lord and Savior God, who protects us from all evil, protect us from the devil in my daddy!"

The wife kneeling by his side is chanting in tongues. I tell my partner to assemble my D50 as I set up my IV equipment. The man in bed is hooting- Hooo! Hooo! Hooo! Just like a white winged dove...I start humming.

"The devil's in him!" The man's wife is frantic. "He was reading the bible but then he started tearing out the pages and eating them."

"Not very nutritious, those bible pages. I hear the Diamond Sutra's a little more sugary. Probably would've been better."

"Huh?"

"Nothing, ma'am. Is he allergic to anything?"

The chanting is increasing in volume, and it's at least 100 degrees in the room. It's a circus. My partner drops the D50 and it shatters on the tile floor. "Grab another from the box in the unit," I tell her. Under my breath, I say to myself "This could not get any worse."

This is what we refer to in the business as a "Mistake."

You see, fate has a hard-on for jinxing health care workers.

At this moment, the family's daughter runs in. She sees me kneeling over her gyrating father, the son yelling, and the mom crying, and does the only thing she can - runs up to me, and grabs my hands, which are currently uncapping an 18g IV.

"What are you doin' to my daddy?!"

I don't answer immediately, as she stares down at my hand, which now has an 18g hole in the meaty part of the palm. I look down at my hand as well. "I was going to start an IV on him, but it's going to wait for a second now."

I take off my glove, put a 4x4 on my hand, and put another glove on, grab another needle.

"Ok, ma'am, I need your help to start this IV on him, so I can fix his sugar."

My partner, meanwhile, has come back. The man is rolling around. "Keep his arm still for me, guys."

I sink the IV and manage to get it secured. I push the sugar in. The son and mother are continuing their litany. Hallelujahs and Our Fathers bounce around the room, and any moment I expect a tambourine player to bust out of the closet, sweaty, messing around with a rattle snake.

The man comes around.

"Oh Jesus! Jesus Healed my father! Oh thank you! Jesus, Thank you! Jesus be praised, my lord and savior be praised."

Damn it, I hate it when someone else gets the credit for my work.

We start to get the man loaded up. Just as we are leaving the residence the man's pastor pulls up in a brand new caddy, he is dressed impeccably in a black suit, and his hair has been laid out, parted down the middle of his head.

He stops us. "A prayer for our brother."

He goes into another chorus of Hail Marys and Thank you Jees-us-uhs. I look at my watch.

We get it wrapped up, finally, and bring the man to the Catholic Hospital down the road. We are informed that it will be a 2 or 3 hour wait for a room.

Guess Jesus couldn't help us out with that one.

-MM

- R and R

2007-10-05T21:57:00.000-05:00

So this past week Spiderman and I had a chance to take in something truly despicable. That's right, ladies and gentleman, we got to see GWAR.

We had known about the show for a few weeks but it looked like we weren't going to be able to see 'em - our schedules synced up wrong. But then, impossibly we both managed to switch. So at 9 o clock, swaddled in trashbags, we were able to witness the most gruesome show I've ever been party to. The pit was crazy. Easily one of the best shows I've ever seen. Oderus, Flattus, Balsac the Jaws of Death, Beefcake the Mighty (WOO!), and Jizmak.

The show was loud, fast, and brutal. Let me tell you folks, it's hard for me to write about. Words can not describe the Awesome.

Look, if you have a chance to go to a GWAR, go.

I'ma go clean the blood out of my ears. After all, I've got a date tonight.

-MM

- Old Hands

2007-09-24T14:29:00.000-05:00

Lifeless eyes stare through the ceiling as my partner does compressions. The bicarb we pushed in a little while might be helping out because even though we don't have pulses yet, our patient has reached an organized rhythm. My partner, the new one, is getting tired quickly. This is the first time she's ever performed CPR on a real person.

"Get your shoulders over the chest a little more. You want to be at a 90 degree angle" I coach her.

The other paramedic squeezes air into the man's lungs.

The patient in question is a 51 year old former employee of the company I currently work for. He had moved into our service area recently after starting his own safety business. We've called in the chopper and are on our way to the LZ across the bayou.

My partner is starting to tire out, so I tell her to take over bagging and I take compressions. The other medic, who I went to paramedic school with, pushes in another epi. I feel the burn start in my shoulders as we pull up to the LZ. The Flight Medic opens the back doors, looks inside. The man on the stretcher was his partner for 2 years, back when he was still on the truck.

"Fuck. What we got?"

I give a rundown of the patient - 51 year old male, told his wife he was having trouble breathing, dropped. CPR almost from the moment he hit the ground. All we've had on the monitor is PEA.
IO drilled, number 7.0 tube, almost done with his first bag of fluid, 6 epis in, maxed out on atropine, bicarb in, d50 in, narcan in. Hypertension, didn't take his meds, no allergies.

The Flight Medic loads up the patient. The other paramedic flies in with him.

The man doesn't make it. They lose the rhythm shortly after takeoff and don't ever get anything back. They later say it was due to a massive infarct.

I wipe the sweat from my forehead, walk back to the cab of my unit, pick up the phone. Could I've done anything different? I run through my algorithm in my head. I treated the hell out of him.

The funeral service is well attended.

I walk out of the funeral home, run into the Flight Medic. He and I aren't on the best of terms - I don't think he's a very nice person, and he has a lot of disdain for the paramedic factory that I was churned out of, which I don't blame him for. Some of my class mates were less then stellar, and some of those were less than competent.

He takes a drag from his smoke.

"I was really mad at you, MedicMarch. When they called him, all I could think of was that you did something wrong, or fucked up somewhere, and it was your fault he wasn't coming back. I was looking for someone to blame."

I stand there silently, wondering if I'm about to get hit.

"Then I thought about it a little more. Thought about the report you gave me." He points inside. "Thought a lot about him. He never listened to his doctors."

He takes another drag. "I just wanted to say I'm sorry about that. You did what you could for him, and I'm embarrassed for having been mad at you. It was very unprofessional of me. I'm sorry." He sticks his hand out and shakes mine.

I walk to my jeep and get in, rest my head on the steering wheel for a moment. At home that evening, I am sitting on my porch, and I pour a little of my beer into the garden. One for me, one for my homie.

-MM

- Switchblade McGrew

2007-09-16T23:29:00.000-05:00

So my buddy Chad is currently in Iraq.

I'm not going to go into the politics involved. I've already said this.

Well, Chad is sending me a present. I had mentioned to him how upset I was that my old SpyderCo G-10 was stolen - it fell out of my pocket one night while laying on a couch, and when I went back the next day it was no where to be found. It was a great knife that I really enjoyed and I got a lot of use out of - it worked fantastic and handled whatever I tossed at it.

So I was chatting with him about it and he told me that in 4-6 weeks I shall be receiving this :

Pretty, No? A real nice knife, expensive, but it's gotten good reviews.

I'm excited! Are you excited?

-MM

- Requiem

2007-09-12T18:45:00.000-05:00

I was a junior in high school. I was sitting in Ms Gauthier's Gifted American History class and the period had just started when the teacher next door came in. "A plane hit the World Trade Center!" she said. We turned on the television to see. One of the towers was burning - it looked like it was wearing a belt of fire. The test we were taking that day lay forgotten.

Then, as we watched the television, the second plane hit.

I know we all have our particular memories of that day, but sitting in the back of the classroom, next to my friend Matt, the silence among us is what I remember most. It was a dead silence, that lasted about 15 seconds, but watching the debris fall from the other side of the building, it was in slow motion.

Our teacher turned off the TV, and faced us, pale. "We....We have a test today. Time starts now."

We took our test and turned the television back on, and watched the fire trucks, the police cars, the ambulances, responding to the scene.

We watched the towers fall.

It's been said that 9/11 was my generation's Pearl Harbor or Kennedy Assassination, and I'm inclined to agree.

* * *

When I stopped in at my mother's this morning to play with the dog and get some free breakfest, I remarked to her that this was the first year that's gone by that the wounds 9/11 left on me haven't felt like they've been rubbed with salt. I don't say this to suggest that the passage of time has eliminated the pain and rage I felt that day, sitting in my orange chair at my black desk, useless, hopeless. Time has merely dulled my choler and hurt, made it almost bearable.

Almost.

I've seen some horrible things at work, been a part of some hopeless situations. I manage through these because I can. However, I still have trouble watching the attacks played again and again on television. Something twisted in me that day the hasn't been set right, that has healed broken. However, the memory of those killed in the attacks will live on through all of us. We are all survivors of those attacks, and we are all tributes to the dead. I would challenge myself to remember that. I live on in the place of those victims, and I'm going to live life to its fullest.

I'm not going to go political on this, but I think this country has a lot of problems that we aren't addressing. But I also think that we are the greatest county in the world, bar none. And I'm proud to be an American.

-MM

- From now on, you're my cleaning lady.

2007-09-07T15:37:00.000-05:00

How do you motivate someone to do the worst, shitty, bitch jobs that EMS has to offer? All the stuff that to the casual observer would not be what they think is involved - all the boring stuff.

-Washing the unit
-Cleaning the unit after calls and at the end of shifts
-Cleaning the station

I've tried to show leadership by taking the helm and showing my rookie the ropes of doing all the nonglamorous-but-necessary shit we need to do so that we can concentrate the rest of our time on "actual" work.

Personally, I don't know if I'm weird, but I've rarely had to have been asked to wash and clean the unit or station. I'm not obsessive compulsive but when you think about all the shit that happens in the back of your unit...

Plus, I like being in a clean unit. I take pride in it. I Pledge my tires. I disinfect the keyboards of out MDTs. I take the mattress off our cot and spray it with a hose. I go the extra mile, and I like to inspire my new Basic to do the same. Not only does it look good, it's healthier for you.

Case in point: 3 medics at one of our stations were diagnosed with Staph infections. Nothing but guys worked at the station and it was notorious for being a sty. I hate to think what might've been crawling around the back of their unit. I had worked over time out at the station, and when I woke up before shift change and started to mop, and asked the paramedic to give me a hand, he looked at me like I was retarded. "I'm the paramedic," he said. "You're the Basic. You do the Bitch work. That's what the B is for!" I thought he was joking, but when he refused to pitch in, I got pissed off.

I don't want to be that paramedic. I do realize, though, that the Basic gets the short end of the stick when it comes to stuff like this. For me it was part of the territory. So to instruct my new Basic partner I've been trying to lead by example. I try to make her do her job duties by explaining why they're important - like doing your inventory at the beginning of the shift. I rely on the oxygen and boards and other equipment. Until she can look at the cabinets in the unit and instinctively know what's missing, I want her in the back, with the sheet, going over each item. She just plain hasn't had enough experience to pencil whip though the inventory. I'm not blaming her yet - her preceptors, I think, might've showed her the easy way instead of the right way, and now it's biting her in the ass. A lot of times, she doesn't even know she's screwing up, and then when I point it out, she gets slightly frustrated. But what bothers me is that she seems to be lacking Basic skills. I ask her to do things like hook up the 4-lead or spike a bag, then I have to drop what I'm doing because she doesn't know how. At least she learns quickly. I just don't want her to get upset and too frustrated and sometimes I think I'm throwing a lot at her.

I've told her that if I take something from her on scene and do it myself, I'm not mad at her, I just can do it quicker because I've been doing it for longer. I always make a point after to show her the way I need and like it do be done, and that seems to be working pretty well.

This hasn't been the case with her station duties. I had to prompt her to wake up and sweep the station several times yesterday before I went outside to restock my bag and begin washing the unit.

She ended up falling back asleep. By the time I walked back inside to mop out the station it was near crew change and the station wasn't swept. I had to hop on another unit across the parish so I didn't have time to do it myself. When I woke her up and told her that she needed to get up, she gave me a real hostile look and it pissed me off, so I turned around and walked back out and finished the unit. Whenever we did changeout with the oncoming crew I told her she needed to sweep and mop the station now because I couldn't stick around to do it.

Well, apparently a few minutes after I left so did she. Our supervisor came by to give us some Narcs and saw the station hadn't been mopped. I got a pissed off voice mail from him asking me to come back to the station to do my station duties. I was already on the other unit by this point, but the oncoming crew mentioned that'd I singlehandedly washed out the unit and cleaned it up while she was supposed to be sweeping and that I was on my way to work. He called me back to apologize. Later I found out he gave her a light ass chewing over the phone

All of this could've been avoided if she'd done what I asked her. I think the problem heremight be that that I'm two years younger then her and she might precieve that I'm ordering her around....I don't know. I just wish she'd get with the program. I do my best to help her out but I'm too busy as a new medic trying to keep my own shit together to do much for others right now.

Thoughts?

-MM

- Voices

2007-09-05T00:01:00.001-05:00

The man in black laughs at me as I compress the baby's chest. His mother found him face down in his crib, unresponsive. I try to ignore the small cold body that I hold in my arms as we get back in the unit.

The man in black laughs at me as I play my flashlight around the body lying in the field. He has been thrown out of the back window of a car, and lies, motionless and broken, in tall grass near the interstate. A beetle crawls across his nose, which I brush off.

The man in black laughs at me as I watch a nursing home CNA do lazy, ineffective compressions on the chest of a resident, her hands splayed across the middle of his chest. She does not lean over the body or press down much. The man's eyes stare vacantly at the ceiling.

The man in black sits in an easy chair across from the patient I am now assessing. His heart is beating 30 times a minute and he is so pale that he looks like a black and white photo of himself.

"You're too late. He's going to die." The man in black is leaning over my shoulder as I fasten the velcro of the cuff around the man's arm.

I can't obtain a blood pressure.

"He's going to die," he says. Smiles. "He's going to die. You can't save him."

I quickly run a twelve lead. No STEMI. We load into the unit. Oxygen is applied. We get enroute to the hospital.

"You're going to miss the IV. He's gonna die. You can't save him."

I stick the IV in his arm. Pace or Drugs? Pace or Drugs?

The man in black sniffs at me with a grin on his face. "You're killing him. Every second you wait you're killing him. He's going to die."

I compromise by slapping the pads on the man and pulling up my atropine.

"A little medicine to help you, sir!" I cinch the line and push in the medicine. The man's heart rate rises to 35, 40,37...stays in between 35-40.

The man in black looks at me sourly. "It doesn't matter. He could be having the big one. He's going to die."

I try again for another pressure and get a systolic of 70. No bottom number.

"You should've gone with pacing!" The man in black is gleeful again. "You've killed him."

Shut up, I think to myself.

I push in another half milligram of atropine.

Slowly, the man's rate picks up. I look at him and see he's gotten some color back in his cheeks. Not today, buddy, I think to myself.

I leave the line wide open and patch the hospital. His rate is now in the 60's and I have a pressure of 100/50. We bring him into the cardiac room, and I walk out, sweaty, tired. But I won. I won it this time.

* * *

I slide the atropine boxes into the trash can and look at the man in black triumphantly.

He stares at me petulantly. "I win in the end!" He says. "I win! I always win in the end."

I give him the finger.

"Maybe so," I say, my voice strong and loud. "Maybe so, dipshit. But not today."

-MM

- Calling Dick Tracy! Come in, Tracy!

2007-08-29T00:34:00.000-05:00

We have been getting slammed all shift. We stop in at the Golden Arches in Lakeside, because hey, it's just my arteries clogging, nothing important, right?

I walk in and place my order.

"I CAN HAS CHEEZBURGER?"

The lady at the register eyes me as one might eye an annoying mosquito - or perhaps a tired looking EMT giving her lip and holding up her line.

"What?"

"Number 2, with cheese, plain, please. Coke to drink."

Take that, arteries.

Of course, we get a call right after we place our order. Dispatch can smell when something good happens to paramedics, and they don't like it. Think Narcan to a heroin addict. Yeah. That level of hate. Well, god bless the stalwart employees of this restaurant, because our food was ready in no time flat once they realized we had a call. So with cheezburger in hand we take off down the road.

The section of town we're in is infamous for violent crime and drugs. We arrive to the residence to find the fire department on scene holding a lady's arm up. It is wrapped in a large bandage. The lady looks familiar to me. They are sitting on the steps of a rundown home. I walk up and introduce myself. The Firefighter tells me it's deep and will definitely need stitches. When I ask the lady what happened. In a rapid narrative, she tells me "I was washing some dishes and there was a broken glass, uh I broke a glass. Last night. It, uh, I broke it and put the glass in my sink. And I was doing dishes, and I didn't see it. I cut it." She will not make eye contact with me.

It doesn't take a Mensa membership to figure out she might be lying. My partner takes over and I ask the cops if they've been inside. They say they haven't been past the living room, where the lady was sitting. I ask him to come with me. He humors me and we go in the front door. There is a large puddle of congealing blood. It trails in from the kitchen, but I see immediately that it doesn't trail from the sink. It trails from the hallway. Just to make sure, I check the sink - no broken glass. I check the trashcan - no broken glass. Something ain't right.

Gingerly, carefully, watching my every step, I follow the trail of blood into the bathroom. There, I find a larger pool of blood, and a small broken window. There is blood and bloody fingerprints all over. Hmm. Crime scene, I realize belatedly. Uh-oh. I carefully walk back out and tell the police officer what I've found. He calls it in and as I'm leaving I suddenly realize where I recognize the lady from - she's the Woo-Woo You-Hoo!

I walk back outside. "You used to live in Mosquito Bayou, didn't ya."

"Yes."

I kneel down. "Did you try to hurt yourself today?"

"Yes."

"Why?"

She looks up at me. "The rock. I can't handle it no mo'."

We bring her in. I tell the Doctor at the hospital what has happened. When I leave, she is getting stitches put in her wrist. I go over to her, and grab her hand, and tell her it will be ok.

* * *

A few months later, another crew returns to the residence. A female matching the description of our patient was found dead of an overdose.

-MM

-5000

2007-08-28T19:19:00.000-05:00

5000 pages visits? Holy crap. I didn't even know you guys were paying attention.

Revere, Massachusetts?

Congrats! In keeping with my giant stack of GI Joe Marvel comics, you win a No-Prize! Enjoy!

A Big shout out to PIXIE, for referring the visitor! Thanks!

Also please welcome NYC EMS to the blogroll!

I'm working on a post right now, expect to see it this evening!

-MM

- Sweat

2007-08-22T16:00:00.000-05:00

The man is cold and sweaty, lying on his floor in the kitchen, orange juice spread around my boots like a bizarre neon flood. He is unresponsive to me. I put him on the monitor

"I was here last week," says my partner. "It took G-Money four sticks to get a good line."

G-Money's IV skills are legendary. He has tubed countless victims.He has been a paramedic for 15 years and had precepted scores of paramedic students, most of whom now work solo on choppers and planes or are the EMS chiefs for local fire department. His bowel movement smell of roses. His touch heals the sick and infirm, and he's got a golden halo that spins above his company cap.

On the other hand, I'm a newly cleared paramedic with sticky orange juice boots who's only been on his own for a month, and who's friends admit he has self-confidence "issues." (actual quote.)

I leap, puma like, into action, barking orders. I order a CBG as I put my patient on the monitor and grab a pressure. It's lower than I like, but I can work with it.

"14." Says my partner, rummaging in our ALS bag.

"What? No, that's way too big. Give me an 18 or 20."

She smiles as she comes out of the bag with a tourniquet, a 20g IV catheter, an assembled amp of D50, a lock, and tape. "No. His sugar is 14."

"Oh. Ok."

I take a tourniquet to his arm and start looking for a vein. I note some scars on the arm that look surgical...something else is going on on this arm. I feel around. Something hard and plastic is under the skin. Crap. Shunt.

I wrap the tourniquet around his other arm. I can actually see bruises where G-Money was trying to get a line. This guy's veins are crap, and when I do a little test poke, roll away from me like all the girls I've ever asked out. I stick and miss an IV in his hand. I get another in his wrist that blows. I can feel panic rising inside me. "Glucagon," I tell my partner. "If I miss this one, we roll. I don't want to play around." I stick the Glook. If I can't get the stick soon, and the Glucagon doesn't take, I'm going to have to drill him, and I don't want to do that.

I rewrap the tourniquet higher up on his arm, shooting directly for his AC. I nail it! I beat G-Money!!! As I secure it I realize that our patient is too sweaty for our tape to stick. I ask for a kling wrap from one of the firefighters, who I don't recognize. He's new. Uh-oh.

I secure the IV best I can by drying off the skin and wiping it with and alcohol pad. I push in the D50. The firefighter has yet to find the kling and is now rearranging my ALS bag. Screw it. Just as I reach across to grab some more tape the patient starts moving his arms away from me. The IV, of course stays in my hand. Blood is now mixing with the orange juice on the floor, and I curse and wrap it up. Sweat is pouring from my head, into the mess on the floor.

Finally, the patient is starting to come around and wake up, and he's up enough to sit up and take some oral glutose. I get him loaded up and prepare to start looking for another site, my confidence bolstered by the fact that I managed to hit his crap veins twice already. I pop another IV in his AC and hang some D5. As we pull up his CBG reads 147.

When we arrive at the hospital, he is laughing and joking with us. I get him a sandwich. The nurse asks us if I want some OJ to go with it.

"Well, ok."

Although I have enough OJ in my pants now to provide breakfast refreshment for the Minnesota Viking's O-Line. Fabulous.

* * *
Due to staffing shortages, I am being assigned a brand new EMT-B next week on a permanent basis. Anyone have any tips or tricks for training someone new? Besides patience, and lots of it?

Also, a shout out to my man AD, who may have found him some lovin. We're rooting for you, big guy. And hey, Babs, you got a sister? ::wink wink::

Welcome Babs to the blogroll, everyone. She's a fine, upstanding southern lady nurse with a heart of gold and hair to match. Check 'er out!

-MM

EDIT: FIXED AMBULANCE DRIVER'S LINK...thanks Babs!

- Ejection

2007-08-16T09:27:00.000-05:00

Man that was a good game...wish I could've gotten a few more minutes of sleep. Well, at least I'll make it to work on time. If I'm late again they'll fire me. I can't believe that trooper gave me a ticket back there.

Where are my smokes? Fuck! Where'd they go? Oh...on the floorboard over there.

I think I can reach em....stretttchhh.....

***

"Well, shit. I'm out of ideas."

Best Partner Ever and I are gathered at the foot of the highway on ramp, with other representatives of the local first responder cadre: some BackWater Parish VFFs, a couple of Backwater Parish deputies, and a Trooper. The Trooper kicks his tire in disgust. He has just been denied clearance to halt traffic on the interstate long enough for us to sneak down the wrong way and come up the other side.

The problem is that along this stretch of Interstate there is nothing but water for seven miles - we are near the beginning of the bridge and the accident is somewhere in the middle - but the bridge is so narrow at a choke point over Bourbon River that the 18 wheelers, stopped in both lanes the whole way down the roadway to the accident, do not have room to pull off to either side. This time of night is prime driving time for truckers and they line the interstate the whole mile and a half to the crash site. Our ambulance will not squeeze between them. The night is too foggy to allow use of the choppers, and no one can tell us if traffic is getting through the accident site. If it isn't we can send up a unit from the other side of the bridge, in the wrong lane, to come and pick the patient up. And If it is going through, we can stop it. But to do that, we have to get on scene.

I look at BPE. He and I are thinking the same thing.

"OK," I state decisively. "We Hoof it. Troop, start trying to get those trucks out of the way so we can get the Rescue Rig up there if we need it."

We load everything we think we might need on the stretcher. I chunk the suction underneath the head.

The call had come in thirty minutes earlier. A pickup truck had strayed too far to the side of the interstate past Bourbon River, clipped the side at 70 miles an hour, and began flipping. Luckily, the truck did not flip over the guard rails into the swamps 30 feet below, but the driver wasn't wearing his seatbelt, and is thrown out of the front window at some point during the rotation. Luckily, since he was ejected and it seems no one else is in the car, we can afford to wait on the rescue rig. It's a gamble.

"You ready?" I ask BPE. I know right now he has to be regretting taking up smoking. I know that I'm regretting taking up cheeseburgers.

He shrugs. "Fuck it. Let's go."

We start jogging with the stretcher between us, up the incline of the Bourbon bridge. It's a good quarter mile up to the top, on an incline. At least we'll be OK coming down the other side, I reason. Let me tell you something, folks - there's a reason the treadmills have an Incline option. I'm feeling the burn. Drivers and Passengers that we're running by gasp as they realize who we are.

We are both sweating pretty well by the time we get to the top. People have suddenly realized that there is an emergency now, but can't still can't pull of to either side.

We crest and then start down the other side. Back at the bottom of the hill one of the VFFs has manged to get his metro in between a small gap. It's another quarter mile down the bridge, back onto the elevated interstate and I can finally see that traffic is stopped completely - the truck is lying diagonally across both lanes. I grab my cell phone and call dispatch, and tell them it's clear to send a unit up the other side.

We go maybe another half mile before we get to the crash. It is a mess. The patient is lying on his back, and an off duty deputy is holding c-spine. "He started breathing funny about 2 minutes ago." As he says this the patient lets out a great snoring respiration.

BPE and I've only been working together for 3 months, but we are like a well oiled machine. I slap a collar on the patient. Against the tops of my fingers, I can feel a massive head wound. I finish hooking the Velcro and open my hands as BPE tosses me a BVM. He readies his intubation equipment as I hook the BVM up to hi-flow and start bagging the patient. He has not breathed since the first snoring respiration on scene. I slide out of the way as he scopes the airway and looks in. He asks for pressure and I give it. He slides the tube in and gets no resistance. The ETCo2 shows us in. I slap pads on him and we have a bradycardic rhythm at 50, with a slight pulse. BPE does his trauma exam. We board the patient, BPE confirms good lung sounds. He feel some creptius on the ribs, but it's not interfering with anything yet.

All of a sudden there are flashing red lights and I see another crew pull up. They are from out of the service area. We load up and the out of town medic jumps in the back with BPE and they start working the guy. I get behind the wheel. We are thirty minutes out from the nearest hospital and 40 minutes out from the one that can take care of him the best. I hear the familiar CHUNK of the defibrillator. The patient has tach'd out on us. I slam the gas, leaving the out of town EMT to get all our gear. A supervisory unit is going to bring up our unit as soon as the traffic clears.

We bring the patient, who has started to move against our straps and headbed, into the ER. As we wheel him in I grab his hand and squeeze it, and tell him everything is going to be OK, that he's at the hospital. Faintly, he squeezes back.

Unusually, the state troopers have all of the patients information - he had been pulled over coming through Smokestack City for speeding, and the ticket was found on the floor inside the vehicle.

We hand off and go outside. In the unit there is blood everywhere. It takes the 3 of us an hour to clean everything.

* * *
We visit the patient about 3 weeks later. He is still in the ICU and has not come around. We ask to see him, but the staff will not let us. "The case is under litigation. The family is suing the state for inadequate response. That they refused to close traffic down."

I remember how angry the trooper was when he was denied his request to shut everything down.

Later, a doctor who realizes who we are tells us that he has a 1 percent chance of ever getting back normal neurological function. He had coded a few times and they think he might've had an anoxic event.

* * *
A year later I am in the lobby of small nursing home/hospital up in the northern part of the state. A nurse recognizes my name. "Did you transport my son?"

She tells me the details and the call comes rushing back to me. Apparently she remembered seeing my name on the run report they received.

We talk about the call. Apparently the dad was a lawyer and was really upset at what happened but then dropped the case when they received our run report with the details of the call.

My palms sweat around my coke as I ask her the question.

"Did he make it? The doctors didn't give him much of a chance, last I heard."

She smiles, and tells me to walk down the hall with her. She brings me into a room.

Our patient is lying in a bed. He looks at me.

"He can't talk, but he can understand everything you say. They said he's been slowly getting back some function."

I walk over to the patient and grab his hand and squeeze it.

He squeezes back.

-MM