Gardening in Meth Central

notes to self

2009-07-10T10:06:00.000-07:00

I am fairly sure I've mentioned in previous postings that it's generally a bad idea to run from the police. Especially the great big furry ones with doggy breath. I may not have mentioned Zito in particular, but his reputation does tend to precede him; the last bad guy he bit was wedged so far into something that only his face was showing; Zito got the attack command and latched onto the guy's jaw. . .took 81 stitches to fix him up. (actually, it took more than that. . .they just stopped counting at 81.) The current bad guy Zito bit had just sprayed his stepdad in the face with a blast of shotgun pellets and was heading for a toddler when the po po showed up. His teeth numbered higher than his IQ, and that's giving him the benefit of the doubt. After I struggled through the irrigation of his doggie tooth puncture wounds ("ooooohhhh, aaaaiiigh, what's that?" he would scream, poking his filthy finger into the hole I'd just finished cleaning and yanking out pieces of adipose tissue. ""Oooohhh, it hurts so effing bad!" and he'd yank his uncuffed arm away and flail his legs around.) I went outside and loved on Zito, good Zito, sweet great big puppy Zito.

note to self #1: don't run from the po-po. and carry doggie biscuits.

So later on in the day and we're working up a psych patient who, if you didn't know her, seemed fairly lucid. But by the end of her stay she's got the people on the other side of the curtain convinced that they've got brain tumors, aneurysms, and some sort of gangrenous disease that makes their blood float around the outside of their bones instead of living in the marrow where it belongs because she knows just enough medical terminology to be convincing to people who don't know the difference. She doesn't care if you listen to her; she'll start talking like she's got a motion sensor as soon as you walk in the room and she'll just keep talking until she's winds down, regardless of whether anyone's in the room or not.

note to self #2: any information gleaned through the curtain divider of an emergency room is highly suspect.

Just about lunch time and we get a chest pain patient. The guy is in fairly good spirits, points to his inferior sternum, laughs and says yesterday he went to his mom's and had some of the worst coffee ever, and he's been feeling this weird chest pressure ever since. He's 55, fairly active, smokes less than a pack a day but that's his only risk factor. I'm ready to slip a 20g single lumen in his arm when he goes on to say that he mowed his lawn after the terrible cup of coffee and had to quit half way through because he got so worn out. Initial EKG 12 lead says normal sinus rhythm, but I just have this feeling. . .so I trade out the 2o for an 18 and a dual port lock and go to refill my IV tray. 30 minutes later and it's almost break time when lab calls with an "OMFG" troponin, the charge nurse looks up at the monitor at the nurses' station, sees v-fib and says, "is that his real rhythm?" and the wife screams "HAAAAAEEEEELLLP!" out the door of the patient's room. We called a code, as you might imagine. Crazy, though- I've never seen a patient in vfib responsive. . .the guy was obviously alert but understandably panicked. . .the first time we shocked him into a unresponsive PEA; epi shot him back into a conscious torsades that kept slipping back into vfib so we shocked again. He'd look at me with terror and then go into hypoxic seizures. Doc pushed mag and amiodarone and we shocked him one more time back into a sinus rhythm. Repeat EKG showed remarkable ST elevation, as if we hadn't figured that out already. I started two more fatty IVs, talking to him the whole time; we got him calmed down and on the table for a balloon and stent. I went and saw him later and he grabbed my hand and called me his angel.

note to self #3: avoid mom's crappy coffee. Hire a landscaping company to mow the lawn. Pull the tarnished halo out of the coat closet.

and today's job security award goes to the 25 year old male who called from the ER room of the other hospital to see if he might get better "service" from our ER. Turns out he just wanted more narcs to ease the pain of constipation; he turned down the other ER doc's offer to digitally disimpact. He called our ER 5 different times before finally making it over; each time, our doctor informed him that, as our patient, he would get the medical screening due to him by law, but the other physician's work up and treatments and his recent past visits to both hospitals would be taken into consideration. The guy showed up anyway, got his medical screening, and was offered an enema. He declined.

note to self #4: you can't cure stupid.

firefighter girl steps up on the bitch box

2009-07-03T08:22:00.000-07:00

The ED is where the maimed, sick, injured and generally decrepit paramedics are put to pasture. At least, that's what I tell patients when they ask me. What I don't tell them is that we are also put in the ED for comic relief, manual labor and general ass-chewing from grouchy nurses. When I'm at work, my nametag says "everybody's bitch." I also don't tell them of the number of times we've saved some not so great RNs from making very bad decisions with their patient care, or that we've had numerous great nurses say that in critical situations they'd much rather have a medic than another nurse in the room, or that "where's my medic?" is one of the first things most doctors will yell upon entering a room and finding a patient in a bad way.

A decade ago, several nurses in the ED where I currently work took offense to the medics' scope of practice in the ED, and fought long and hard to limit it. At that time, the physicians' group petitioned to have control of the medics, but the hospital chose to take it on itself, and the "ED tech" job description was so vague that it left much room for interpretation, so you never knew, really, when you were going to get in trouble for something.

Two years ago, we got a new department manager, and he and I spent a lot of time rewriting the job description of the medics. Somewhere along the way, our little hospital was bought out by a nasty, terrible, horrible company, but things didn't change much in the day-to-day stuff. We continued to flesh out our job descriptions, and had several of the doctors volunteer to be our physician advisor. We were finally starting to feel like more than housekeeping with IV and CPR skills.

And then, a couple of months ago, we get a letter from the nasty, terrible, horrible company stating that ED techs in their hospitals (techs with the same number of years of training as RNs, mind you, with the same associates' degree and prerequisites, but with more clinical hours and more requirements for continuing education) are no longer able to cardiovert, pace, start EJs or IOs, remove sutures or staples, etc etc etc etc. We are, however, now able to digitally disimpact.

rock on.

oh, the shame and embarrassment

2009-04-28T07:03:00.000-07:00

I'm a very persistent, stubborn woman. Ask anyone. Especially ask the Rock Star, who actually thinks it's one of my more endearing qualities. So this past weekend was our last for snowboarding, and we headed up to the resort we went to back in February, on Valentines Day, the day I broke a few of my ribs on the left side at the sternum and at the bone/cartilage joint.

Apparently, I didn't do it well enough the first time, so I did it again. First run. It was icy, and I wasn't going nearly fast enough for the turn I wanted to take, and I took it anyway. Stupid of me. I knew it was going to be a hard hit, so I tried to tuck and roll, but I ended up landing on my right arm.

You EMS and medical folk, you know that sound that happens when you're doing good CPR. I heard that sound when I hit the ground. And it's kind of cool on somebody else, but it made me throw up in my mouth a little when I heard it coming from me. Or maybe that was just a normal reaction to the incredible flash of pain that jolted through my body as two of my bones snapped. I stayed very, very still for about thirty seconds, then stood up, assessed, and decided I could manage a few more runs. ("what?!" you say. . . I know, I know, but I was doing really well on improving my turns, and this was a huge group of friends I hadn't seen for a while, and it didn't hurt all that bad, and I'm a master [mistress? matron?] of denial, etc etc etc. . .)

I managed about four more lifts, one of which I rode clean from start to finish (yay me!!), then hit the bar for a much needed beverage and reassessment. I did try one time after the bar, but I was favoring and guarding so many different body parts that I ended up riding sloppy and decided it was quitting time.

After the Rock Star helped me get undressed, he tried to help me into bed. Bad idea. You've not truly experienced crepitus until you've felt it (and heard it, dear lord) on yourself. Even the unflappable Rock Star got a little pale.

It's a little embarrassing to admit that I broke both sides of my rib cage two months apart. And I don't want to hear any "maybe you should quit snowboarding"s, because it's something I love and something I'm actually starting to get better at. Feel free to suggest various forms of protection, however: so far, I've heard some real winners, including chest protectors from super cross racing; pillows, duct tape and baling wire; DDD boob job, and hockey gear. Personally, I think I'll stick with a calcium supplement and not falling anymore. And a lot of percocet and ibuprofen.

i'm such a softie

2009-04-09T09:33:00.000-07:00

I may not have mentioned any of this before.

Some time last year, oh, around October, I realized I have this really incredible insurance that I'm paying out the wachoo for every month. And MixMan already got his cochlear implant, and they paid all but around $300 of the $60,000 of that, so I started thinking that maybe I should be taking advantage of that spiffy, pay-out-the-wachoo insurance and get some stuff done. Particularly since you never know when my mouth is going to get away from me and get me fired.

So. Although little Firefighter Girl and Rock Star babies would be beyond cute and incredibly amazing, as far as babies go, after some brief discussion about the possibility of same and then some shared horrified looks between myself and Rock Star as that potential future loomed, and realizing that with Miss Diva turning 7 this summer I am only 11 years from freedom, and I'll be damned if I start over, I decided to get the tubes tied. And one of the reasons I decided, with Rock Star's input, to do that instead of him getting the old snip-snip (which he volunteered to do, and attempted, but because he is still young-ish and doesn't have kids of his own, his doc wouldn't refer him. Feh!) was because I also had really horrid varicose veins on the right leg, and apparently one of them was throwing clots. And you can't really get a doctor to take those out unless you promise you aren't going to get preggers again. So.

Tubal in October, laser ablation at the end of January.

Still had stitches in my right leg on valentine's day, when the Rock Star and I and a few of his friends went boarding. And- funny thing- I was really concerned about hurting my wrists, and even went so far as to check out some wrist guards that I ended up deciding were really pointless. But the wrists, as it turns out, weren't what I needed to worry about. So, second run down, I'm getting a little cocky because my turns are looking beautiful, and I make a turn from toe edge to heel edge and then catch just a little bit of ice on the slope, and suddenly I'm airborne, and then suddenly I'm not. I landed right smack in front of two 16 year old boys who, I notice, are wincing.

I won't kid you, I knocked the air out of myself, and I haven't done that since I was a kid and tried to polish my brother's chin-up bar while it was still mounted in the doorway. I finally rolled over and scooted to the side of the slope, where the Rock Star caught up to me and asked me some standard paramedic type questions. All I knew was that my whole chest hurt like hell, but I figured I'd just end up with bruised boobage. We headed up a different lift and by the time we made it to the top, I was having a hard time breathing because it hurt so bad, and every single turn, bump, and fall was excruciating. I am not proud to say, I yelled at the Rock Star. And his friend. And anyone else who would listen. And then I spent the rest of the time in the bar at the lodge, drinking and seething and hurting and generally feeling sorry for myself.

But it turns out, you see, that when I landed (on my mp3 player that was in my front pocket), I cracked ribs 6, 7, and 8 at the sternum, and then broke ribs 5 and 6 where the bone meets the costal cartilage right under my left breast. I could barely breathe for 2 weeks, and I would wake myself up in the middle of the night trying to roll over. Luckily, I'm mostly healed now.

All of this is a really, really long introduction to tell you that. . .I've gotten a little soft. I haven't run or worked out for months due to surgeries/pain/injuries, etc. And when I got on the scale on Monday, after realizing that my pants were feeling a little tight, I decided that was enough, by gum, and I'm going to become a Jillian Michaels convert.

That's right, people. Firefighter Girl is going to become a Shredhead. Thanks to Motherhood Uncensored for the inspiration.

prepare yourself for some righteous indignation, because I've been stewing in it all night

2009-03-06T05:14:00.000-08:00

The ambulance report: a 56 year old female, chief complaint is "generalized weakness and depression." We roll our eyes at each other, certain that we know what we'll see when the patient rolls through the door. And sure enough, it's a 56 year old woman with messy gray hair, in a dingy old bathrobe, smelling faintly of pee. And so I sigh, and follow the street medics into the room, and get a look at this woman's face, and my god.

You know in horror movies, when the hero and heroine come across the skeleton that's kind of half decomposed? you know, with the skin so taut across the skull, bones jutting out everywhere? That was this lady's face. And I'm listening to the medic tell about her medical history--none, except for cancer in her humerus decades ago, and a history of mild, unmedicated depression, and trying to fit that in with the way her face looks. And then he mentions the bilateral pitting edema in her lower legs.

Sure enough, it looks like all the weight from her face and upper body slipped down into her lower legs. And then she starts telling us how she's been depressed, and so she went to a psychiatrist two weeks ago, and was so weak she couldn't make it out of the car, so he came down from his office to the car (how kind, you're thinking, but no, keep listening) and crouched down beside the passenger side and scribbled a few scrips--two for antidepressants, one for a benzo since, in this psychiatrist's opinion, the weakness was not a physical but a psychological issue, and, regardless of the fact that her face looked like a skull upholstered in jaundiced leather, she was obviously suffering from anxiety that prevented her from leaving the car. Uh huh.

So the nurse and I keep asking her questions, and we find out that for the last two months she's had to use diapers and a commode, and although she eats the same amount of food as she always did, she's lost over half her body weight. She's afebrile, she denies pain. Just too weak to get around on her own anymore, she says. I help slip the bathrobe off, and suddenly there's this horrific smell. The bedsore smell. Except it's coming from her chest, and the dark green flannel nightgown she has on is saturated with what appears to be blood and pus. So I peel that off, gingerly, and find that what she has on one side of her chest is an enormous bloody and oozing hole where one breast used to be, and a dried, brownish flaking mass that still kind of resembles a nipple on the other side. Her WBC came back at 34, in case you were wondering.

Yeah. 34.

That is what breast cancer looks like, people. And yes, she should have sought help sooner--she didn't because she was disgusted and embarrassed, and her husband was so respectful of her and her wishes that he didn't insist. I doubt she would have told us about that gaping wound if we hadn't found it. But that psychiatrist, a medically trained professional, saw her edemetous legs and did nothing. Nothing, except throw prescriptions at her like candy.

Isn't it funny--and I want to slap myself for this--but when I've thought about breast cancer before, it's always the survivors who've had mastectomies and stand tall and proud that I think about--you know, the ones who look like Amazon warrior women who cut off their breasts so they could shoot an arrow straight and true. And maybe that's a good thing, that I think about these survivors as strong and fierce. But among women in the US, breast cancer is the most common cancer and the second-most common cause of cancer death after lung cancer. Women in the US have a 1 in 8 lifetime chance of developing invasive breast cancer and a 1 in 35 chance of breast cancer causing their death. So for every 34 Amazon warriors, there's 1 woman in a hospital bed with a rotting breast.

I will never, ever forget the way that looked.

raccoon love

2009-01-27T12:47:00.000-08:00

Let me share with you the absolutely exquisite sound that woke me from a deep, lovely sleep long before the buttcrack of dawn.

I startled at the noise, because it sounded like it was coming from under my bed. Initially I thought it was a dying cat- god help me- but when I opened the door to my bedroom, I saw both my big white toms, Jem and Scout, sitting there, staring at me, looking rather concerned. Apparently the noise woke them up, too.

As I listened, though, I realized it sounded less like a feline and more like a. . . like a. . .like a giant hamster in a fight with one of those aliens from the movie "Signs," you know, with the clicking and the whirring noises. So yes, a giant hamster vs an alien, under my house. At 0230. And then- oh yes, my friends, this story gets better- the pipes started rattling, and various detritus that collects in the crawl space beneath any old house started flying around down there as the hamster/alien thing rolled crazily around, nattering and clicking and yowling away. I could hear the dog in the apartment upstairs pacing, the noise was so worrisome.

If I were brave, and it were less cold outside, and a little more light, I might have stuck a hose under the house and turned it on full jet. But it was very cold, and very dark, and I was not feeling very brave at all, and did not feel prepared to deal with anything that might come screeching out at me. So I stomped up and down on the floor, and then got down on my hands and knees right next to the crawlspace trap door in my closet, and shouted in my meanest, angriest voice, "knock it off!" which had no effect whatsoever on the giant alien hamster still crashing into pipes and such, but which caused the cats great consternation.

So I got back into bed and lay there with a pillow around my ears until the giant clicky shrieky hamster thingie made its way outside, and I peeked out the door and saw what appeared to be a large, fuzzy ball that could very well have been the alien hamster I'd imagined in my head that eventually stopped making noise and turned into two raccoon butts sauntering away from me.

Raccoons mating. If you've never been blessed with the sound, consider yourself very, very lucky. I'm going to have nightmares for days.

firefighter girl turns in her bunkers for good. . .maybe

2009-01-03T08:18:00.000-08:00

Once I got off of night shift last summer, I spent so much time lounging in the sun getting rid of my night shift pallor that I got out of the habit of writing on the computer. And frankly, I was spending way too much time in front of the screen, anyway.

So, let me get a refill on my coffee--there--and brush the biscotti crumbs off the keyboard, and I'll try to start where I left off ages ago.

MixMan is doing amazingly well with his implant. Watching him learn to hear is truly remarkable, but it's funny how quickly it becomes commonplace; now he's learned to ignore his parents when they're talking to him just like any other 8 year old boy does. And, unfortunately, he's picking up on (and using!) some tones and inflections (you know, that certain sigh of bored, put-upon youth that is accompanied by an eye roll) that he was not previously privy to from his classmates. But his teachers say that he is beginning to open up and initiate conversations with them and with other students without his interpreter present.

Miss Diva has enjoyed having a brother as opposed to someone she must act as interpreter for; the two of them love having a back yard to tromp around in, and they go on nature scavenger hunts, and they've developed an interest in all things spy. Her Diva-ness is losing some of her girly-girlness, but she still loves the color pink, and in fact has all-pink days quite frequently. She's waaaay ahead of everybody in her class on reading and socializing. And she comes up with the most stunning observations sometimes. I love tucking her in at night, when she looks at me and says, "Mama, I think tomorrow I'm going to have a sensitive day." and I know exactly what she means.

Recently, a box arrived in the mail for MixMan, and shortly after, one arrived for Miss Diva, too. Having been forewarned as to the contents, I hid the boxes in the closet for a while, because I knew that my days of limited peace and quiet would be over. The boxes contained a trumpet for MixMan and a recorder and fife for Miss Diva, courtesy of my brother. (When I told The Rock Star about this, he squeaked, "Egad! Does he hate you?" and "egad" is hard to squeak, let me tell you. But no, I informed him, my family just has a strange way of showing affection.) MixMan played that trumpet until he had a blister on his lip; he slept with it, he tucked it in and made me kiss it goodnight. Now things have calmed down a bit, my headache is gone, and we're discussing lessons.

Meanwhile, across town, a new hospital was opening, which made for some big changes at the small hospital I work at. Like how none of us are sure that we'll have a job by next year. And I'd been thinking about my profession a lot lately, anyway; how the only paramedic positions around here are in ERs and on fire departments, how the ER job was supposed to be until my injury healed and I could get on to a fire department, but how because of my injury I'll never be able to hoist hose effectively again. So, after much discussion with the honey, and a lot of soul searching, I decided to go back to school again to become a licensed massage therapist. It's a very portable profession, and I want to eventually focus on hospice care. I've seen a lot of death in the last few years, and some people go with such dignity and grace, it's an honor to be a part of that, even when I'm fighting so hard against it, pushing drugs, defibrillating, doing CPR. I want to help ease terminally ill patients into that place of grace and acceptance, and massage therapy is one way I can do so. Plus, like I said, I can do it anywhere. So I started school fall term; it should take me about a year to finish up. The honey's getting me a massage table, but I think that's because he's sick of lying on the floor for his massages.

Since my new hours weren't quite making the rent, I took a second job at a new urgent care clinic the docs from my ER opened up. And just in time, because I was informed last month that my position in the ER is being eliminated. Luckily, I have senority, so when the dust settles I'll have a job again. But for now I'm stuck in an office, learning more about hospital policies and JCAHO national patient safety goals, etc than I ever, ever wanted to learn.

I don't know what the next year will bring. I know I don't feel terribly maternal most of the time, and figure the kids are probably better off with benevolent neglect instead of active parenting from me; as long as they know I love them, I think they'll do okay. And sometimes, it's all I can do to show them that. It is so hard doing this alone. So hard. Thank goodness I have sisters and a great mom who help me with parenting advice. As long as I've got that and a what-will-become-of-me bed with lots of pillows and a cushy down duvet I can hide under, I think I'll mostly be okay.

So. That's the news from Meth Central. Happy holidays to all of you!

mixman's bionic ear

2008-08-21T08:39:00.001-07:00

So, after almost a year of discussion and work and preparation and trips to the BigCity LittlePeople Hospital for tests and meetings and appointments, MixMan got his Cochlear Implant yesterday. He says now he can feel the bump behind his ear, and things are kinda itchy. They fired it up to make sure the device wasn't faulty, and said they got great nerve response. So on September 2nd, they'll turn it on and do the initial mapping, and we'll see if it works. The patient is doing fine, although is rather disappointed that his stylish head bandage is white instead of black, which would be infinitely more cool. He's very excited, though, about his robot ear. So now we call him RoboMan.

one in each kneecap

2008-08-11T09:03:00.000-07:00

I am a very, very lucky girl that I have so many good, kind men in my life. I say that because I am starting to understand how women become man-haters; if I didn't have the boys I have to balance the assholes, I could very well be a man-hater myself. In the last year, I have been raped; cornered in the stock room of the ER by a co-worker I trusted (who shoved his tongue down my throat and his hand up my shirt); and groped and come onto by several patients who seem to think that the ER is a great place to pick up girls.

All of them had in common the inability to hear the word "no." Repeatedly. And, due to the red-headed temper I had as a kiddo, I was raised to talk things out, leave a situation before it gets violent and confrontational, count to ten before shouting, be cautious. Of course, my parents assumed I'd remain in a fairly sheltered Mormon existence. Little did they know. And unfortunately, in the last year, in all of these situations, my skills set has come up sorely lacking.

I have been angry, and sad, and so ashamed since last summer; ashamed that I couldn't talk my way out of a situation I was in completely by accident because all my fail-safes had fallen through. Over the last few months, I've started lifting again, and I have a heavy bag I beat the shit out of on a regular basis, and my cardio is better than it ever has been. But I am still sad, and angry, and have felt so powerless. And over and over again, I have wondered how it is possible for someone to be so disrespectful that they would disregard the wishes and free will of another person and violate not just that person's body but their soul.

People who know me will tell you that I might be cranky fairly often, but I rarely get really pissed off. Sometime last Wednesday, in the five minutes between finding a man on my patio watching me through my curtains and the moment when I lost my temper and threw myself out the door after him because he wouldn't leave, I became a person, a woman, capable of killing another human being.

But I'm pretty sure I'd rather just maim.

somebody explain to me all the assholes in the world

2008-08-07T08:50:00.001-07:00

So last night, I'm lying in bed, reading a book, as I'm wont to do. I have the sliding glass door in my room open a little to let in a breeze, and I'm half in/half out of the covers and half in/half out of sleep. I hear a noise on the side patio, and I'm assuming it's a raccoon-- they like to tip over my plants-- so I get up to scare him off. I push the curtains aside, go to open the door a little more, and right there, I mean right there, is some guy sitting in one of my patio chairs that he's moved right up against the glass.

My first thought, as you can imagine, is "wtf?" because this is not a scene my mind can quite wrap around.

My second thought is "thank god I don't sleep naked."

And then I start getting a tad angry, and the adrenaline starts up. And I look at him (he hasn't even moved, but he's watching me) and I say, "what the f--- are you doing on my patio? Get out of my yard."

And he starts talking to me, apologizes, tells me he hopped the fence and he's just waiting for his friend and his back pack and blah blah blah and he's so sorry if he frightened me.

And I'm shaking my head, trying to get the sleep out of it, and things start coming a little more clear. Like the fact that my fence is not easily hoppable in any direction. And that I didn't hear the chair move at all, so he's probably been sitting there for quite a while. And that he's still there, staring at me, and I'm getting really sick of men who don't know me assuming that because they find me attractive that it is their right to tell me so, or watch me, or grope me, even when I tell them no.

I tell him again, "get the f--- off my porch, and don't let the gate hit you on the way out." And he apologizes again, says he'll give me some weed to smoke if I want. And he's still standing there, and he looks me up and down, and says,

"Hey, you've got that sexy librarian thing going."

I'm afraid I temporarily lost my mind. The wise thing to do, of course, would have been to close the door and call the cops. I didn't do the wise thing. I got very, very angry, and that adrenaline was really pumping, and I threw open the sliding glass door and lunged out, all 5 feet 5 inches and 130 pounds of me, and yelled "get the f--- off my porch or I will beat the living shit out of you!!"

He ran through the gate (he knew exactly where it was) to his car parked in front of my house, started it up and took off. And I sat down very fast and laughed.

and then I cried, and called the cops.

I woke up this morning and saw that he'd been watching me before I went to bed, too. The chaise lounge on the back porch is turned so that it looks directly in the dining room window at the table, where I sit and write every night before bed.

I was just starting to feel safe again, you know?

But you should have seen his face when I came out at him.

cliff surfing and more proof that i'm regressing

2008-08-04T08:07:00.000-07:00

This is the full version of the carefully censored story I told my mother the other day.

On a recent camping trip, me and the Rock Star and a few others went mountain biking on a 14 mile trail (real mountain biking, like on the side of a mountain, with a steep drop down one side, straight into a river that stupid people ride in big rafts). anyway, about a third of the way in, we'd pulled aside up against the cliff face to let some other bikers pass going the other way; one of their back tires nicked my back tire, my bike tipped, and I slipped over the side. (Yes, you read that right, I fell off a bike that was not moving.) Frankly, I thought I was going to go all the way to the river, but I caught myself about 10 feet down. I'm very bruised- everyone at work is joking that Rock Star beats me, and I reply that no, he just throws me off mountains. I'm guessing the fall was rather spectacular to watch, judging by the look on his ordinarily deadpan face. And the fact that I regrouped before he did, which is difficult to do when you're picking shrubbery out of your hair, your heart is trying to jump past your uvula, and your limbs are so rubbery that sitting and contemplating the scenery seems like a really, really good idea for oh, an hour or so.

I did get a fairly remarkable gash in my leg and a couple of sprained fingers. Luckily, we had a pretty extensive medic bag back at camp (that's what happens when you go camping with a bunch of firefighter/medics with foresight and a lot of beer), so after things clotted up, we finished the ride and then I washed up in the river and poured down some liquid courage and we steri-stripped me. I've included a picture for your viewing enjoyment. That would be my right thigh. A week post-incident. It's going to be a big scar.

I don't recommend cliff sliding, though. I darn near wet myself.

a very brief recounting of the worst day ever

2008-07-26T09:04:00.000-07:00

Grief, I think, is the most difficult part of our job. It's not the code blues (or 99s, or whatever your particular agency or hospital calls it when a patient crumps and dies, maybe right in front of you, maybe not), because in a code situation, training takes over, and it's much easier to think of the person in front of you whose chest cartilage you are cracking with every compression as a collection of skin and bones and cells and systems that all need to work together in order to keep a body alive. And so you try to pretend that what you're doing is to save a life, which might actually be the case, but more likely you are just keeping those organs alive on the off-chance that the person you are doing cpr on is an organ donor, or maybe you're pushing drugs and pumping someone's heart and slipping on a slick of vomit on the floor for just long enough that the person's family can get to the room and say goodbye to what they still think of as a person, but who you can tell is really just a corpse.

I hate doing cpr in front of family members. I hate the after, when I'm soaked in sweat, face flushed, trying to keep the mess on my scrubs to myself, when the family comes up to me, crying, and thanks me for all I've done, and hugs me hard. I didn't do a damn thing- there's your wife/mother/sister laying on that gurney, still dead from the abdominal aortic aneurysm she had that we didn't know about until she started vomiting and then her stomach blew up like a balloon, right in front of us. I hate watching that numb and silent grief that I can't do anything about, slicking up the fingers of another dead woman with KY jelly to slip her wedding ring off to give to her mute husband, the one she'd been married to for four decades. He asked for her toe ring, too, so I pulled the blanket back and revealed bright coral colored nail polish, so incongruous on the 68 year old foot.

I can handle the dead, the dying. It's the living that stay behind that I don't know how to deal with, the ones for whom the death is such a surprise. I didn't know your mother. I didn't know your wife, or sister, except maybe to start their IV or help lift them from the ambulance and get them hooked up to our equipment, continuing a steady stream of conversation to help them feel more comfortable. And I am so sorry that what I did couldn't save them for you, even though I did everything that I could. There is nothing, absolutely nothing that I can say to the grieving to ease their loss. All I can do is mop up the shit and vomit, tuck a clean sheet around the body, pull off the gold tokens of a life together, and hand them to you before I walk out the door to sit on the back stoop and cry.

on the menu: beer and tissues

2008-07-25T22:05:00.000-07:00

Today was the worst day ever. Ever.

it's my magnetic personality

2008-07-10T22:29:00.000-07:00

some of you may have heard about my previous experiences with certain monitoring equipment on the ambulance and in the ER. Well. RevMedic, you'll get a kick out of this. . .I can hear you laughing all the way down the I-5 corridor.

my new position is in the fast track section of Meth Central Med Center's ER. Better hours for a single mom (I get off work while it's still light outside!), plus I'm not tempted to do things that might get me in trouble, like

brief digression:

pushing D50 on a combative diabetic patient with a CBG of 33 who is brought in by medics after causing a rather large wreck on the freeway that sends 4 other people to the trauma center and the diabetic patient to our little ER with no IV, which I manage to get, and then without thinking, grab that big fat syringe sitting bedside on the tray, and when I'm halfway through the IV push realize that while I am certified by the state I live in to paralyze patients in the field I am not allowed to push farging sugar water in the ER. Whoopsie.

end of digression

anyway. ahem. So now I work three beds with one monitor to do intake and discharge vitals on 20-30 patients a shift. I am not rough on my equipment; I treat it with respect. I don't throw it around or stomp on it or dunk it in saline. Noooooo. However, the nurse I work with informed me tonight, after replacing the SPO2 sensor for the third time this week, that I was no longer allowed to touch the damn thing.

by the way- the Zoll is back. Took them 2 months to fix it.

karma in action

2008-07-10T21:54:00.000-07:00

if, by chance, you happen to be Meth County's eminent and most sought after car thief, and you have, in the last few months, focused much of your attention on the vehicles in the Meth Central Med Center's parking lot, and many of the vehicles you have stolen or broken into belong to Meth Central Med Center's employees, and you decide to get stabbed by a butcher knife while mumble mumble mumble mumble (the details are still a little unclear here), and the stab wound goes into your abdomen, through your liver, through your diaphragm, and into your lung, and the person who stabs you feels some remorse (and perhaps the long arm of the law tightening around their neck) and decides to dump you in the ambulance bay of an ER, where you proceed to bleed all over the asphalt and screech loudly enough to wake the dead, or at least the security guard, you may not want to be carrying your lock-picking set or threaten the caregivers attending you that they better make sure you don't die. Better yet, you may want to gently inform your assailant that the ER on the other side of town may be preferable for future stab and dumps. The compassion index might be a tad higher.

Maybe.

stop me if you've heard this one. . .

2008-05-15T07:25:00.000-07:00

South County ambulance arrives with a female patient who "hurts all over." Patient has been evaluated (not to her satisfaction) at the two other hospitals in the area, and so has decided to make the trip- by ambulance- to Meth Central. Patient is tearful and has a lot to say about her previous hospital experiences. Nurse Zee starts the assessment while I hook the patient up, half listening to what she's saying.

"that other hospital, the doctor was so rude. He didn't listen to anything I had to say, and -oooowwwww I am in so much pain- and he was brusque and could have been a poster child for that book "How Doctors Think." And the nurse, oh my goodness. She just sat there and looked over the tops of her glasses at me and blew bubbles with her bubble gum. The nerve. What is this world coming to? Ooooohhhh, it hurts!"

I freeze with the tympanic thermometer half way to the patient's ear and shove my gum to the little niche between my cheek and upper teeth so that I won't be tempted to chomp or, heaven forbid, blow bubbles. Zee looks over the tops of her glasses and sticks out her tongue at me.

Ahem.

it is just sooo difficult to be heard over the voices in a schizophrenic's head

2008-05-02T07:24:00.000-07:00

This is weekend is the last for my new hobby, ie tempting fate by sliding down steep mountains on my face, er um snowboard.

I started running again. Not away from anything, just running because I love doing it and it's good for me blah blah. I managed a mile run and a mile walked without my lungs hurting last week- that's the first time since I had pneumonia last october; it took me a half hour, and I used to run 4 miles in 30 minutes, but hey, baby steps. I also started lifting my little 5 lb weights to try to strengthen my upper body since PT wasn't doing much for my bad shoulder. I was pretty proud of myself, finally getting some muscle tone back in my arms, and when I told Rock Star, who has been body building for a decade, he said, "oh, so that means you'll be a little more of a challenge when we wrestle?"

Dude. They're five pound weights.

catfight in the ER

2008-04-28T08:48:00.000-07:00

There are very few patients who push my buttons. In fact, I'm the one that the nurses come to when they have a patient they don't want to deal with. So when one of my favorite nurses (she refers to me and herself as "the alpha bitches," which from her is a compliment) snagged my arm at the nurses' station and started telling me about the patient she'd just brought back, I kinda rolled my eyes.

"firefighter girl, she's 17, diabetic, states she's had high sugars for a week and a half and is now convinced she's DKA. She refuses to put on a gown, has a leopard print blanket and a red heart teddy bear, and claims she's a hard stick. p.s., the woman with her is her mother, but don't expect her to say a damn word."

Alpha Bitch leans close and grips my arms hard enough to leave bruises. "good luck."

Piece of cake.

I grab the IV tray, and if I coulda set it twirling on top of my index finger, I would have- my game was that good, baby. I love patients who are "tough sticks." Especially the ones who think they know my job better than I do.

I walked in to see the princess sitting criss-cross applesauce (we used to call it Indian style) on her gynie bed throne in a private room. Mom stood anxiously at the foot of the bed. Amazingly, as soon as I entered the room, the princess started Kussmauling. I leaned in a little closer and sniffed for that sweetish ketone scent a true DKAer would have, but all I could smell was the pungent odor of bullshit. I looked at her, sat down on my rolling stool, and started preparing the IV goods.

"Just so you know, I'm a tough stick. You're only going to get me from here up, and even then you'll have a hard time," she says, gesturing to her antecubitals. "It always takes them four or five times to get me. At least." She glared at me triumphantly, then resumed her Kussmauling.

I recommended that she calm her breathing down before her hands got all numb and tingly and stuff. Her eyes narrowed. I started asking my standard questions, things that I ask every diabetic patient: how high have your sugars been, for how long, what are they normally, have you been sick, do you take your insulin regularly, etc etc etc, blah blah blah. Princess stops her hyperventilating long enough to take a deep breath in order to deliver a speech she's hoping will scorch my eyebrows off.

"I. Am. A. Brittle. Diabetic. When I am sick or stressed my sugars go way up. We'd all do a lot better if you'd just shut up and quit judging me and start paying attention to what I'm saying. Understand?"

It makes me blink a little. I try to cover up my guffaw with a cough. I explain to her that these are questions I ask every diabetic, I've never met her before, I haven't read her chart, I'm here to start an IV and draw some blood. I am being very, very nice and oh-so-polite. And as patient as god, I might add; my mother would be so proud. She sighs and flips her hair. I ask for her arm, and wrap the tourniquet. I dutifully check her ACs- nothing doing- and then, lo and behold. . .

a beautiful vein goes POP in her right hand. And another one springs to attention in her wrist. And so I reach for the swab. . .and she yanks her hand away.

"Excuse me. We just went over this. You're not getting any vein down there; they roll. And while you screw around with that and miss, you're wasting precious time that you could be using to start an IV where I tell you so I can get the medication I need."

I'm afraid I may have started losing my patience. I give her the standard "I will take your suggestions into consideration, but I do this all the time and I will start an IV in the place I feel is best. Please allow me to do my job" speech. I reach for her hand, swab at that gorgeous, bouncy blue vein, and she yanks her hand away again.

"If you aren't going to listen to me, you aren't going to start my IV. Go get somebody else."

I unwrapped the tourniquet and said, "fine, honey. I'll go see if I can find somebody to help you. We're awfully busy, though, so it may be awhile." and I smiled at her, left the room, and went into the store room to kick some boxes. It was that, or pull her hair and scratch her face with my nonexistent fingernails.

I decided to ask the one male nurse on shift if he could fit in the IV. I had a feeling the princess would prefer a guy, anyway. And I told my young, buff medic student to hang around and soften her up a bit, too. Male nurse said his rooms were all full, but he'd get to the princess when he could. I thanked him, asked if there was anything I could help him with, offered to wipe his patients' butts because that would be far preferable to dealing with the brat. . .er, princess. . .again. He laughed. I warned him I would be getting the better end of things. Pun intended.

As I walked by the room, I noticed the brat's mom hovering outside her door. I mentioned that I had someone coming in, but it would be a while before he could get there. She said, "you know, she's such a hard stick, it would probably be best to get the IV team in here to do it."

I smiled at her. "Ma'am? I am the IV team."

Medic pay in the ER? not much to write home about
The incredibly self-satisfied feeling I got, watching her jaw drop and her mouth open and close like a fishy while she attempted to stammer an apology for her spoiled rotten daughter? priceless.

fyi: if my daughter ever, ever treats anyone like that, she will be flogged and bound and forced to watch reruns of . . . of. . . Barney until she gets control of her lip. I cannot imagine treating anyone as poorly as that 17 year old girl treated every single person entering her room with the sole intention of helping her. And I wasn't the only one kicking boxes in the stock room last night.

how to pay karmically out the ass for your next 15 lives

2008-04-25T10:27:00.001-07:00

be an arsonist, and decide to light the lovingly rebuilt, restored, revamped Lincoln Continental of a tattooed paramedic/firefighter nicknamed. . .well, nicknamed the name of a guy you probably wouldn't want to mess with, who happens to be good friends with most of the cops in Meth Central. Oh, and pay no attention to the Maltese Cross on the back window, the one that says "american association of firefighters." Yeah. Good luck. Have a nice life.

mini update

2008-04-25T08:49:00.000-07:00

1) we picked the implant we liked, and MixMan's surgery date is June 25th.

2) BSUYAM told me the position is mine and approved the schedule we made. (can i get a whoa! and a hell yeah!)

3) The hair pet problem seems to be under control. Although the stench of rosemary and tea tree oils with a light note of neem rolls out of our house in waves when you open the front door.

a few of my favorite things

2008-04-24T07:43:00.000-07:00

working night shift does crappy things to your brain. It messes with your emotions and your mental health, especially if you aren't getting any sleep for three of the several days you work because you happen to be a mom, too, and kids don't understand night shift. But that is neither here nor there, it just is what it is. I used to be such a cheerful, happy person, fairly compassionate, and then I got pneumonia at the end of october, and was in bed for two weeks, and by the time I got back to work- still sick, mind you- I realized that most of the people in the emergency room as patients were less ill than I was. And that made me a little bit pissy.

Anyway, I decided this morning that I need an attitude adjustment, and the best way I know how to do that is to make a list of all the things I love, and all the things I'm thankful for. So here it is. . .my freaking joy list:

my bed, with its cushy top and down comforter; the color combination of pink and green, tulips and daffodils, ranunculus and windflowers; my son's toothy grin, lying in bed with movies, books, and a notebook, poetry penned on napkins and restaurant coasters, found poetry, colors so gorgeous and vivid I want to pop out my eyeballs and soak them in it, rainbows after a violent storm, the warmth of my lover next to me in winter, lying naked in front of a fireplace, pears and cheese with wine, the perfect pair of jeans, or failing that, the near-perfect pair of jeans, Jembosaults, my daughter's uncensored laughter, the way an iv feels going into a vein just right, coffee so strong and thick a spoon stands up in it, realizing that you can live without a certain someone but you'd really rather not, sitting under a tree on a blanket in the summertime, sundresses and sunhats in the garden, flip flops, toe rings, chokers, piercings, tattoos, LuLu Guinness glasses, grippy toes, bare feet, hot tubs, hiking, camping, snowboarding, views that take my breath away, my mama's hugs, spending time with my family, how loose and lovely my body gets after 15 hard minutes on the treadmill, dancing away all my give-a-shit, strong bass I can feel in my bones, listening to my deaf son sing, any music with real soul, books I can get lost in, home- not necessarily the place you live, but a place that feels so right you don't want to leave, wet kitty noses, the smell of old books in leather bindings, art almost as old and grand as god- the Sistine Chapel, the statue of David, you know what I mean-, mud between my toes, my children's safety, good friends who love me unconditionally, recovering from a Sylvia Plath moment, redheaded sisters, geminis, astrology, handwritten letters, love letters, getting flowers, gifts that show somebody's listening, affection, public displays of affection, mail slots, running my hands over the Rock Star's shaved head, the crinkles at the corners of his eyes, lips so soft I want to suck them off, holding babies (and then giving them back!), hot showers, lavender plants, rose oil, necklaces, clothes I can change with my mood, secrets, massages, interior design, getting down to the nitty gritty in a relationship and really knowing the soul of someone else, fuzzy socks, text messaging, all the Lou Whos, fingerpainting, love and being loved, trust, and last but not least, R E S P E C T.

what you never, ever want to hear your sweet five year old say

2008-04-22T19:20:00.000-07:00

"Mama. Isobel said that Elena had lice. I love Elena. What are lice?"

tonight, we're washing everything. Everything.

it was a really close shave

2008-04-22T04:36:00.000-07:00

patient comes via ambulance with vague abdominal complaints. Doc goes to do a quick stool occult. Suddenly, from behind the curtain, we hear this:

"well, son, you've got somethin' shoved up there!"

I hastily cleared a private room.

a gentle reminder: never do anything you can't explain to the paramedics. or the ER staff.

i like throwing myself off mountains

2008-04-21T07:28:00.000-07:00

Even though I'm having a really hard time moving today.

this is a thing called hope, and it's on the horizon

2008-04-19T08:50:00.000-07:00

MixMan and Miss Diva woke me up this morning at 0730. They'd been up for an hour already (why is it that during the week I have to drag them out of bed at 0700, but on the weekends they're raring to go all bright and shiny? I need my blasted beauty sleep.) They're downstairs, watching Saturday morning cartoons in their pajamas, MixMan with his cochlear implant brochures tucked under his arm. I'm upstairs in the work room, studying a couple of canvases, some emails, and contemplating another pot of coffee.

A friend of mine and I were discussing some rather personal things last night. I may have mentioned in a previous post or two that night shift has made me a little crazy, and I'm finding my Bell Jar moments are becoming more frequent; so much so that at least one of my friends is starting to refer to me as Miss Sylvia. But I was trying to figure out how it was that I became so impenetrable to emotion. And it's not that I don't feel it, I do. And I honestly feel like I show it a lot, too. . . but that's apparently not the case. During ACLS classes, a couple of the veteran night shift nurses were talking about how tough the testing used to be, how they'd throw up before "mega-codes." And I said, "me, too! I hate testing, I get so nervous I can't breathe." And one of them looked at me, and said, "yeah, right, FFG. Whatever. Nothing gets to you." And I've had ex-boyfriends tell me that they get so petrified of doing anything wrong because if they do, they get "the look" that makes them feel like they just killed someone's puppy. And yes, that's a quote.

When did that happen? What jacked up bull crap kind of coping mechanism is this, that pushes everyone away when I need them the most? Sheesh. Night shift and lack of sleep certainly haven't helped. In this profession, too, it's necessary to maintain a very delicate balance of compassion and cynicism, and frankly, the compassion index is usually a little low. But (Blow-Sunshine-Up-Your-Ass)istant Manager posted two new medic positions for noon to 2200, and when I mentioned that I was interested, he told me to go ahead and make my schedule. So I handed it over to Rock Star, because he's better at these things than I am. And he came up with a schedule that gives us lots of time together, and time with the kids, and time for sleep and real life. (isn't he amazing? I think so.) Now to pass it by BSUYAM. . . keep your fingers crossed for me. And that light you see at the end of the tunnel? I'm running as fast as I can toward it.

overheard. . .

2008-04-17T17:55:00.000-07:00

from the front seat, while driving children home from school

my five year old, dainty, blonde-haired pink-clad Miss Diva: "MixMan!! Pull my finger!!" with the usual result and great belly laughs ensuing.

in the break room at work

the blow-sunshine-up-your-ass new assistant manager of our ED, speaking to one of the docs:
"hell, no, I'm not having any more children. I just inherited 37 of them when I got this job."

sometimes, dreams come true

2008-04-17T13:49:00.000-07:00

three months ago, MixMan was telling me about his dreams, which he likes to do. Usually, they involve a great deal of running and shooting and 'splosions and magic power jewels and all things Sonic the Hedgehog. But this particular time, he looked at me and said, "Mama, in my dreams, I can hear, and I don't have to sign."

the next day, I started gathering up referrals and getting everything in order to determine his eligibility for a cochlear implant.

so on Tuesday, we went up to Big City Hospital. Before we were even out of town, MixMan's daddy started complaining about my car and my music and my driving. He said I drive like a grandma.

whatever.

Anyway, I told him to shut up or he could walk. He shut up.

Once we got up there, MixMan went through a battery of audiological tests. He stayed focused and worked so hard, and it turns out that his hearing loss is in the profound range (which I knew, but he's so sneaky and smart and hated the hearing tests so much that we never could confirm it). In any case, he's definitely eligible for the cochlear implant, and we spoke with the surgeon, and picked out the model that we like, and we'll be scheduling the surgery for some time this summer. The audiologists and the surgeon are all very very hopeful and optimistic about MixMan's potential with this-- he's had such dedicated speech therapy since he was 10 months old that in addition to being able to hear normally at 20db with the ci (instead of the 50db he hears at a whisper with hearing aids, and to put that in context, a normal conversation takes place at 35-40db- which means MixMan is very good at lip reading), his voice tone will also most likely improve. They did say that because of the profound hearing loss, he is eligible for bilateral implants, but most people we've spoken with recommend unilateral with the hearing aid in the other ear, at least for a while. The ci also comes with little attachments for an ipod or mp3 player, so MixMan can listen to music instead of just the thump of the bass.

MixMan is so excited. and so am I.

this is a new one, even for me

2008-04-14T04:23:00.001-07:00

so yeah, streetlights go out when I walk under them, and when I worked with him, RevMedic jokingly called me his little EMP because of how many pulse ox sensors would just stop working when I touched them.

This is what showed up on the Zoll I use most often when I turned it on to cardiovert a patient today. It took a second to register what I was seeing. No, I haven't tampered with the picture at all. And nothing any of us tried would make it go back to normal.

This has me a little worried.

why i am drinking an alcoholic beverage at 0430. . .again

2008-04-13T04:41:00.000-07:00

really, I don't ordinarily make a habit of drinking when I get off work. . .there's something that doesn't seem quite right about having a beer half an hour before a lot of normal people wake up for the day. but sometimes, there just isn't enough mentholatum in the world to shove up your nose to keep the bad smells out. I think we went through our entire backstock of Fleet enemas tonight. It's been a dookie kind of week.

Question: If you are a stupid person, and you are running from the po-po because you a) wrecked a car, b)were driving while intoxicated, c) have warrants out, or d) took something that wasn't yours, and they chase you (because they always do) and they happen to let the K9 out of the car (which they always will), why is it that you must always end up in a thicket of blackberries?

a word to the wise- never run from the cops. Especially the ones with cold, wet noses. Their bite is worse than their bark. And all those scratches from blackberry thorns? Insult to injury. And it's going to hurt like hell when i clean them out.

p.s. when you come in to the ER at 0300 with really non-specific 10 out of 10 pain that magically migrates from lumbar region to sacrum to abdomen, with strangely point tender spots in random places, and you are weeping and wailing while the person on bed 2 is being told that they have a mass on their brain and the person on bed 9 has a heart rate of 179, and the doctor is kind enough to give you a prepack of Ativan to help you sleep, and you throw it at the 30 year veteran charge nurse and tell her that Ativan just doesn't work for you, and she tells you to get out before she calls security, don't be surprised when she calls security and they escort you to the lobby to await a taxi the unit secretary was kind enough to call for you. And when you decide to yell and scream at the admit secretary, and lunge across the desk and grab her arm, don't be surprised when she calls the police with the little button located under her desk. And really, really don't be surprised when they show up code 3, tasers at the ready. And if you happen to look up and see firefighter girl and 5 meth central firefighter/medics watching and ready to fight over who gets to pull out the taser prongs, well, understand that it's nothing personal. Really.

why i am drinking an alcoholic beverage at 0430

2008-04-12T04:32:00.000-07:00

because last night, the patient in bed 11 had breath that smelled exactly the same as the (digitally removed) poo of the patient in bed 10.

and those were two of my first patients.

it didn't get any better in the 12 hours I was there.

p.s. no, you don't get a numbing shot before you get your iv. this is the ER! and if you 1) know that such numbing even exists and 2) ask for it and then bitch at me when I tell you "no," chances are, you are not having an emergency.

got my coccyx spanked by a mountain

2008-04-10T07:26:00.000-07:00

Apparently, after 5 months together, I've moved up to the next level of Rock Star. I know a couple of his friends, just because he and I work in the same place, and I've met another one in passing, but this week, the Rock Star invited me on an overnight snowboarding trip. He said he wasn't quite sure who else would be going. So when we got to the meeting place, imagine my surprise when his three best friends walked out of the kitchen. Without their wives/girlfriends/significant others. Dear lord. I looked around for an escape route; the Rock Star was blocking my only exit. He leaned close and said, "just so you know, they're not going to cut you any slack."

I can handle it. Bring it on.

The drive to the mountain was a tad uncomfortable, little ole me packed in a biiiig chevy pickup with four rather manly men. Haven't felt that way since sitting in an engine on the way to a fire, and that's been a while. The testosterone was almost overwhelming. But a couple of nudges and reassuring smiles from the Rock Star, and I settled in. When we got to the resort town of HighFalutin' we dumped our stuff and headed out for "a beer" and some food.

Waking up the next morning hurt a little bit, but once I got my land legs under me, I was fine. Ahem. Really.

We got to the mountain, the Rock Star got me signed up for rentals and a lesson, and then the boys took off. I sat in the cafe and waited for my head to stop throbbing.

The lesson didn't go well. I guess I'm not much of a student, so it's not necessarily the teacher's fault. Just tell me how not to die on a snowboard, and I'll figure out the rest for myself- I don't need a bunch of coddling. And the bunny hill is a crappy place to try and learn. By the end of the lesson, the teacher was frustrated and I was almost in tears.

After a brief pow-wow over nachos and a pitcher, the boys decided it was time for me to have a real lesson. Rock Star asked if I might like to come to the top of the run they'd been doing. Half way up the lift, with the ground very, very far away, I asked how the hell he'd managed to talk me into this. He just smiled, and hugged me, and his best friend said, "you're just as crazy as he is. . .that's why the two of you get along so well. You'll be fine."

I'm not sure what that's supposed to mean.

Too bad that was the last run of the day. It is so much easier to learn with four no-BS teachers and room to ride, and I had an absolute blast, even after sliding down the steeper parts on my face. It may be a while before I can sit down comfortably again, however.

Oh, and judging by the hugs and "you have no idea how nice it is to finally meet you"s, I think I passed this level of Rock Star. And that makes me pleased as punch.

does not play well with others

2008-04-07T19:45:00.001-07:00

do you think it says something that the one question I missed on the ACLS written exam was the one about teamwork and instructive communication?

hmmm.

p.s. I run with scissors, too. sort of. Do trauma shears count?

boredom is a chronic disease

2008-04-06T11:29:00.000-07:00

I really should be cleaning the house. There's a whole list of stuff I need to do this weekend while the kids are gone, but I mostly find myself staring at my computer screen or blankly off into space. Sometimes I come out of it long enough to dab at the drool collecting in the corner of my open mouth with my shirt sleeve.

Night shift is getting to me.

Spent Friday with MixMan getting a CT scan and then fighting with the MRI tech about what test he was doing. . .he insisted on a full brain scan: 40 minutes in the imager with an IV for contrast for an 8 year old OCD deaf kid afraid of needles? HA! and I tried to tell him this wasn't for a diagnostic, it was specifically for the surgeon to be able to see the inner auditory canal, or IAC, for placement of the cochlear implant. I pointed that out to him on the order sheet from MixMan's PCP: "MRI IAC." and this is what he said:

"I've done brain MRI's on lots of deaf people. And I'm sure many of them have gone on to have cochlear implants."

Whaaaat?

Had a pretty good stretch at work this last weekend. Several drunks with head injuries, shocker there, eh? One of them apparently slipped on some peanuts at the Roadhouse and smacked her head on a table. Medics brought her in, she kept insisting she had a right to refuse treatment because of her religion, paganism. umm. okay. She loved the boys, though- the security guard, the CT tech, the 60 year old male nurse. Oh, yes. But anytime one of us girls would walk by her room, she'd yank the pressure bandage off her head, wave her arms around, scream, threaten to sue, and then start spurting blood in wide arcs from the little arteries she'd sliced open in her scalp. When we finally sedated her enough to suture, I had to hold a flashlight above the lac so the doc could sew, since our portable light in the psych room wasn't good enough. With the flashlight, and the blood everywhere, I kept thinking I heard choppers and the theme music to MASH playing somewhere outside the room.

My favorite patient was the LOL who came in from a nursing home, hx of CVA with right sided deficits, with sudden unexplained weakness in her left arm. CPHSS was normal otherwise. Staff said she was somewhat unresponsive and not her usual self. Excuse me, but if I'm not working, I'm usually somewhat unresponsive at 0300, too. Sheeesssh. But she's all dressed up, hat on at a jaunty angle, mardi gras beads around her neck, and I asked her if she got all gussied up just to come to the hospital. "Nope," she says. "I always dress like this." I find this rather curious, ask her what jammies she wears to bed. "I don't wear jammies. I like to be ready."

I'm a little confused by now, and I'm pulling off her hat, and glasses, and beads, and fuzzy sweater, and button up shirt, and tank top, and thinking of all the possibilities of what she could be ready for, this little old lady from a nursing home. So finally, I ask. And she says, "whatever might happen!! you never know when somebody is going to ask you to go dancing."

Well. She has a point.

sooooo. . .you may have noticed something different

2008-04-04T22:33:00.001-07:00

yeah, I changed the name. Since I can't really play in traffic anymore, and I spend the time I'm not at work puttering around at home instead of dinking around in the back of an ambulance or running into burning buildings, and while a lot of my posts are about Meth Central Med Center ER, many have been about home and gardening and single parenting and MixMan and Miss Diva, so I thought perhaps it was time for something a little different. But. . .a rose by any other name still smells as sweet. So remember that the next time I'm writing about patient vomit and such.

there we were, in the congo

2008-04-03T04:53:00.000-07:00

humans are not meant to be awake in the middle of the night. I look at some of the hard core ER nurses who have worked night shift for thirty years, and frankly, I don't ever want to be like that.

The docs have started a new schedule rotation so they can maintain a little consistency. This entails working the same shift for a month. There are a couple of doctors I'm not all that fond of, but they're completely different people at night. Particularly after the fourth or fifth shift, when they start getting a little punchy. Doc D, who on days is rather serious and nitpicky, and likes to micromanage, has scolded me on more than one occasion, but the other night, as I was headed into the fray with the IV tray, one of our critical patients with an Na of 108 started moaning and yipping. (those electrolytes. . .) Doc D looked at me, waggled his eyebrows, and said in his best gather 'round the campfire voice, "there we were, in the congo. . ." and the nurses' station erupted with laughter. Except for the charge nurse, who is one of those previously mentioned hard core thirty year ER night shifters. She doesn't much laugh at anything.

but tonight rounded off my last of 6 in a row, so now I've got a few days free. That makes for a happy firefighter girl. New tattoo tomorrow, an ACLS recert on Monday, snowboarding on Tuesday with the Rock Star, and the fact that the sun has been out for three straight days in a row makes me even happier. Besides, you just know, when you've hardly had any sleep because the kids need you, and you're heading into a 12 hour shift and you're so tired you can barely get the straw from your Starbucks lite honey frappuccino into your mouth as you walk down the hall for report, and the nurse stops you and says there's a junkie on bed 10 who desperately needs an IV and everybody else has already tried their two times and you put your coffee down and you walk in the room and you smack your head on the monitor so hard you see stars and you still manage to get the EJ on the first try. . .then, you just know that life is good.

2008-03-04T09:45:00.000-08:00

hey, Monkey Girl? I have that cold, too. I begged a doctor the other night to puncture my sinuses with a 14g since the holes at the bottom of my nose aren't quite doing the trick. Note to patients: when we give you a mask? wear it. I don't care how "uncomfortable" you think it is. If you don't wear it, you may find yourself getting sneezed on while I'm starting your IV because I can't let go of the catheter to grab a tissue or you'll bleed all over the floor, and we can't have that, now, can we?

Right now in the Meth Central Med Center ER, we all sound like lounge singers. we're gonna install a baby grand at the nurses' station, get sequins and bling for our green scrubs, and wear stiletto Danskos. Whaddaya think?

the (Grateful) Dead had it right. . .sort of

2008-03-03T19:56:00.000-08:00

so i've had a few medic students in the ER doing their clinicals lately, and it's made me a tad introspective. I had a couple of them tell me they passed first term at the head of the class because of me, and that makes me feel weird but good, especially since my first preceptor during my own internship two years ago told me I needed to pick a different profession. Bitch. (whoopsie, was that my outside voice?) Hell, I still get excited when I get to put in a 16g IV or shock somebody, but mostly that's because it reminds me I'm a real medic instead of housekeeping with IV skills. But watching a medic student shake with nervousness while putting in an IV or starting a saline drip, and seeing them getting excited about some broken bone they saw in an x-ray makes me a bit nostalgic, and since the honey is in Tahoe and I'm taking a little break from practicing Guitar Hero on the PS3 he left with me, and I've had a couple of beers, well, I thought I'd take a little trip down memory lane.

It's amazing to think how far I've come. Five years ago, when I first brought up the idea of being a paramedic with Miss Diva's dad (who I was still married to at the time), he told me about all the gnarly things I'd see. And maybe I got a little woozy when I had blood drawn, and I'd have to sit down fast when I started thinking about broken bones and needles. But I had a feeling that it was what I was being called to do, and the feeling didn't go away. In fact, it intensified over the next year, and I finally started the process by becoming an EMT Basic and volunteering with a local rural fire department.

My first real fire was a fully involved structure fire with a fatality. That was also, aside from funerals, the first dead body I'd ever seen. When we found her body the next day, what was left of her consisted of a head, hair intact, a flannel shirt-clad torso, and a pair of feet. The coroner used a small body bag and rested her feet on her chest before zipping it. I remember going home and sitting on my couch, the sound of traffic and shouting and my neighbors fading into the background under a strange buzzing in my head. To this day, I cannot open a box containing a Resusci-Annie CPR dummy without thinking of that woman, because that's exactly what she looked like.

The next body I saw was a woman a year older than I who drowned while rafting the McKenzie. I'd never seen pupils fixed and dilated, never seen flesh that pale blue hypoxic color. Now, of course, I'd recognize it anywhere.

Once I got past the mental block that blood is mythical and mysterious, once I got used to the metallic tang of it fresh and the sickly sweet smell of it after it had been spilled for a while, once I'd inured myself to the weight and temperature and feel of dead flesh and the crack of ribs separating from sternum during good CPR, once the smell of death no longer got to me, I managed just fine, and I'm pretty sure I've become an okay medic.

so yeah, it's harder if I look at their faces, and definitely harder if they crump in front of me. The only patient I ever lost in the field? Her daughter lives across the street from me, and every time I see her I feel a rush of shame, although there was nothing I could have done.

The babies, the ones my age, the ones that come in talking, those are the ones that keep me awake occasionally. Do I do more good than harm? Hard to tell sometimes. So maybe I spend most of my time now with other people who understand what I do for work, who aren't grossed out when I talk about boob smegma and projectile vomit and patients who shit out their mouths, and who can see the humor in being groped by a dead man. I still feel called to this profession, and I don't know really where I'm going to go from here, since the dream of being a medic/firefighter is over thanks to that one patient whose life I did save tearing my biceps tendon while I tried to wrestle him to the ground. My life has been saved more times than I can count by the patients I've cared for, the ones with grace and dignity and moxie. It's been a long, strange trip, and the compassionometer has fluctuated wildly from zero to overflowing. I would still rather feel too much than nothing at all, and so if I cry while I'm doing CPR or hugging the mother of a 3 year old Downs Syndrome girl just diagnosed with leukemia, well, that's just me, and you can look away or leave if it bothers you. And maybe I don't save a life every day, and I get a little jaded when it comes to migraines and chronic pain. But I am so thankful to be a part of this, and it is so hard to imagine doing anything else.

dancing for ekg geeks

2008-02-17T13:30:00.001-08:00

http://www.youtube.com/watch?v=BhGGzB09wQk

you will wet your pants laughing

random musings of the mildly emotionally dispossessed

2008-02-10T17:02:00.000-08:00

Mom's here visiting. She got a little worried last week when I called her bawling incoherently, crying so hard my eyelids were swollen shut, which made it difficult to drive, quite frankly. But I had just been at the home improvement store, and there was no school, and my paychecks aren't quite covering the living expenses, and night shift makes me crazy, and the kids were at each others' throats, and the lady at the home improvement store ran up and started freaking out about them playing around the big hanging rolls of carpet. So they climbed out, and MixMan started talking to me while I was talking to the lady about vinyl tile, and he's losing more hearing, and so doesn't really know when his voice gets loud, and I was trying to sign to him while talking to her, and she looked at me and said, "I can't even hear myself think." and I apologized, pointed out that MixMan is deaf, that he doesn't know how loud he's being. And she shakes her head, and glares at MixMan, and says, "I can't hear myself think to talk!!"And I guess I kind of lost it, because I said, "he's deaf, deal with it. I live it, bitch." I've never done that before in my life, called somebody i don't know a bitch.
Anyway, Mom flew over here two days later. She's kind of like me, wants to be present even if she can't really do anything. And she's as stubborn as I am. So. She's here until Wednesday, and the kids are loving it. . .all this personal attention from grandma, and I get to lounge on the what-will-become-of-me bed in my pink and green bedroom.
So I'm sitting here, listening to Sia, and keeping an ear peeled for trouble in paradise downstairs since my mom is at church and is not currently around to play peacekeeper. Mostly what I'm doing is thinking about what it means to be a parent, and a lover, and a friend, and how to balance all of those things into something that feeds the heart and soul.
I frequently think that my children are much better off with me being benignly neglectful than actively parenting. . . and I wonder how many years of therapy they're both going to have to go through because of how short my temper is with them sometimes. But they are so very forgiving, aren't they? I could learn a lot from them.
We lose sight of the fact that really, all we're here for is to relate and love and communicate with other people. What could possibly be more important than to know and be known, to open yourself up to someone else? Anything that prevents that is an excuse, and I am guilty of making those excuses myself. . . opening yourself up to the possibility of being loved, why the hell does that make us all so afraid?
I sit here, and I paint, and I listen to my music, and I drink my coffee. Sometimes I cry, sometimes one of my kids comes in and gives me a hug and a little kiss on the cheek. Occasionally, I rock back on my heels, hug my legs, rest my chin on my knees, and wonder how we all became so fragile and broken.

a first time for everything

2008-01-29T09:02:00.000-08:00

RevMedic's been giving me a tough time about the whole not posting for a couple of months thing. He can do that, though, because he's the sixth god of EMS, and he can stomach my chewy coffee when others only politely choke it down. So for him, I'll make an effort to post more often. Besides, when you have a story like this one, you have to share it.

So last night, I hadn't even been at work for an hour when a truck vrooms up to the ambulance bay and stops. The driver saunters into the waiting room and informs the triage nurse that his friend in the truck isn't breathing. He doesn't seem terribly concerned about this. She asks, to clarify, "your friend is having trouble breathing?" no, the man reiterates, he's NOT breathing. At all.

Oh.

As we pull the man out of the truck, the bizarre story unfolds. The patient had been at a friend's house out in the boonies and had collapsed. The friend had loaded him into a car and driven (rather erratically, as you can imagine) not to the hospital; oh, noooooo. To another friend's house, twenty minutes away, but also in the boonies. When I say boonies, I mean boonies. As in the northwest version of Deliverance country, where the tattoo to teeth ratio is very high, and where every single-wide trailer. . .er, um. . .home. . .has its own still out in the back yard, not for selling, but for personal consumption. But. . .I digress. So that second friend loaded the (pulseless, apneic) man into his truck, and drove the 40 minutes to the Meth Central ER doors.
By this time, the guy has been dead for well over an hour, if the friend can be believed. But because the patient is young, and he died under somewhat suspicious circumstances, and the friend's IQ is about the same as the GCS of a rock, the doctor decides he wants to work the code. We cut the man's clothes, start ventilating, get the crash cart at bedside. I start CPR. We see what looks like a very fine v-fib, a shockable rhythm, on the monitor, so we charge and clear. One of the nurses drops the arm she's putting an iv in. We all step back and the doc gives the order to shock. The guy lurches- nothing abnormal there- but that loose arm swings up with the shock and smacks me in the ass.

Imagine my surprise.

maybe a six on the grody scale

2007-11-11T12:33:00.000-08:00

My first day back to work was halloween, and thank goodness it was slow. I'm still not 100%, but I got my sense of humor back yesterday (didn't really realize it was gone until one of the doctors looked at me and said, "you're feeling better, arent you?") It's nice to work in a hospital; I take patient admits to the floor and then turn on the portable oxygen tank on the way back down to the ER, suck some O's until I have to go back to work again. The nurses laugh at me, but they're also very careful to make sure I'm not pushing myself. Awww, isn't that sweet?

Meth Central Med Center is now a fully operational cardiac hospital. We've had our emergency cath lab open for a couple of months, and we've had a few emergency caths in that time, but my first one was last week. It was the night I was wearing new shoes, which you may not give a hoot about, but it's an important part of the story. Those of you in EMS already know what that means.

So it's about 15 minutes before my break, and we all know what happens when firefighter girl gets hungry. Well, we don't all know, but RevMedic, you can fill them in. It's not pretty. Medics call in with code 3 traffic. Their patient is a 69 year old male who crumped and did a face plant at the dinner table right into his pasta salad. Heart rate initially 20, they have him externally paced at a rate of 70, on a non-rebreather mask and an assload of versed. All other vital signs are within normal limits.

We get the guy on our table, I get him on the monitor, move the oxygen to our wall outlet, etc. etc. One of the nurses grabs me by the shoulder and hisses in my ear, "I can't get our defibrillator to pace him! Make it work!" so I sigh, and connect the our zoll to the pads already on the patient. I look up, see one of the medics watching the exchange. We try not to laugh, because this is a serious situation.

The 12-lead EKG shows some stellar ST elevation; highest I've ever seen. Dr. Twitchy is in rare form tonight, and his 3 espressos and 4 diet cokes were obviously not enough caffeine. He's going by the cath alert check list instead of his normally well-working brain, and the nurses and I wait impatiently for his orders. He ticks off the cath alert sheet-- nitro drip dopamine drip heparin drip oxygen-- and asks if the patient has had aspirin since entering the hospital. We all stare at him in disbelief, then stare at our mostly non-responsive patient, who still has pasta salad stuck in his ear, and moans occasionally with the jolt of the pacer. There is no way that man is chewing up and swallowing anything.

I try to draw blood with the third IV I start. You can tell the patient smokes- the blood is dark and thick and hard to draw, even through an 18g catheter. Lab tries drawing on the other side. We finally end up with maybe 20 mL, and as I'm pushing it into the tubes, I notice the floaties in it- little chunks of what look like butter.

I am not kidding you.

Let's remember, this is a cath alert, and the man is having a heart attack. Lest we forget, a heart attack happens when the vessels in the heart become clogged with blood clots or plaque-- stuff very similar to the chunkies sitting in the test tube in front of me. This guy is maybe 5' 10" and weighs approximately 165 lbs. He is not a large man. Although his oxygen saturation is 99%, his skin is still grayish. This concerns us until his wife walks in. She looks a lot like him, down to the gray skin. She also reeks like cigarette smoke. We're starting to have a really good feeling about the success of our impending heart catheter placement.

We get the guy onto the cath lab table. The cath nurse asks my charge nurse if I can stay to help, and that's pretty cool because I've only ever seen one of these from the outside. We get him all hooked up and they're swabbing him with iodine in his nether regions and he starts shivering a little so we cover him with a blanket and I've got all the lines and pumps untangled and running and the oxygen is ready to transfer from the gurney to the wall and I reach to hand the tubing to the cath nurse and the guy hangs his head over the side of the table and starts puking into his mask which I yank off his face so he doesn't aspirate and they're grabbing suction and he pukes again

all over my new work shoes. And my scrub pants. And the floor, and the cords and tubing and everything else. There is a moment of silence, when all you can hear is the plop plop of the puke dripping off the table. And then the guy's top dentures slip out of his mouth and clatter on the floor, and the tech behind the glass- the only member of the room not currently coated in regurgitated rotini pasta salad- tries very hard not to laugh.

on a completely different note: remember John, from the last post? We got a letter letting us know that much of his bone and tissue was used in transplants. And I wish I could tell the people who got his stuff about John's last three hours.

levaquin dreams

2007-11-01T16:24:00.000-07:00

Got called into the director of Human Resources office yesterday to discuss the traveler nurse and his traveling hands. I made the mistake of telling the assistant manager of the ER two weeks ago, and he was actually really cool about it. But then he told the manager, who called me into his office for another meeting. I came away from that one feeling like shit. He kept insisting that I must be suffering some ill effects from the incident. I just stared at him, told him I wasn't sleeping, but I'd get over it if everyone would just leave me alone about it. I work in the ER, for chrissakes. You have to be able to let go of things, or you'll go crazy. He finally threw up his hands and told me to talk to HR, which I put off until yesterday.
We do that more often than we think, at least those of us who are emotionally and mentally healthy. Letting go, I mean. There is a resiliency in the human spirit that we don't think of very often, but I see it almost every day. I watch patients and their families adjust to news they never thought they'd have to face. . .the smart ones, the ones who will make it, take it in stride; they let go of the whole life they had planned and open themselves to whatever it is that's been thrown at them. Sure, there's some shock involved-- "yes, ma'am, you've just been diagnosed with a very large tumor in your liver" takes some getting used to--but you can almost see the shift in their minds as they adjust and move on, and face whatever it is they need to face.
I see it in the dying, too, although resiliency becomes grace at that stage. I know that certain things take on almost mystical properties when my emotional armor gets left at home, when I'm over-tired or under stress, like I have been because of the traveler nurse issue. But we had a code a couple of weeks ago that shook me, and everyone else in the room, in the three hours the patient was there.
I'll call him John. He was 46 years old, found down by his sister and mother. No history of drug use, this guy was clean. Medics almost tubed him but he came around, and was conscious by the time he came into the ER. I sat with him, started his IV, drew his blood, cleaned the vomit from his face and neck, smiled at him, talked to him, reassured him. He looked so scared, and I told him everything was going to be okay. He nodded, and smiled, and I squeezed his hand before I left the room. His mom waited outside the room to hear the prognosis of her only son.
Next time I passed the room, they were pulling out the defibrillation pads, and John was seizing. As I was wrapping my brain around that, one of the nurses in the room screamed for me, the doctor started shouting for an NG tube and suction, and all hell broke loose. John's heart rate was over 200 bpm. We cracked the crash cart and the nurse went to push drugs, and we realized that John had sweated his IV right out. I started another on the left arm, then another on the right. And then his heart stopped.
The doctor ordered CPR started, and one of the nurses began. I shoved him aside and started compressions, screaming for a stool to stand on. Once I could get leverage, I discovered something: the chest of a 46 year old man is much different than the chest of an 80 year old man. And ribs break a lot harder and a lot louder. I could feel them pop with every compression.
We got pulses back, and then a pressure. John's left pupil was blown. We all sighed, and looked at each other, and stepped back from the bedside, shaking. The doc shook his head and ordered for the air ambulance to take John to OHSU in Portland for definitive neuro care. I left the room and headed to start a couple more IVs.
Ten minutes later, he flatlined again. His mother still sat stoically outside the room. Turns out she'd lost one of her two daughters two weeks before; her other daughter, the one who had been closest to John, was racing to the hospital from out of town. John's mom just sat, and waited. We explained what we were doing, the care John was receiving, the fact that his prognosis wasn't good. She nodded, said she'd just wait for her daughter to come.
I did CPR on John two more times before he finally died for good. The doctor called the code twice-- the first time, we had a spontaneous return of pulses before the monitor was turned off. But this is where grace in the dying comes in:
John laid there, tubes in every orifice, vomit in the creases of his neck, bedding soaked with sweat, ribs broken, wires everywhere, brain dead but heart still beating. He waited there, until his sister came, and that was truly one of the most beautiful things I've ever experienced-- watching that woman kiss her brother's face, rub his shaved head, tell him how much she loved him, told him he could go. And then he did, and nothing we did could bring him back that third and final time.
By the end of the three hour code, even the doctor was crying. Say what you will, but the human spirit is resilient. And some people who haven't amounted to much in life leave that life with an enormous amount of grace. And I am honored to be part of a leaving that is so graceful, even when I fight so hard against it.

new moan ya

2007-11-01T16:23:00.000-07:00

yep. some little tiny bug in my right lung. And today is the first day I've been able to hold my head up for longer than 2 minutes at a time. I don't really feel sick at all, just incredibly weak. I've been in bed pretty much since I got off work a week ago Tuesday morning, although I have attempted the bedroom to bathroom route once or twice, and I did manage a 24 hour change of scenery by exchanging my walls for someone else's this past weekend.
On Friday, after giving me a 2cc shot in the ass and a bag full of Levaquin, the doctor informed me that I'll be 100% in six fucking weeks.
Okay, he didn't say fucking.

another lesson or two

2007-11-01T16:21:00.000-07:00

If you're looking for levity, you probably shouldn't read this post. I've been trying to write this for a week, now, and make it funny or sarcastic or witty. . .but I start it, and everything that comes out sounds so unlike my usual self that I get disgusted and cancel the whole thing. And even now, I've taken it down, and put it back up, and changed it and messed with it and I start to think that maybe I shouldn't leave it up here for all my friends to read. . .like I have something to be ashamed of. And that's just wrong. I need to be able to tell this. The thing is. . .I can't sleep lately. And yeah, I could blame it on my funky work schedule (even though I've been on a crazy schedule for the past 4 years. . .), or loneliness (umm. . .doubtful. . .I love sleeping alone--or used to. . .) or all my injuries or too much coffee or dry air or noisy neighbors or insert other excuse here. But I know that none of those are the reasons why.
I've worked really, really hard to become the person that I am, and I've lost a lot along the way, but I'm generally happy and content, even if my life isn't so-called normal. I'm a very private person, I like being alone, and it takes a lot to get to know me. I don't let many people get close to me, and the people I've dated in the past would be hard pressed to tell you much about me, and honestly, I'm skittish about relationships. But. . .I like my life, and I love my home and my kids and my art and poetry and writing and plants and books.
A month ago, a traveler nurse I considered a friend developed traveling hands and a traveling tongue a couple of nights before transferring to his next assignment. He's married, and has a bunch of kids, and he trapped me in the stock room and seemed a little shocked when I shoved him away. And two nights later, on the last night he worked, at the end of my shift, when I told him that he creeped me out with the kissing and the groping, he apologized, asked if he could make it up to me, and tried to do the same thing again. Which is when I ran out the back door of the break room and called for the friend who was waiting outside. There is more to this story, of course--how this brought up feelings for me from an incident last summer; how I blew it off when I was telling friends about the nurse because I didn't want them to think I wasn't strong, or that I'd somehow asked for it; how afraid I was the full twelve hour shift I worked with him that last night, and how nothing got stocked in the ER because I didn't want to chance getting cornered again, all the things he said to me the first time in the stock room and then on the last night before I ran away.
You wouldn't think that one person could take away something so integral to who you are. But that's exactly what happened: someone took away a piece of the person that I am. It is amazing that something so simple can strip so much away from somebody-- although of course I've still got my self-respect, and my independence--I've worked too hard to let anyone take those away from me. But I can't sleep. And I haven't written or painted or read a book in the last two weeks. I stay awake and restless until my eyes can't stay open anymore and then I fall into bed.
We are all so very fragile, with so many walls we think are solid and indestructable. I've built a few myself, and maintained them carefully, not letting anyone get too close. I'm not sure what the lesson is in all of this, but I'm finding something cathartic in the telling of it. . .and I guess I'm realizing that right now, I could let this experience and the fear it caused close me off again, just when my heart is starting to open up for the first time in a long while. Or I can use that energy to tear down the remaining walls I have built around me. . .because as much as it hurts, I would rather feel too much than nothing at all.

some things I learned last week

2007-10-19T15:11:00.001-07:00

a couple of nifty EKG rhythm tricks from some other cardiac nerds, firsthand knowledge of caffeine toxicity, a punch in the chest really can start a flatlined heart beating again, and- of utmost importance- shoving vicks vaporub up your nose too many times in one night may indeed keep the dookie odor out and clear the sinuses, but it can also make your nose bleed.

save a life

2007-09-26T09:18:00.000-07:00

The days I forget my armor are the worst. . .when the dregs of humanity
fill the waiting room coated with a slick of dirt and sweat and desperation,
the running joke of “save a life today?” plays out every time I start an IV
for a migraine or a toothache and the junkies line up to have their abscesses drained
without pain medication because even if I could find a vein, anything the doctors could give them isn’t nearly as strong as the heroin they injected with their dirty needles. I don’t
expect to walk into a room after a particularly bad drainage, blood and pus all over
the floor, scrawny junkie whimpering on the bed, and feel anything but the usual
businesslike disgust of caring for yet another slow suicide.
But I surprise myself, and I start crying. Not terribly good patient care, I
suppose, but there you go. And as I finish taping the gauze over the hole
in his flesh, the junkie grabs my wrist with his other hand and says “thank you”
and promises to get clean. I look him straight in the eye, tell him he's lying, dare him
to prove me wrong
Guess it doesn’t matter what he said after that, because a week or a month
or a year from now, it’ll be his body on the gurney the medics bring in,
CPR in progress, his eyes fixed and staring, code called after five minutes of
definitive care in the hospital.
My friend Luke wrote me last night from work: “One of my patients just passed. . .what
a strange job we have. . .time goes so fast you know and there is just no way
to go back. . .sometimes I wonder what the hell I am doing. . .am I leaving
the world better than I found it. . .”
And I remember, again, “did you save a life today?” and the code we had
last week, 76 year old guy in town to celebrate his 50th wedding anniversary with
his family. . . I did compressions for 10 minutes, sweat pouring down my face and back, while the doctor pushed every possible drug and the man’s wife waited in a wheelchair
in the lobby
I looked at his face. . .what was I thinking, I never do that, dangerous when you’re breaking someone’s ribs trying to push their blood to the rest of their body, dangerous
to think of them as a person instead of a collection of cells and blood and systems
that all need to work together to be a life. . .it haunted me, his face did, but I don’t
know now if I could tell you what he looked like.

and I’m wondering, really, if I’m saving anybody’s life but mine

you know it's a good day in the ER when you have to change your pants

2007-08-17T14:38:00.000-07:00

huh. That didn't sound quite right.

Just about the only thing that bugs me anymore is smell. I mean, I can handle the sight of blood, guts, gore, dangly adipose tissue, broken bones, poop, pee, puke, appendages dangling by a tendon, abcesses, nasty infected holes in people's legs. . .but smell. . .well.

it's not so bad when you can prepare; rub some vicks under your nose or inside a mask, then head into a room. But when you're walking down the hallway to start an IV, swinging the IV caddy jauntily, minding your own business, singing a little song to yourself, and a head injury patient projectile vomits directly into your path, and it's loud and voluminous and very, very colorful, and it splats on the curtain and the bed and the floor, and you've just gotten back from dinner. . .

that's not so great.

greetings from another planet

2007-08-08T08:57:00.000-07:00

I may have mentioned that I come from a large family. A large, Mormon family. I have four siblings, all older than I. They, unlike me, have managed to remain married to their spouses, and produce several children in wedlock. I have 22 nieces and nephews, and 3 grand-nephews, in fact. All good, wholesome folk. Plus my parents. In my brother's mansion. Me, my kids, and a bunch of non-drinkin' non-smokin' non-swearin anti-liberal pro-life over-educated over-populated over-whelming people. 25 of them, in fact. Yep. I fit right in.
Sooooooo. Sunday. Noonish. Get the kids in the car, on the road. We've just hit Brownsville when Miss Diva asks for the first, but not the last, time, "how much longer?" I grit my teeth. I have a goodie bag of new books and coloring stuff in the front seat. I figure if we can hold out until Portland, I can dish out the goodies and we'll be set until we hit my brother's house, where the shindig's happening.
We barely make it to Portland before I start doling out the books, the coloring markers, the notebooks, the clipboards. The kids make it to Vancouver before they finish the books and start telling me they're bored.
Vancouver, Washington. Not BC. Vancouver-across-the-bridge-from-Portland. By Castle Rock, they're bashing each other over the head with the clipboards.
But we made it, albeit six hours later. And we ate some dinner, and then woke up the next morning and ate and played in the go carts and one nephew had his Eagle Scout celebration and then we were weirdos around the campfire, my sister and I dancing around to "Father Abraham" and today we went to the aquarium and Pike Place and the little magic shop is still there and we jumped on the trampoline and yelled and screamed and fought like families do.
Granted, when I wake up I'm slightly bleary, and my whole family laughs loudly as I stumble to my car and drive to Starbucks, and they tease me about my coffee addiction. And I do occasionally have to hide in a closet and whisper all the curse words I can think of just so I don't accidently let one slip in polite company. But I am one smartypants loudmouth among many, here. . .I mean, I had to get it from somewhere, right? It's just my smartass comments are occasionally sprinkled with naughty words. ahem.
My sisters and I all snort with laughter, my brother and I mush hamburger patties together in lumps when his wife isn't looking, and earn ourselves a lecture; I watch my sister and her husband leave black streaks of rubber on my brother's race-track driveway trying to run each other off. And I watch my favorite nephew, who does great accents and has the best one-liners, try very hard to hide the fact that he is gay. Or maybe he doesn't hide it, really, and I'm the only one who notices it.
He'll be a good role model for MixMan, who recently told me he'd rather be a girl. When I asked him why, he looked at me like I was stupid and said, "girls get all the best dresses!" And he rolled his eyes and walked away. Well, duh.

here's an excuse for shopping at victoria's secret

2007-07-31T19:13:00.000-07:00

Just worked five twelves in a row, and the freaks really do come out during the full moon. So do the gardening injuries, the drunk drivers, the broken arms (5 sugar tong splints in two days!! Geez!!), the heart patients, and the stroke victims. Had two brain tumors diagnosed in the ER that night. My favorite nurse looked at me, waggled his eyebrows, and said, "see, firefighter girl? Nurses can put in 18g IVs, too." I told him I woulda shot a 16.
It's somewhat sobering to see these patients in the ICU a couple of days later, though, knocked out from propofol, tubes in every orifice. Particularly when you saw them talking, or trying to talk, 48 hours earlier.
We had one woman who had been in an MVA earlier in the day. Medics got called to her home; they boarded her just to get her out, since she could barely walk. Doc cleared her C-spine, and he and I rolled her up on her side with the standard "give yourself a hug!" Apparently, my eyes widened rather comically when she flailed her arms around and one of her hands landed square on my tuckus and then held on for dear life, because Doc started laughing. However, her hand remained, and Doc took it upon himself to ask her if she had developed a fondness for me. She released her iron grip, patted my butt, and apologized. I have a feeling I'll be hearing about that one for a while.
Was having one of those days. You know. Where everything you pick up, you fumble, or drop; when the saline flush falls out of the lock right before you set the IV; when tape sticks to your gloved fingers, when the velcro on the knee immobilizer attaches to everything but what it's supposed to, when the underwire on your favorite bra snaps right at the curve, and you suddenly feel a sharp pain and an amazing lack of support. Then you get home, try to read before falling into a dead sleep, and your glasses snap right at the bridge. Seems like a sign. You know. Like maybe it's time for a little R and R.

mixman gets a splinter

2007-07-14T12:19:00.000-07:00

This morning, I sat outside on my back patio, enjoying the shade, my coffee, and a great book. It's been a while since I could sit out there- the cherry tree has decided to make cherries this year, and they are small and dark and hurt like hell when they come pelting down and smack you on the head, or foot, or leg. Plus they leave a really attractive reddish purple stain which the children decided looks a lot like blood, and have taken to smearing all over their faces and stomachs, and then chasing mom around the yard making spooky, goulish monster noises.

Anyway, judging by the number of cherries on the ground and smooshed all over the inside of my house, I felt it was safe to sit outside. There honestly could not be any left in that tree. I had just gotten to the best part in the book when I felt something warm and icky spooge on my shoulder and down my arm. Cherry colored bird poop. Yum. So. No more sitting on the back patio for me.

MixMan has developed the oddly disturbing (to his father) and rather funny (to me) habit of passing out at the slightest hint of blood or injury. School friend's loose, wiggly tooth? MixMan, down on the ground. Miss Diva's broken foot blister? Whump, MixMan flat on his back. So when he came to tell me he'd gotten a splinter and needed a bandaid, and I got out the tweezers and he ran from me, screaming, I didn't bother to chase him. I saw how pale his face was. I knew I needed only to wait for the inevitable vagal response before I could dig that sucker out.

Worked an extra shift at Meth Central Med Center this week. I started out covering for the unit secretary at her command post, and briefly entertained fantasies of running and hiding in the supply room, under all the IV supplies. I managed to hold it together until she got back from her class. I'm not sure if all the Unit Secs scowl that way all the time, or if it's just at me. Whatever. I left the nurses' station and made myself happy by sticking several people with 18g IV caths in the hand, just because I could. Oh, yeah, and because they needed 'em. Then I realized it's been over a week since I missed an IV, and I probably just cursed myself by saying that. Whoopsie. But I have floor nurses call and ask for me by name now when they have a tough stick. The last time was the med floor; they had some 300 lb cantankerous old lady cursing like a sailor who needed an IV, and they were all somewhat frightened of her, I think. So I get in there, introduce myself, and she says, and I quote, "I don't give a rat's ass where you come from or who you are; shut up or I'll shove a sock down your throat."

Well.

The nurses all made clucking noises. I looked at the lady, who cocked one eyebrow and dared me to respond. I grabbed her hand, swiped it with alcohol, and said, "you and my mother agree on something, then," slid a 20g in and taped it down. Her jaw dropped so far I coulda shoved a couple socks in, but the thought didn't even cross my mind. Honest. And that whole part about my mama isn't true, either. But it's good this lady didn't have my work socks on hand after a long shift-- I usually tuck those into a biohazard ziplock bag when I get off work, which in my humble opinion is the best place for them.

A couple of medics brought in a Charles Manson lookalike last week, and we put him in the psych room. He was a bit antsy, and hospital security wasn't cutting it, so we called the cops. One of the two officers who showed up is almost always good for a laugh, so I hovered outside the door and listened.

Officer Friendly: What's going on, sir? Why can't you do what these nice people ask you to do? They're just trying to help you.

Charles Manson: I can't, my--

OF: (sighing) you know, I was just sitting down to my coffee and doughnuts. I love doughnuts. I'm very hungry right now, and I was really looking forward to eating my sugar sprinkles.

CM: (squeaking) you want to eat me?

OF: (roaring) do you look like a doughnut? Do you have chocolate frosting and little rainbow sprinkles? No!! But if you did, I might eat you up.

Charles faints. Or maybe the Ativan kicked in.

2007-07-11T04:34:00.000-07:00

hey, folks. been busy, been tired, been processing some slightly disturbing things that have come up here in meth central. Tune in in a couple of weeks, maybe I'll have some coherent thoughts.

:)

a little excursion

2007-06-05T17:00:00.001-07:00

short shift last night; only 8 hours. In that time, two alcohol poisonings, two intentional ODs (tubed one of 'em), three little kids who got into their parents' aspirin and/or tylenol. Three years in EMS and I've never seen activated charcoal used, but the black goop was flying last night, I tell ya.
Had to take a run to imaging to restart an IV for a woman undergoing an MRI. I got in there and unloaded all my metal medic paraphernalia--trauma shears, clamps, name badge and key, retractable lanyard, watch, spiral ER pocket guide. Got next to the MRI and felt my Who hair ponytails vwoom toward it. Shit! Bobby pins! About 5o of them! No way was I taking all of them out. So I made the tech stand between me and the imager while I got a nice little IV in the patient's upper arm. It was a beauty.
Today, my daughter and I took a walk in the neighborhood. I am trying to make up for my inattention during the last three years of school and work, when I spent the days I wasn't commuting two hours to the coast for twenty-four hour shifts recovering from those 24 hour shifts. I am also trying to make up for the shoddiness of our neighborhood, the sheltered indoor life we seem to lead most of the time. We turned out our driveway, went east instead of west because the shooting last month was in the cul de sac to the west, and walked the sidewalks to get to the playground nestled in between several other duplexes. I almost cried when I saw the empty playground; broken glass covered the decrepit tennis court, and all that was left of the swing set was a rusty slide with bolts sticking out of it. The rings and the swings were gone, stolen or broken, and had never been replaced. I looked around at all the backyard fences, saw gang tags on every one. I don't know when this happened.
Nervous about the three men circling us on bicycles, I convinced Miss Diva to walk home with me sooner than we planned, promising we'd make a list of all the things we'll do this week. "Yeah," she said, "like go to Disneyland!" I held her hand tightly, my other hand locked around my phone in the front pocket of my hoodie zip-up. As we walked, I noticed the garbage stacked in front of houses, under bushes, spilling out of cardboard boxes. I noticed the peeling paint on the duplexes, the worthless cars in yards, parked haphazardly across overgrown grass; stray bedraggled cats missing chunks of fur. Here and there I noticed little secret gardens, plants and flowers in pots, and I wondered at the absurdity of it all, wondered why we even bother, when hell and poverty are closing in all around us.
Some days, I don't know how I do this. I don't know how I manage as a single parent with two children and four cats in this shit hole neighborhood, where my attempts at a flower garden seem pointless, where I can hear the sirens and the music booming in cars and babies crying and people screaming at all hours, even through my double paned windows, even with the doors double locked and curtains closed against the sound. Some days, I don't know how I do it. Some days, I don't know why I bother. But I do bother, and I do it, every day, because gardening and mothering are my little attempts at revolution. I wake up and I try to smile at the kids, even before coffee, which is no small feat. I pour their milk and cereal. I drink my coffee. And every day turns out okay in the end.

firefighter girl 1, snails 100 and counting

2007-05-19T10:19:00.000-07:00

It's early Saturday morning. I'm sitting on my back patio in the cold, damp air, drinking gnarly coffee. I make it strong, anyway, but there was just a little bit extra in the bottom of the bag, so I dumped it in. . .maybe a bit too much, even for me. But at least I'm awake. The kids are inside, playing monkeys and monsters. I'm not quite sure what the rules are, but they're giggling wildly, so it must be fun--either that, or the game is just a cover for kitty corralling. Anyway, they're so high energy it makes me tired; fueled by youth and a breakfast of three kinds of cereal, dumped together in the same bowl, that, when mixed with milk, looks a lot like cat vomit. But they seem to find it delicious.

I don't usually have both of them on Saturday, but MixMan's daddy went out last night to celebrate his birthday, and Miss Diva's daddy had a Salsa dancing lesson last night. So yesterday we played hard, ran through the sprinkler, built, painted, and planted a window box, and stayed up late watching Toonsylvania. I checked this morning to see if the snails had eaten any of the new plants. Only two casualties, but this is becoming a serious problem. I don't like killing anything, and apparently news has spread in the neighborhood that my yard is a snail sanctuary, with tasty plants to boot.

This is war. Time for the heavy artillery. Beer. In shallow dishes. Snails love it, or so I hear. And yeah, they die, but at least they die drunk and happy. But I'm not behind this idea one hundred percent; I mean, it seems like a lot of work. I'll have to check itty bitty snail IDs, limit entry to snails at least 21 days old. Still, it's probably easier than my nightly snail chucking, when I toss snails into the grass and hope that at least some of them make their way to the neighbors' yards instead of back into mine. I dunno. I'll keep you posted.

Yesterday, MixMan's school had a first grade performance of music from around the world. I loved watching him sign the words, singing quietly with his sweet voice. Afterwards, one of the parents said to her kid, "Let's get a picture of you with the little deaf boy!"

WTF?!! I am so glad that MixMan didn't hear that. There are benefits, I suppose, to being deaf. On the way home, to channel my anger into something constructive, I turned up the stereo in the car, bass thumping so MixMan could feel it. We sang along to one of my favorite songs, the Black Eyed Peas' "My Style." It starts out with an a capella round "Lord have mercy, Lord have mercy," except I swear they're singing, "Lord have MRSA, Lord have MRSA." And why not? Everybody else does.

drama system entries

2007-05-11T08:13:00.000-07:00

The poem in the previous posting seems particularly applicable this past week. Two kids, 10 and 16, were shot through their sliding glass door in the next cul-de-sac over from mine last week. This makes me feel angry, and helpless. And it doesn't matter, really, that it was the result of some ongoing family feud that most likely involved drugs. All that matters is that the work I've done on my garden, my home, my sanctuary pales in comparison with the need for safety for my children. I decided, of course, that I needed to move immediately, but then realized that anyplace I could afford would have the same problems, but at least here, I know my neighbors, and we take care of each other. So I dig in the dirt, plant flowers and seeds with a little prayer for peace.

I've had this feeling, lately, that I should be doing something productive for posterity. I mean, I've got the school and career thing under my belt, I think I've got a handle on parenting (although just when I'm congratulating myself on being a fabulous mom, Miss Diva shatters the illusion with a zinger like this: "Mommy, remember when you said I'd have to live outside until I was 8?" but before you get all up in arms and call DHS, I should mention that I would have provided her with food and water and blankets. Really.) Anyway, maybe I should buy a house (yeah, right, that's gonna happen anytime soon) or work on my paintings or publish a book. So I sit down to write the great american novel and what comes out is. . .nothing.

Well, not really nothing. I mean, I type, and words come out on the screen, but what it really is is moose puke. Or yak butter. Yum. So maybe the great american novel isn't my style, and I should stick with poetry that will never, ever see the light of day.

Anyway.

I just finished up the TNCC (Trauma Nursing Core Course) that I'm required to take for my ER job. It was great to be in class again, but I didn't even open the book, because the lecture and the subject material seemed mostly like the second term of paramedic school. I breezed through the practicals (airway, spinal immobilization, trauma patient assessment) and watched with some amusement as the ICU nurses struggled with some of the biggies: Cushings, Becks, IOs, the rehydration formula for burns. I have the greatest respect for ICU nurses- the amount of information they retain is enormous- but it was interesting to see the tables turned, however briefly.

I've been working mostly night shifts, lately- 1545-0415- which makes day care much cheaper and is easier for the dads' work schedule. Plus, some very interesting patients come in at o'dark hundred. The ones who come in retching and wailing with pain, the cries a doppler effect as they're led past the nurses' station, then abruptly stop on entrance to the room, but the loud retching mysteriously starts up again when the patient hears footsteps outside the doorway, kinda like Pavlov's dog salivating to the dinging of the bell. After initial treatment of IV, meds, and a warm blanket, the nurse and I sit and engage in some mild black humor. "aaaaaeeeeeeerrrrrrkkkk," I gag quietly, mimicking our loud and proud un-puker, and the nurse laughs. "Drama alert!! Drama alert!!" she whispers. Doc D glances at us. "Heartless, absolutely heartless! Where is your compassion, people?" But before you take him too seriously, remember the time one of the other doctors saw a carpenter ant and raaaaaaan down the hall in the other direction, and Doc D jumped up on one of the rolling stools, waved his arms, and squealed, "a bug! a bug!" before sedately resuming his dictation. Compassion, my tuckus. Fun as night shift is, I'm discovering that my preference lies with the day shift nurses and doctors. Just the other day, we were so busy, and I was running back and forth starting IVs and cleaning wounds (it was a good day for heart attacks and table saws, apparently) when a guy came in with a bloody towel wrapped around his thumb. This is rarely a good thing. He didn't speak much English, which made things even more difficult. How do you say "bone rongers" in Spanish? Because that's what the doctor called for when he saw the guy's thumb. Or what was left of it. And rongers look like they're for exactly what they're for. Bone crunching.

Watching is bad enough. The sound is worse. Snip, snip, snip. Clank when the bone hits the stainless steel bowl. Blech. The patient pales, but remains stoic. I clean him up after the stitching, gently wash his little thumb nub, then apply a liberal coating of bacitracin, adaptic, and enough tube gauze to give him a Looney Tunes mega-thumb.

After I'm finished, he sits and ponders everything but the thumb. The nurse is trying to arrange for a ride home for the guy, and when she finally gets ahold of the taxi company, she calls for the interpreter, who is nowhere to be found. So she gets the guy's attention, and gives him a big smile and a jaunty thumbs up.

Whoopsie.

any day's a good day for poetry. most days are good for god, too.

2007-04-22T18:48:00.000-07:00

Occasionally, I find a book I like to read over and over again. Most of Anne Lamott's books are like that for me- she's got the tattered Christianity over the previously messed up life that seems to fit me quite well, too. And this poem by W. S. Merwin was the epigram in one of her books. No matter how many times I read this, it speaks to something visceral in me, and touches deeper every time.

Listen
with the night falling we are saying thank you
we are stopping on the bridges to bow from the railings
we are running out of the glass rooms
with our mouths full of food to look at the sky
and say thank you
we are standing by the water thanking it
standing by the windows looking out
in our directions
back from a series of hospitals back from a mugging
after funerals we are saying thank you
after the news of the dead
whether or not we knew them we are saying thank you
over telephones we are saying thank you
in doorways and in the backs of cars and in elevators
remembering wars and the police at the door
and the beatings on the stairs we are saying thank you
in the banks we are saying thank you
in the faces of the officials and the rich
and of all who will never change
we go on saying thank you thank you
with the animals dying around us
taking our feelings we are saying thank you
with the forests falling faster than the minutes
of our lives we are saying thank you
with the words going out like cells of a brain
with the cities growing over us
we are saying thank you faster and faster
with nobody listening we are saying thank you
thank you we are saying and waving
dark though it is

W. S. Merwin

printed from "Travelling Mercies" by Anne Lamott, Anchor Books, a Division of Random House.

off-gassing on earth day

2007-04-22T18:32:00.000-07:00

I woke up at 0700 yesterday, after only two hours of sleep. I’d gotten off a 12 hour shift at 0415, and getting out of bed was sheer torture—until I remembered why I was doing it. We have a burn to learn scheduled. I drag my sorry tuckus into the shower and out to the car, slam a few shots of coffee, and make my way to station 1, where we pow wow and team up.

We drive up to the burn site in the Rescue just as Leapfrog Towing was dragging—er, towing—the last of the three mobile homes into place. “Mobile home” in the most literal and also most generous sense of the phrase, because these three structures hadn’t been decent living spaces for some time. I vaguely remember going on a chest pain call in one of them a couple of years ago; you know, the typical 300 lb patient naked in the very back bedroom, hallway barely big enough to walk through even before it was stuffed full of tchotchkes and National Geographics.

It’s a small crew today; five teams of two or three folks each, and then Incident Command, who has brought his lawn chair, two engineers, the Safety Officer, and the usual light team, who will also act as team leaders inside, since only a couple of us going in have our FFI certs. I’m partnered with a kid I’ll call DogBoy, since his official nickname is BeastMaster for reasons we won’t go into now. DB’s dad is a career firefighter, DB has been a volunteer for a while, he’s a good kid with a good heart and a great sense of humor. He looks dubiously at the third mobile home, a hulking brown mass of metal held up by wood blocks and tires that have been so flat for so long the rims are half-circles. He clears his throat. “That one makes me a little nervous. Why can’t we burn houses instead of mobile homes?” he complains. I point out that 1) we are in Deliverance country, or at least the Northwest version of Deliverance country, and there aren’t any houses out here, and 2) at least we are getting rid of some of the mobile homes. Three in one day, actually. He concedes, and quits whining. Briefly.

We start setting up, laying lines and filling the porta-tank, locating the cooler and the potty, identifying exposures. DB and I are first on exposures, so we get to hose down a couple of tall, moss-covered trees and a beat up old fence with foam that looks like drippy flocking on a Christmas tree. My feet and hose line get tangled in a Judas limb hanging over the side of the fence, and down I go. One thing I love about being a firefighter, though, aside from the fact that I get to squirt lots of water at big fires, is that everyone is klutzy in turnouts, and while I might fall down a bit more often than most, it’s nothing out of the ordinary. And unless you can see the back of my helmet, nobody knows it’s me. (Although on a different fire, I did hear somebody ask where I was, and Chief said, “Look for the firefighter who fell on her butt. That’s Firefighter Girl.” So maybe turnouts aren’t as anonymous as I’d like to think. . .) Anyway, one of the firefighters on RIT, or Rapid Intervention Team, whose only purpose is to rescue downed firefighters, came at me and the tree branch with his axe raised. Rescuing a firefighter downed by a renegade tree branch may have been stretching his job description a tad, but he rose to the occasion, and the branch was kindling after a few whacks.

DogBoy takes this opportunity to tell me that he had a small bout of diarrhea this morning. I’m not quite sure why he feels the need to share this with me. I ask him if he’s nervous, and he gets that guy thing going—you know, the squared shoulders, the look of disbelief and aloofness on his face. As if. By this time, it’s our turn for attack team, and I’m kind enough to let DogBoy have the nozzle for the first couple of attacks, and he’s new enough to not realize that later lights have better fire. Heh heh heh.
The teams managed a couple rotations each through the first mobile home, and then the second, which I would describe more as a hovel, had four lights before our turn comes up again. Captain Snappy and Chief lit the second of the two rooms, and Dog Boy and I sat and waited to go in. I watched our three-person back up team check each others’ gear, and nudged DB. They looked like nothing more than a bunch of chimps in a line, grooming each other. DB started laughing. I started having doubts about their competency. But then DB started poking around my mask and hood, under my helmet, and I made him promise to eat any bugs he found. He crossed his heart, hoped to die, and stuffed my errant ponytail down into my coat. Then we sat, and watched the light take hold.

A usual training light is nothing special. Maybe a couch or a pile of pallets on fire, lots of smoke, some good, controlled flames. But Captain Snappy knew it had been a while since I’d seen fire. And he also knew I’d let DogBoy have the nozzle the first few lights. I was about to head in, and Snappy held his arm across the doorway. “Oh, no, FFG. Wait.” So we watched as flames climbed the walls, and smoke billowed out the vents and windows. “Now?” I asked. Snappy shook his head. Flames started rolling over on the ceiling. “Now?” I asked. Snappy shook his head again. We backed away from the heat of the doorway, flames poured out the top, and Snappy said, “Take it whenever you want, FFG.” Whoot whoot!! And I got it. I got it all, and then they let the whole thing burn.

Afterwards, sitting in rehab, sipping on a Gatorade and munching on M&Ms that had only slightly melted in my turnout coat pocket, DB finally got it, finally realized that perhaps good things come to those who wait; ie, better fire. I promise him the nozzle for all the lights in the hulking brown thing. They’ve just started lighting it, and it goes faster than the other two—burning mobile homes is like starting a fire in a big metal box. They burn hard and fast once they catch. DB gets one good light, we’re rotating teams like nobody’s business, and we’re on backup just getting ready to go back in when the tones go off for a severe respiratory distress up valley.

IC points out an engineer—120mph—and DogBoy and I to take the call. We drop our helmets, coats, masks, packs, and gloves, race to the Rescue, climb in, and then race back to the packs to turn off the air and bleed them. Then back to the Rescue, me behind the wheel, 120mph in the officer’s seat, DB in the back. We go enroute, and this is much easier than driving an ambulance code 3 on the coast highway, but 120mph is asserting his testosterone and comments on my cornering. I bite my tongue to keep from mentioning the bucking sawhorse he ran over with the engine last year, or the fact that he tipped the engine into a ditch once. I look down at my mud-splotched, ash-streaked arms, the flotsam coating my turnouts. I slow the Rescue to appease 120mph, see DogBoy in the back with the paperwork, getting our gloves ready. And I feel a sudden flush of comraderie, that feeling you get at family reunion campouts after you’ve been bickering with your relatives all day but then you look at them in the light of the campfire and see how big their hearts are.

We pull in to the residence, grab the gear, and tromp in. Our patient is sitting in his LazyBoy watching his big screen TV. His new caregiver hovers nervously. I recognize this guy, seen him in the ER a couple of times, and he turns, looks at me, points his finger like a gun and winks like he’s some kind of dapper Rico Suave instead of an overweight, chronic respiratory train wreck. The caregiver may have exaggerated slightly when she called 911. I laugh, bat my mud speckled eyelashes at the patient, and get his vital signs. We chat until the Meth Central medics get there.

Once we wrap things up, we head back to the burn. DB seems anxious, and I ask him if three lights wasn’t enough for him. But he’s more concerned about missing lunch, and we pull up just in time for fried chicken, potato salad, and cookies with little tiny m&ms in them. It wasn’t just a good day; it was a great day, and even after two hours of clean up back at the station, when I knew exactly where my body would be aching the next day, and I knew I’d need 14 hours of sleep, 6 advil and a whole tube of BenGay to even move the next morning, I wouldn’t have changed a dang thing.

not really my idea of a great date. . .

2007-04-17T19:21:00.000-07:00

I came off a 16 hour shift at 0415 this morning, driving to pick up my son with my head hanging out the window in the rain so I wouldn't fall asleep. Busy, busy for the first few hours, then steady the rest of the shift. A dozen IVs, and I only missed one, and that was because the patient's PCP was bedside, and I get performance anxiety. But I got it on the second try, although I cheated and went AC with an 18g. But, yeah. A sixteen hour shift.

What was I thinking?

Oh, yeah. I was thinking about paying rent, and insurance, and car; fuel, power, phone, and that one slightly important thing for little ol' hypoglycemic me. Food.

Of note to male hospital patients (I think I'm going to type this up and hand it out when I put op sites on IVs): While starting an IV and drawing blood are, by their very nature, intimate, just because I'm sticking you with a very big needle doesn't mean I'm coming on to you.

Repeat after me: IVS ARE NOT FOREPLAY.

On the other hand, I think one of the reasons I love my job is it allows me so much human contact. I used to be such a touchy feely person, but somewhere along the way, even hugs from friends started making me uncomfortable. In any case, the contact of another human, even through purple nitrile gloves, is nothing to sneeze at. We all need it. And patients appreciate the human aspect of a caregiver who is willing to touch them, hold their hand, offer support more compassionate than empty words. I've watched medics, nurses, and doctors with patients, and the ones who have the greatest rapport with people are the ones who are willing to touch.

Near the end of the 16 hour shift, when an ambulance brought in a patient for nausea, vomiting, and diarrhea after eating at Taco Bell, the charge nurse made a small, snide comment about the slightly expanding waistlines of some of the older medics. One of said medics, in the middle of ordering a tasty breakfast sandwich from the night kitchen, who actually bikes 40 miles a week, and who obviously has lost no hearing whatsoever from almost two decades of sirens, abruptly hung up the phone. He glanced at me. I glanced at the charge nurse. She and I snickered. The medic shook his head, then shook his finger at me, and said, "You be a good girl, now."

There must be some sort of blue light special lately for comments on my behavior. Which is, I might add, always good.

sisyphus in my own back yard

2007-04-12T11:19:00.000-07:00

Yesterday, the angst that has been building all week came to a head. When I get angsty, I need to get outside and dig in the dirt, plant flowers, turn compost, whatever. The day showed promise early on; you know, sun breaking through the clouds and all that. I lingered over coffee, finished a book, headed out to the garage for my gardening tools. As soon as I unlocked the garage door, thunder crashed and a wall of rain hit the pavement.

Okay, it wasn't quite that dramatic, but it might as well have been. So I sighed one of those long-suffering sighs and headed back in. I decided to be optimistic about the whole thing, and poured another cup of coffee. The sun came out. I headed outside. See above. Rinse. Repeat.

Back to the whole angst thing. Like I said, it's been building all week. The kids and I have been working in the back yard, building raised beds for an herb garden, digging into the hill to lay a patio. The wheelbarrow perched precariously on the hill no matter which way I tilted it, and so for every successful load of dirt carted to the compost pile, another tiiiiiiiiips back into the hole with a boomcrash. Just like Sisyphus, only my rock is a flippin' wheelbarrow. Anyway, that's what I'm working on, shovel in hand, sweat pouring off me, when I hear the sound of 4 boys, all around 12 years old, giggling and saying, "heeeeeere, kitty kitty." I look up and see them crouched around a car, rocks and very large sticks in hand. I should mention that I don't lose my temper often. But the few things that make me see red involve bullying and cruelty to animals and children. I charged up the hill with shovel in hand, screaming at the top of my lungs, red faced and, quite likely, frightening to look at. MixMan and Miss Diva paused briefly in their playing and stared, gape mouthed. The boys and cat scattered in opposite directions. There was a brief moment of silence, and then Miss Diva said, "Mama. You said the f-word."

Whoopsie.

So when I found the pet rat dead on my front porch yesterday morning, I just assumed the little 12 year old punks had left it there, even after the neighbor who disposed of it declared the predator must have been a hawk. Miss Diva and I headed to the garden center to buy some flowers to cheer us up, and came away successful. The day was brightening, at least until I bent to get into the car and smacked my head on the roof. My immediate reaction was to jerk away, and I bonked the other temple on the door. I showed great restraint in the language I spewed at full volume there in the parking lot, you'll be happy to know. I double checked with Miss Diva, and she confirmed I hadn't cursed once. Good thing I've been practicing with make-up, because I have a positively stellar bruise on the side of my forehead.

Firefighter Girl, thy middle name is Grace.

Miss Diva is adept at conversation. So much so that I forget sometimes she's only 4. She sang in the shower this morning, some made up song with the refrain, "I'm a grumpy old soul, yeah, yeah!!" I shake my head in wonder. She is so demonstrative, too- huge hugs, sloppy lip-gloss kisses. Sometimes, she comes up behind me, pats my tuckus rather hard, and says affectionately, "I love your great big butt!"

Ohh. Thank you.

So we wait for the rain to pass. The kids play Plinko behind the futon with the round wooden coasters; MixMan builds impossible block towers and reads Dr. Seuss out loud, vrooms his cars and trains on the floors and up the walls. Miss Diva flounces around in her princess dresses and crooked crowns. She declares today a blue day, and will wear only clothing items in shades of blue. I write poetry, listen to music, clean muddy footprints and puddles of water from the doorways, sneak bites of chocolate from my hidden stash while the kids aren't looking.

On the Meth Central Med Center front- my IV skills are getting better, and I've managed a couple of tough ones on the maternity and surgical wards. I was congratulating myself on a tough foot stick in the ER- this guy had one, and I mean only one, vein, and it was sitting there on his foot, and I stuck it with no hesitation with a 22g, got a great flash, advanced, it was in, I was ready to tape it down, and he started screaming. Whoa. I wasn't even touching the damn thing at that point. There was a reason he didn't have any other veins, and I'm pretty sure he was hoping for some pain drugs, and I let him know that this was his one chance for IV meds, and he told me to f--- off and get it out. So I calmly removed the catheter, smiled politely, and left him there.

My new car is finally growing on me. Well, not really, because that would be kind of bumpy and make jeans even harder to wear. But I'm learning its moods, when it doesn't like starting, what makes it happy.

Going really, really fast makes my car happy.

Itemized list of things found behind the futon while vacuuming today:

2 slightly battered wooden coasters
1 catnip mouse
feather collection (I thought the pillows were feeling a bit less plump)
1 gameboy game (Yoshi's Egg, I believe, and it found its way behind the couch rather forcibly when MixMan got frustrated with it)
2 markers in colors very similar to the fresh markings on the wall of the stairwell
1 very frightened cat
2 hairballs

Guess what? The sun just came out. I think I'll sneak up on the garage, see if I can get some digging done in the back yard.

Firefighter Girl. Digger of hills, champion of stray cats and snails.

quaking in my boots. . .er, um, sensible shoes

2007-03-30T11:39:00.000-07:00

Sorry my posts are so erratic, folks. Had to cancel my home phone, and with it my dial-up. Yes, dial-up. In any case, this is a loooooong one, so grab a beverage of choice, put up your feet, and enjoy the story.

Last week, my first preceptor came in with a patient. (Long story short, she and I had a serious personality conflict, although I still haven't figured out why. Luckily, I was moved to a different preceptor for the end of my internship, and I did fine.) I didn't know she was even in the ER until the fine hairs on the back of my neck stood straight up, and I sensed EEEEEEEEEVVVVVVVIIIILLLLL. I turned around, caught a glimpse of her, started shaking, did a quick soft shoe routine behind a curtain, and made like a stack of laundry. Or equipment cart. Anything to avoid her. But she caught up with me in the cafeteria, damn it all. Our exchange was very. . .um. . .polite.

Cleaning beds after an ER rush, one of the new nurses asked me where to dispose of bio waste. I pointed mutely at the large red garbage can in the corner. She giggled. "Whoops. Guess my blond is showing." I asked if the streak of blond framing her face in otherwise brunette hair was like a blondometer that increased in width when she was having a blond moment. (I can't help it. Sometimes these things just shoot out of my mouth.) She looked at me and then laughed. A deep, long belly laugh that shook her from her blond roots all the way to her toes.

thank goodness.

I did CPR for the very first time last week, and was sore for days after. Pt was a 36 yo female found down in a field. The entire code team and half the ER nurses were in there, but I shoved my way to the bedside, climbed up on the stool, and started compressions. That craaaaaack as her ribs separated from her sternum was one I was expecting, but it felt icky. Weird icky. Not at all like the dummies we practice on. Damn good upper body and ab workout, though. Maybe I'll get to add it to my regimen.

Only had two marriage proposals in my last few shifts. It's been a slow week. Maybe it has something to do with my self-tanning moisturizer accident. You know, the stuff that is supposed to be fool-proof. Apply it like lotion, it builds up color gradually. Somehow, I managed to get streaky, anyway. I wonder if I'll ever get the hang of this girl thing.

My parents came to visit this week. My mother apparently had an issue wiping with kleenex instead of Charmin (ahem. . .I'm a bit low on funds lately), because on the second morning of their visit, they showed up with a Mack truck sized package of toilet paper. It doesn't fit under any of the sinks, so for now, it's taking up valuable shoe space on the floor of my closet. I think Mom is hoping that it'll last until their visit next year.

Patient highlight of the week (aside from amusing myself with conversations with little old ladies who have been given Morphine. . .what a hoot!!) was the girl who came in POV after a fight with her boyfriend. They'd been discussing breaking up while they were driving on the freeway, and she decided the discussion was over, opened the door, and jumped out of the car.

Ouch.

Damage incurred: broken shoulder, cracked T1, several abrasions, and a deep, messy lac extending from her right eyebrow all the way to a hematomato in her hairline. The surgeon stepped in to take a look, and his only comment (he's a man of few words) was, "Oh, damn."

Last Monday was a great day. RevMedic brought a patient over from the coast, and stopped by my house after the drop off. I'm pretty sure I squealed like a girl when I saw him, I was so excited. Oh, wait. I am a girl. It's a good thing he wasn't hungry, because all I had to offer was my trademark chewy coffee, but hey, he drank it without complaint. We got caught up on work stuff ("how's everybody?" "same as usual." "The ocean?" "Still there.") and headed briefly into the personal, and then he told me all about his trip to Baltimore. I sighed wistfully a few times. I'm proud to call RevMedic family, and honored to have been his trainee. Of all the folks from that job, it's him I miss the most. Now if he'd just send me that employee movie. . .

They headed out after a bit more conversation. RevMedic rolled down the window and waved. "Be safe!!" I yelled. He grinned, wiggled his eyebrows like Groucho, and yelled back, "be good!"

I have absolutely no idea what he was referring to. I'm always good.

Don't look at me like that.

the sweet smell of singed flesh

2007-03-19T17:12:00.000-07:00

yesterday's 12 hour shift started out like any other. Night folk meet in the break room before the shift change, we all tease each other, DT attempts to show me various pressure points on my wrist and behind my ears. "Does it hurt? Does it hurt? Huh does it?" And I have flashbacks to my older brother doing the same dang thing right before he broke my wrist. I slap DT on the shoulder and give him a quick jab to the ribs, and that's the end of that. We saunter out to the triage desk (if it's possible to saunter in ill-fitting scrubs and sensible shoes) and check the board. Busy, busy day. My first patient is a twentysomething female with a "3 inch vertical lac to forehead." Easy. She shuffles back to the bed, holding a blood-smudged towel to her forehead, boyfriend in tow. I get her settled and she pulls away the towel to show me a thick gash that goes from her hairline down to the bridge of her nose. I nod, impressed. Then-- flop flop-- the skin on both sides of the lac sort of slip, revealing a lovely, smooth, blood slicked expanse of skull. Spurt spurt go various blood vessels onto my clean scrub shirt. I hastily replace the towel with a lot of 4x4s, report to the RN and the doc, and get the lac tray and sutures ready. The doc meets me back at the bed with the cautery gun.

Oh, horrors.

Brief digression:
Last week, it was a warm sunny day. I'd used up most of the energy from my caffeine and Boomi Bar (it's hippie food, and that's all you need to know) chasing my best friend's cat around the front yard, into the neighbor's back yard, and into a tree, which I then climbed to perform a five o'clock newsworthy rescue. I got to work still a bit out of breath and sweaty from the chase, and headed to the back bed to help out the MD with the suturing of a dangly, hanging-by-a-thread finger of a squirmy, screaming, pissed off 18 month old boy. I'm helping hold the patient. Mom has the kiddo on her lap. They're both crying, we're all sweaty, the heat from the spotlight is almost unbearable. We're all doing remarkably well until the doc pulls out the cautery gun and burns two holes in that itty, bitty fingernail. The smell was bad enough, but then I realized the doc was using the fingernail like a lacing card, and sewing up through the holes.

Ewwww. Grody.

Suddenly, the smell of the. . .and the idea of the. . .and the squirming and the sweating and the screaming and the hot light and the lack of carbs all became a bit much. My vision narrowed, my ears started buzzing, and I informed the doctor in a very pleasant voice that I needed to leave post haste. He took one look at me and ordered me out of the room, and I didn't hear the end of it for the next two shifts.

How embarrassing.

End of digression.

Imagine my dismay when I saw that cautery gun. But I mostly held direct pressure with one hand and fanned the stinky smoke back at the doctor with the other, and we all came out of it just fine.

The holy spirit came in again, this time with the story of how she lost all three of her children when the sun imploded in Jesus' chest earlier in the day. God told her to come to the ER to get some rest, and that's exactly what she did. There was some mention of spaceships and demons, and she wouldn't stop fidgeting until we told her none of it was her fault. After that, she slept easy.

I guess sometimes, it's just nice to have somebody tell you everything's going to be okay.

from hippie chick to firefighter girl

2007-03-07T16:37:00.000-08:00

I was a bookwormish tomboy growing up. Bonafide, dyed in the wool, jeans, tennies, and t-shirt kind of tomboy. I did have waist length red hair, but always kept it up in two tight pigtails. The dusting of freckles across my nose and deep tan during summertime completed the picture. Granted, the jeans were hand-me-down bell bottoms with flowers embroidered around the bells, but they did have respectably worn knees. I announced to the world (at the tender age of 7) that I wanted to be a firefighter when I grew up. Grown ups smiled, and several boys in the neighborhood told me, in no uncertain terms, that I couldn't be a fireman, because I was a girl. Whatever. My mother, to her credit, allowed me my overflowing bookcases, Hot Wheels, cap guns, tree houses, and shunning of the color pink, but insisted that I wear a dress each week on one day in addition to sunday so I wouldn't forget I was a girl.

Ha! As if.

I did like playing dress up, and had a fairly large collection of cast-off makeup from my three older sisters. I never quite got the hang of it, though, and so my essential makeup kit as I went through my teen years consisted of mascara, powder, and lip gloss. Sundays, I wore dresses and flats, but went defiantly bare-legged, which my mother pretended not to notice.

She cringed and almost cried when she saw my first tattoo. I was in no hurry to tell her that I had a couple of others hidden under my clothes. By the time she noticed my pierced tongue, all she could do was cluck hers and shake her head. I think by that time, she realized I probably wasn't going to turn out quite like her other daughters. Late teens and early twenties, I slipped into hippie chick mode; I never did wear patchouli or tie dye, but I was big on the no makeup/no high heels/all cotton wardrobe. At the age of 24, I got a job as co-manager of a clothing store. My parents were ecstatic- Firefighter Girl picks a career! In a female dominated field! Doing girl things! But that only lasted a few months.

After I went through academy and my first year of school, I was still hell-bent on being a paramedic/firefighter. Interestingly enough, the more time I spend in this field, the more girly I get. I now own 5 pink shirts (yes, I do). I have a few pairs of high heels, and as mentioned in a previous post, I can even walk in them. I'm still getting the hang of this whole girl grooming thing, though. I make Miss Diva say the waxing mantra with me in between screams as I peel strips of hair off my legs: "Beauty is Pain! Beauty is Pain!" She laughs at me, but she's girly-girl all the way through- I don't think she has a single shirt in her dresser that isn't pink. She'll be begging for a razor and wax strips by the time she's 10. Heck, she already paints her nails, and it's not really her fault when half the purple nail polish ends up on the carpet. She's only 4, after all.

I think I figured out how to pluck my eyebrows symmetrically. That was a big milestone a couple of years ago. Hair styling beyond shampoo, conditioner, and a sloppy bun still eludes me, which is why I frequently look like an unbraided Pippi Longstocking. My staple cosmetics are still mascara and lip gloss, although for a special occasion (and if I have the time to putz around in front of the bathroom mirror) I'll put on lipstick and foundation, and if I'm feeling really brave, I'll try eyeshadow. Like this morning.

Here's how it went. I got a girl magazine (no, you pervs, not a girl-y magazine-- it was Allure, one of those magazines filled with advice for girly-girls-- makeup, fashion, tricks and tips for everything from faking a fabulous tan to horoscopes for you and your guy). In said girl magazine was this season's hottest new looks for eyes. I spread the magazine on the bathroom counter, prepared my arsenal, and set to work.

I look like I have two black eyes. Seeeeeeexxxxxxxyyyy.

my dogs are barkin

2007-03-06T19:31:00.000-08:00

12 hour shifts, 4 days in a row. Awake at 2 a.m. takes some getting used to. . .but at least I only have a 10 minute commute instead of the 2 hour commute of my recent past. 45 IVs started, one pneumothorax chest tap, one pretty dang impressive hemothorax. . .2 1/2 liters drained. I was assisting the doc, and we both watched in amazement at the solid red stream that filled the first, and then the second, and then the third evac bottle.

Had a stubborn a-fib that didn't answer to the cardizem, or the two doses of lopressor, so the doc told me to get ready for a cardiovert. Never done one of those before. . .but the doc said, "hey, why don't you do this one!" so I did. Twice. There was a tense 7 seconds of asystole after the first 50j, 7 seconds while we all held our breath, and at about 6 seconds, the doc and I looked at each other and he kind of cleared his throat and chewed his lip, and the relief in the room was palpable as the first q r s complex blipped across the screen, even though the rate was still at 150. We got him again at 120j, but the man's heart just wouldn't stop its atrial twitter.

Saw a six day old baby that was healthy as a horse. Mom was a bit. . .off. Was very concerned about some of the things baby was doing. Mom looked at me, lower lip quivering. "When she sleeps, her legs twitch." And a big fat tear rolled down her cheek. I was loathe to wake the baby with the rectal thermometer, but I sighed and lubed up the tip, and bit my tongue. I refrained from mentioning that Mom's legs probably twitched when she slept, too.

The usual junkies, migraines, NSO abdominal pains. Two aortic aneurysms in as many days. The patient who came in with a belly the size of a bowling ball from burst divurticuli was very pleasant, smiling and talking to us while we took her blood pressure. . .a couple of times, because the 55/20 measurement was somewhat difficult to believe. But no, it was right. Yikes. Three IVs, 3 L of NaCl, and Trendelenberg for you, ma'am. And she didn't even mess up her lipstick.

My favorite was the patient who showed up insisting she was the Holy Spirit. She kept addressing the numerous imaginary children in her belly and some person in the exam room only she could see. She called him Dad. It took a while to figure out she meant God. Kinda spooky. . .I have no doubt she was seeing and hearing something, but the only thing she had to say to any of us was, "gimme an IV!! My babies are thirsty and Dad says you have to!" And we were trying, but damn if her veins were filled with anything but holy water, because no matter how hard any of us tried, we couldn't get that dark red flash in the cath chamber.

Where the hell do these people come from?

the agony and the ecstasy

2007-02-28T08:01:00.000-08:00

I'd almost forgotten what a 12 hour shift in the middle of the night feels like. It started off like any first shift at a new job, although it's nice that I know the employees, and the equipment, and the layout of most of the rooms. But just enough has changed that I feel I'm in some slightly skewed alternate ER- the beds have been renumbered, the crash carts have been reorganized, the charts have been shuffled. At first I contributed my mild confusion to the early a.m. pre-coffee haze, but then realized that this time, it wasn't entirely me.

first IV of the day is an EJ. No, I didn't get to do it, although I could have- the patient had ropes for veins. With the EJ came a marriage proposal from the patient, my first of two for the shift. DeepThroat, my Medic trainer, teases me a little. I tell him it's a little different in the back of an ambulance, where it's just me, the patient, and a bunch of 14 g needles. That combination tends to curb the flirtation a bit.

With DT hovering over my attempts on the next several patients, I botch 4 out of 5 IVs. Grrrr. Granted, I haven't started an IV in a couple of months, and each patient greeted me with "I'm a tough stick," but still. After lunch, DT decided to leave me be, and hovered outside the room instead of over my shoulder and- ba da bing ba da boom- I'm 7 for 7 the rest of the shift, with only one AC. Hallelujah, the tingle is back in the fingertips.

The cops showed up in the early a.m. with a meth head. The guy had been pounding on his sister/cousin/girlfriend's car at 5 a.m (he wasn't terribly clear on this, so take your pick- although since this is meth central, one person could actually be all three). The guy is barefoot, dirty and bloodstained, with blackened burn blisters at both corners of his mouth from sucking on a hot pipe. He is also about 6 feet of wirey, sinewy muscle. Not an ounce of fat on this guy. The night nurses give him Haldol and Ativan, and we calm him enough to get him to a bed. He's definitely high as a kite, but I think he was less violent than terrified of the cuffs, the bright lights, the restraints in the back of the cop car.

Later in the day, an ambo brings in a homeless guy who is somewhat disagreeable. He was drunk, and got in a fight, and doesn't really want to be here. I am amazed at the disgust his nurse shows him, how rude she is. DT says she's old school, and doesn't like change. Whatever. I can understand getting burned out and sick of the so-called human trash- I live in the middle of it. But I also know that most humans, if given the opportunity, will rise to the occasion when treated like humans instead of pond scum. The guy was lying on the bed, shivering, soaked through from the rain, and his nurse hadn't even given him a sheet. I put my hand on his shoulder, introduced myself. He lowered his arm from his eyes, told me his name. Smiled. I covered him with a couple of dry, warm blankets. He thanked me. The doc shows up, gives the guy a once over, orders dinner for him. Treats him like a human being. Thank god for that doc. I wanted to fwap the nurse over the head with a purple nitrile glove- fwap fwap fwap. But that may not have been my most excellent idea, considering it was only my first day.

I can't think of one employee that I don't actually like at Meth Central ER. Most are good people with high standards and excellent training. The nurses generally fall into one of three categories- the ones who appreciate the medics and view us as colleagues, the ones who view us as nothing more than housekeeping with IV skills, and the ones who resent the hell out of us. Luckily, the nurses in the first category far outnumber the other two, but I am only now realizing the intricacies of politics in the hospital setting- the docs are treated with kid gloves, but nudged along by the nurses, who seem to think the docs have no idea what they're doing. The docs tolerate this because, well, it's best to humor the nurses, don't you think?

it's a miles davis kind of day

2007-02-20T22:01:00.000-08:00

you know, one of those cloudy rainy cold kind of blue days. Give me some Miles, give me some Coltrane, give me something that resonates with the mood of my restless, broken heart.

I'm a single mom, which in many ways is a good thing, although it can be difficult at times. MixMan and Miss Diva are lucky (and by default, I am also lucky) that The Dads (always referred to collectively) are so much a part of their lives. Both I and my two children are truly blessed, in so many different ways.

My son is turning 7 next month. He was born ten days early in Y2K after 23 hours of drug-free labor, 13 of it very, very hard. Nuchal cord, mild distress. Five pounds, 13 ounces. The first few weeks, when he would get colicky, I'd put music on the stereo (he liked just about anything, but jazz, particularly Thelonious Monk and Coltrane, soothed him the most) and we'd dance around my tiny apartment, MixMan tight against my chest. He hated the harmonica, though. My sister tried to play for him (and she's rather good) and he would scream like he was being pinched. Hard. Every single time.

When MixMan was 4 1/2 months old, I noticed a sudden loss in his responsiveness to the sound of my voice. I'd walk into a room and he wouldn't turn his head; he no longer smiled when I sang to him. But it didn't happen all the time, and his dad and I convinced ourselves it was nothing to worry about. But by 8 months, when the random noises he made should have been shaping themselves into vowels and recognizable sounds, he was still shrieking. He got hearing aids 2 months later.

My son is one of the sweetest, most loving little boys in the world. He has a deep, abiding love for animals and his people. He is generous to a fault, although not in ways you might recognize. He terrorizes his little sister, just like any good brother should. He also has autism spectrum disorder.

Watching my little boy collapse in a frantic pile of writhing limbs, screaming the same thing over and over, saying his throat hurts from all the screaming but being unable to stop, and finally covering his own ears because the sound of his own screaming is unbearable. . . it breaks my heart. So I do what any mother would: I sit down beside him. Pull him into my lap. Take out his hearing aids. Press his head against my chest and hum a riff from Miles so he can feel the vibration in his own body. Rock gently. And it's almost like the first few weeks after he was born.

Almost.

call FUBAR #1

2007-02-19T09:39:00.000-08:00

I wish I'd started writing this while I was actually working on my training. Of course, it's the calls that I screwed up on that stick with me, and it's easy to forget the ones that went well. I figure, though, that as long as I can learn from them and not make the same mistake twice I'm okay. RevMedic reminded me frequently that mistakes like this are the reason it is called "practicing" medicine, because we constantly learn and grow with each experience.

It had been a fairly slow day for The Rev and I early in my training. The call came in as cx pn, the address way out in the boonies- took us over 10 minutes to get there, even going c-3. We find a man lying on his bed, barely responsive; a single firefighter has responded and a family member stands by, says his only previous hx is chronic pn, but he'd been in to the clinic for a long-lasting cold a few days before. I ask him the standard OPQRST, but he's unable to answer; I ask him to point out where the pn is, and his hand moves to his right side, hovering over the lower part of his ribcage. I ask him if it gets worse when he breathes in or out. No answer. Lung sounds are clear. No fever. SPO2 is around 90 on the O2 that FD has placed. BP isn't great, but isn't alarmingly low, either. 12 lead shows a controlled A-fib. CBG is fine. My mind is racing. I'm thinking pneumonia with that "long-lasting cold," but all I've got is my gut to go on. The Rev mentions the man's slightly puffy legs; considers furosemide. . .but that just doesn't sit right with me for some reason. RevMedic's searching the house for meds, finds an awful lot of empty methadone bottles. Of course! Pupils are constricted but not pinpoint, but I'm so relieved to find something to treat that my awareness goes out the window. I dig for an IV, can't get one. The Rev gets one in the hand, finally, and I push 0.5 mg of Narcan, standard for this company and most others, although things were a tad different during my internship. SPO2 rises a gratifying percentage. We're in the process of figuring out how to move this short, stout man from his bed to the gurney when I hear a noise. It doesn't register, at first-- I'm so focused on the task at hand-- until The Rev taps me on the shoulder. "Your patient is snoring." He hands me an NPA. And as I lube it and push it into the patient's nose with absolutely no response, the jumble of puzzle pieces that had been falling into place rearrange themselves. This can't be. . .if his SPO2 is rising, his mentation should be improving. If the call wasn't FUBAR before this, it's definitely heading in that direction now, and at an alarming speed. I revert back to my internship, where a full 2mg of Narcan submentally (yes, submentally) injected was the norm, and push the remaining meds. My patient crumps. So much for Narcan being a relatively innocuous drug. We move him with no grace or fanfare to the gurney, strap him in, and wheel him out to the bus. The firefighter says he'd come with us but he's the only one covering his district today. We head out c-3. Halfway in, my patient starts frothing. It is thick, and yellow, and not at all attractive. I knock on the partition, tell The Rev we need to intubate. He pulls over, heads into the back. I try to open my patient's mouth with the standard finger pry and his teeth snap shut, narrowly missing my thumb. I try again, and his jaw is clamped so tight I probably couldn't get it open with a hammer and a prybar. I am not at all impressed with my performance from this point on. I completely blanked on my sux dosage, almost forgot the Versed, and missed both tube attempts. I am sweating and close to crying, because I still cannot figure out what is wrong with this patient. Rev gets him tubed and on the vent, and we continue on. My radio report is remarkably coherent. My mind is not. The ambulance looks like a war zone. My pt starts frothing up the tube. I'm scrabbling through suction caths, the vent is beeping, and now he's bucking the tube. The vec falls out of my hand and goes skittering under the gurney. I go to get the vent on the portable O2 and realize it's empty. ER staff pulls out the gurney, they get him into a room, they take over. The Rev and I clean up. My written report finished, we head back home. Two days later, our physician advisor skins us upside and down. He insists this pt needed Lasix. I do not concur. We check with the ICU, discover the patient had an atypical pneumonia, had almost developed ARDS. Pt received 2 L of fluid in the ER, another 2 in the ICU. Lasix would have been catastrophic.
The list of things I learned from this call numbers in the hundreds. Seriously. I do not push Narcan lightly now, particularly if the patient has an underlying pulmonary condition. I spent much time afterwards fondling various suction catheters, blades, and laryngoscopes, staring at the vent, going over in my head dosages, techniques, indications and contraindications. I read everything I could about naloxone, chronic pain, and types of pneumonia. The Rev taught me a way to prepare meds for an RSI that would prevent vials and syringes from slipping out of my butterfingers. My chart had been shoddily written, with some important things left out- the fact that our pt had trismus, and needed RSI instead of a basic intubation, the fact that the other medic unit was on another call, and could not assist, the fact that the FD had only one available person and was unable to ride along. A glaring typo in the vec dosage.
I forget, sometimes, that every new medic goes through a crisis of faith/education/whatever. But most new medics have something that I missed- that initial feeling of being unstoppable, the paragod factor that allows them the illusion of self-confidence while they build up the real thing. Self-doubt and perfectionism can both be crippling, and in my time, I've had scads of both.

hungry hungry HIPAAs

2007-02-14T17:23:00.000-08:00

Second day of orientation at MethCentral MedCenter. Had to go in a tad early for a chest x-ray since I had a positive skin test in 2004 (well, not really; it turns out the damn stuff was contaminated and what was initially thought to be a positive result bump got very painful and red and swollen and kept growing until it finally erupted in a slew of pus-ish goo about 4 months later. I still have the scar!!). In any case, I no longer get the skin tests. I get chest x-rays.

Ahem. So the radiologist calls my name, and I follow him into the dark hallways of radiology. He's a little bit gawky, still kind of looks like he hasn't grown into his nose and limbs yet. He turns around and looks at me, clears his throat. "So, are you wearing a bra and all that?"

Well. Let me see. I know I haven't got the biggest boobs in the world, and I happen to live in a hippie mecca, but I don't dress like a hippie, and I don't stink of patchouli, and there are more than token bumps under my shirt, so yes, chances are, I'm wearing a bra. But what the hell does he mean by "all that"? A corset? Push-ups? Nipple clamps? I decide not to ask. He instructs me on the use of a hospital gown (?!), tells me that if I have a problem tying it he'd be happy to do it for me.

Yeah, right.

Orientation is another long day of sitting and listening. My brain is swimming in its CSF, drowning in all this information, paperwork, check here sign here answer these questions true false multiple choice. HIPAA, patient safety, disaster protocols. We learned all the code codes (code blue, red, evac, 10, etc). I'm downing coffee like it's water, and my eyelids are still drooping.

Finally, a break, and I head to the ER for a brief reprieve. I talk to the charge nurse, find out I still don't get on the schedule until I finish with the RN orientation this week and next. Three more days of sitting, three more days I don't get to stick anyone with needles. But I find out the three medics I'll be training with are my three favorite medics in the department-- there's DeepThroat, the one who has kept me in the loop this whole time about possible job openings (he'd call and leave whispered messages on my machine every now and again: "psssst. Firefighter Girl. There's something you should know. . ." but I think he only did it so he'd get a bonus when I got hired. Then there's the RN Paragod, who has been around for ages, but is at the end of nursing school and will be leaving the department for a different one when he graduates. And then there's Stu. Good old Stu.

He's young, Stu is. Been a medic for only a couple of years. We bonded during my ER clinicals over a truly remarkable code brown (that one's not in the orientation curriculum, but if you don't know what it is. . .guess). When the stream first hit the floor with a splat and the panicked doc called for help, Stu just shook his head and grabbed the Vicks, rubbed some under my nose, and we rolled up our scrubs sleeves (so to speak) and dove in, log-rolling the bariatric patient toward us to avoid the spray. Yup. I tell ya. There's a lot you can learn about a person in a situation like that.

So. A couple more weeks before I can get my (gloved) hands bloody and dirty again, but it's going to be worth the wait.

search and rescue, country style

2007-02-10T09:11:00.000-08:00

I love drill day. I especially love drill day when the drill is in a crappy little mobile home that I know we get to burn in a few weeks. This drill, though, is SAR- search and rescue-to help Captain Snappy, the training officer, train all the newbies. The mission: Find and remove from harm our victim, Rescue Randy.
Let me set the stage:
The mobile home is set on a hill of dirt. The only vegetation is dead blackberry brambles, each stalk as thick as a rope. The carpet on the inside of this place is soaked with what I'm hoping is water, as opposed to some other unpleasant substance. There's also a large bag of Krusteaz Buttermilk pancake mix torn open in the middle of the floor, and a layer of flour coats everything. There's quite a paste forming on the carpet of the living room. There are toys and cast off things everywhere; cabinets torn from hinges, holes in the floor. You can see the ground several feet below.
I'm engineering (if you can call it that) so that the newbies get some experience with the officers on SAR. About 25 minutes left of drill time, and Captain Snappy decides he wants the last two senior firefighters (that would be myself and Ms. J, the only other female on the department) to do a run through. We mask up and head in, faces covered with our hoods so we can't see. I have the nozzle and the halligan, Ms. J has the radio. We head right, a quick search through the kitchen, and continue down the hall, pausing at each doorway. I leave Ms. J and the nozzle at the door, and take the halligan in, sweeping it with my left arm while keeping my right foot or hand in contact with the wall all the time. On one broad sweep, my halligan hits something. It makes a very loud noise. The noise it makes as it falls on me is even louder, and the noise I make as it lands on me takes the cake, particularly since I have my amplifier turned on. I'm flat on the floor on my stomach, spread eagle under a damn door. I'm laughing so hard I know I'm sucking air. . .I hear Ms. J at the door of the room screaming "Firefighter Girl! Can you hear me!!" And the most I can get out between guffaws is "collapse!" "collapse!" And all the firefighters watching me from outside do just that. In fact, they are so entertained that they decide to come in and follow us through the rest of our initial search. I can hear their little comments and shuffling bunker boots behind me as I crawl through the hallway.
The next doorway, it turns out, leads to the bathroom. I know this because when my Krusteaz coated gloves hit the linoleum, I shoot right over the nozzle and don't stop until my halligan hits the base of the counter 4 feet away. I've still got the hose with my foot, thank goodness, and I've definitely maintained contact with the wall. I search the cabinets and the little closet, and then. . .I've found our victim, Randy, in the bathtub.
He's a heavy bastard, 175 lbs of dead weight, missing a forearm from an escapade a certain firefighter had with him last year that may have involved a long chain, the staff rig, and a gravel road, although I could be wrong. More likely, the arm came off from somebody yarding on it during a different SAR drill (you know the firefighter motto. . .if it doesn't work, force it. . .). In any case, the easiest way to get this sexy beast out of the tub is with webbing. I loop my webbing under his armpits, and then get Ms. J's done up the same way. About then is when I realize there's a toilet between the bathtub and the doorway. I know this because I smacked my head on it when I tried to get at Randy's feet.
Victim removal is not a tidy thing. It's not particularly gentle, either, and in zero visibility, frankly, you're going to run into things. I accept this. Chances are, your victim's going to end up with some bruises. I accept this, as well. Ms. J is on the other side of the toilet, and can't get much purchase, so it's pretty much up to me. I grab onto the webbing, we count to three, and I feel Randy lift over the edge of the tub. The last thing I want is him wedged between the toilet and the tub, so I keep pulling. I've got both feet propped against the edge of the tub, and I'm pulling, up and over, up and over. And there's a scraaaaaaape craaaaaash boom spray and water everywhere. I check the bale of my nozzle, which has somehow miraculously remained closed during the fray. I hear Ms. J on the other side of the toilet, her voice more muffled than usual. The sound of water flowing is getting louder, and I hear someone from the audience start laughing. (thank you. thank you very much.) And it turns out that I took off the lid, seat, and tank cover from the toilet, pulled part of the tank away from the wall, and managed to turn on the bathtub faucet. As I said, victim removal is not a tidy thing. But Randy's out, although he's now on top of me.
From there, we're pretty much home free, just have to get him outside. There was a small incident with Ms. J mistaking me for Randy, yanking on my boot and screaming "I've got him! I've got him!" While I was trying desperately to maintain my hold on Randy's leg. When what she thought was Randy started kicking her, she re-evaluated her decision. By this time, she's trying to give a report to command on what her hold up is (she wisely decided not to mention that the two of us were now wedged into the doorway, weak with laughter. She did manage to tell command that we were planning an exit through the back door, although I'm not sure how much of that was understood by command because Ms. J was snorting so loudly.) The actual exit was uneventful but less than graceful, because I fell out the back door over two steep stairs, and Randy landed on his head next to me.
Guess what? Mission accomplished. Our victim is most likely now a paraplegic, but hey. . .details.

pitchfork, trident

2007-02-10T09:01:00.000-08:00

I have, on my left wrist, a tattoo. This tattoo happens to be from the poem "Spel Against Demons" by Gary Snyder. Perhaps my brothers (the firefighting ones, as I only have one actual male sibling) are somewhat ignorant because I've had this tattoo for ten years now, and frankly, the first time anyone ever really commented on it was when my training officer at the fire station informed me that it looked like two pitchforks f***ing. I have since been asked by at least two other firefighters just what the heck the pitchforks are doing on my wrist. So. A brief lesson in a) garden tools and b)anatomy and physiology. We'll save c) poetry for a completely different time.
A pitchfork, if I may be so bold as to state, generally has 4 tines, similar to (gasp) a fork. It is used for pitching hay, turning compost, and the like. A trident was Poseidon's scepter of choice; "tri-" meaning, of course, three, as it has three prongs.
As far as I am aware (although one never really knows what happens in the tool shed while everyone is sleeping), neither the trident nor the pitchfork have the sentience or the . . . uh. . . equipment to do the deed.
My tattoo, although not pitchfork or trident, most closely resembles the latter.
I hope this clears things up. For any of you still confused about the issue, I have pictures of both for comparison.

bureaucracy sucks

2007-02-09T00:20:00.000-08:00

Showed up right on time for filling out paperwork Thursday, looking rather spiffy, if I do say so myself. Blouse, slacks, heels (yes, heels). Shoot, I even wore pantyhose. I may have been slightly overdressed, since the other new employee showed up in jeans and a "somewhere over the rainbow" t-shirt. It took about an hour and a half to fill out everything I needed to fill out. I don't think I ever want to write my name, birthdate, and the last four digits of my social security number again. Phew! Then they hustled me up the stairs for a pee test and a blood draw (the tech laughed at me after I pointed out my best vein, then turned away and cringed when she came at me with the needle). I was then informed that I would have to come back for a physical in approximately an hour.

Okay. Sounds good. The physical included some random balance testing (walking heel to toe, starting on heel, rolling up to tip-toe) which I can't do even on a good day, people!! God help me if I ever have to do a sobriety test. . .grace is certainly not my strong point (I have been called disgraceful. . .oh, wait, that's something different), although, starting when I was in kindergarten, my parents did attempt to streamline my klutziness into something that passed for normal with years of ballet and then yoga. . .so now I'm an extremely flexible klutz.

Anyway, that segued into fit testing a mask for airborne pathogens and a decon suit physical exertion test which involved me donning the equivalent of my firefighting SCBA, a seatbelt, a car battery, a helmet, muck lucks, and a vinyl shower curtain, and running up and down the hospital hallway several times to "get my heart pumping."

Did I mention I was wearing heels? Tall ones? And have I also mentioned that I am earlythirtysomething, but because of the previously stated long-term lack of coordination, I didn't get my first pair of high heels until about a year and a half ago? I just got my training wheels off, for goodness sake! Ride a bike in heels? yeah, I can do that. Run in heels? With a bunch of extra gear on? Probably not.

So I kicked 'em off, jogged in my stockings. Got some strange looks, but that may have been because of the outfit, not the stocking feet. Finished up with a HR of 68, BP 117/76, RR 12. RN then told me that she needed all my worker's comp paperwork from my on the job shoulder strain from November.

I went home, retrieved the paperwork. Came back. Was informed that I needed a doctor's release to return to work before I could start at Meth Central. I argued, in my nicest, sweetest voice, that because I didn't miss any work for the injury, I didn't get a release to return to work. Was informed that I needed one, anyway.

Huh. So Diva Daughter and I vroomed to the MD's office clear across town. Brought bubble gum, paper, and crayons, and hunkered down in the waiting room for an anticipated long wait. After an hour, the receptionists finally took pity on us and set me up with a doc who, I've heard, ordinarily has the bedside manner of a dirtclod, but who this time managed a grunt and a smile as he signed me off. Seven minutes and a signature, for the cost of a regular appointment, of course.

Back to Meth Central Med Center. (anyone else keeping track? The tally is now at 4) Slid papers under RN's office door. Headed home, kicked off the heels, cooked dinner for my kiddos.

Tuesday, tuesday, thank my lucky stars for Tuesday. A paycheck is on the horizon. . .

glory hallelujah

2007-02-07T19:48:00.000-08:00

Soooooo. Driving from the bank this morning, where I had just deposited a significant sum of money I begged from my parents for February rent, when the cell phone rings. Diva daughter in the backseat is singing along at the top of her lungs to Nelly Furtado. (So was I, but I had to stop singing to answer the phone. . .) It's the head RN from Meth Central Hospital. He informs me the job offer is now official. I cannot contain the "Thank God" that slips out. I think maybe he doesn't hear it over Miss Diva's off-key vocals until I hear him chuckling.

Whoops.

He says sorry for not giving me more notice, but he has to have me in there tomorrow a.m. to fill out paperwork, pee in a cup, etc. so that I can start on Tuesday.

TUESDAY!!

I spent the rest of the afternoon celebrating this fabulous news by cleaning out part of the garage. Still can't get my car in there, but I think my bike might just fit.

in case you were wondering what i've been up to. . .

2007-02-01T17:33:00.000-08:00

The clock keeps ticking. Today was supposed to be my official hire date at Meth Central Hospital, but unfortunately, they forgot that they are a union hospital, and are required by law to post a position in house for a full week before hiring or some such nonsense. Nonsense because the only Paramedics in house already work in the ER as paramedic techs. But laws be laws, and I want to follow the rules. . .I hope something happens soon, though, because I feel like I'm going to gnaw my appendages off from sheer boredom. To stave off losing a hand (that would be awfully messy, really, and would probably get infected), I decided to dye my hair. Yes, really. It was one of those temporary mousse thingies, and since I won't be working for a couple of weeks, I figured I'd go for broke and go burgundy. What I ended up with was a pink scalp and no hair color difference- my hair, apparently, likes the color it is, and is somewhat resistant to change.
The closest thing I've gotten to EMS lately is my son's bloody nose and my daughter's head injury that happened when I opened the front door and the knob connected solidly with her eye. Whoot whoot! There were definitely some tears, some screaming, the usual. Oh, wait-- there was also that minor episode of projectile vomiting when I picked her up from daycare. . . I think more mothers should be paramedics, really. We're already amply prepared for it. My former field training officer told me once he's a sympathetic puker. And he gets car sick in the back of the ambulance. I raised one eyebrow in wonder. . .I've caught vomit in my hands when nothing else was available to hold it, not to mention accidents out the other end. Bring it on, I say. At the age of two, my daughter walks into the bathroom in her little white nightgown, blood pouring out a gash in her forehead. She looks a lot like Carrie at the prom, covered in pig blood. But this is Miss Diva blood, and the bump on her forehead is amazing. She tells me her brother hit her with a train. She says she needs a bandaid. Bring it on. Blood, guts, goo. Chest pain, abdominal pain, itching, weakness, shock, general furking medical, I really don't care. I haven't started an IV in a month, and I'm getting so desperate I may just start practicing on myself. . .if I didn't pass out at the sight of needles aimed in my direction. Okay, okay, we all have our little weaknesses.

Random other things:
Was at the current interest's house visiting him last week when- lo and behold- (and those of you who know me and my Seabiscuit Syndrome will find this both amusing and typical) his ex-wife called. Wanting to get back together with him. And I say this: to those women who can't make up their furking minds: once you dumped him, he became fair game. Once he dumps you, he's fair game. Oh- and I should add this, because I have gotten crap about this from a few male friends' girlfriends: If you've got a problem with him being friends with women, you should probably address those issues in therapy instead of on my phone. On the other hand, if he can't keep his peepee in his pants, you don't want him anyway, and you should probably thank the women he cheated on you with. Ahem. I do apologize. I just wanted to clear that up. Reading my former training officer's EMS blog, I'm actually jealous. . .bone drill, RSI, dopamine drip, all in one day. I've gotten desperate. . .I hadn't realized just how ingrained EMS is in me until I started drooling when I heard sirens outside. I dug out a few EKG strips from my sock drawer, went through them like flash cards. I'm considering letting my children climb on the roof just so I can do a trauma assessment when they fall off. (And if you think I'm actually serious about that, you obviously do not know me very well. . .) Although perhaps I'll try to convince one of the gangstas on the corner to clean out their gutters instead- while it would be nice to have some peace and quiet around the house, it's much easier to ship the babes off to dads' houses than call 911 for a transport. And- quite frankly- the gangstas on the corner are pretty much a waste of space, and letting me practice trauma assessments would be their one contribution to the good of humanity. Although- to be fair- they do provide good entertainment- SWAT stakeouts, drive by shootings, cops swarming over the property, guns drawn; I'm waiting for a taser episode to happen soon- as a medic, I've seen (and cleaned up) the aftermath, but never watched it happen . . .My nightly prayer: please, do not let me become a product of my environment. I'm overly sensitive to crap overflowing from the garbage, the smell of cat urine, home hair-dye jobs, too much makeup, my children's dirty faces. There is a very, very thin line between poor and poor white trash. As I hang up the wet laundry (the dryer is broken, but I've left it in the garage instead of on the front lawn- that counts for something, right?), I think I'll be okay as long as I don't bleach my hair and start shooting meth. I've been so bored, lately, that I've considered starting smoking cigarettes again- until I walk by the overflowing butt can by my neighbor's door, which does so much for the ambiance of my white trash neighborhood. Super sexy.
Was recently discussing music with the son's daddy. We share a love of the good stuff. I dunno why it is that some music has it and some doesn't. Probably just like any other art, I guess- it's all about the soul. (Was talking to daughter's daddy about art, and he mentioned that he didn't really like photorealism in painting- if he wants to see what a tree looks like, he'll look at a photo. What he wants to see in art is the artist's interpretation of a tree. . .I concur!) Back to music and soul- for example: Everclear's "Welcome to the Drama Club" is, for all intents and purposes, a great album, but I just can't get into it. There doesn't seem to be much feeling behind it. 30 Seconds to Mars, on the other hand, has somehow managed to become my favorite music, and has lasted in my car stereo for far longer than just about anything else but a hip hop mix I made once.
Hopefully, with the tax refund this year, I'll be able to afford to move. Hallelujah! Can't hardly wait. . .even though I've done an awful lot to this place-- put in a sliding glass door, a stone path, a large flower garden. . .I want my kids to be able to play outside without worrying about stray bullets and broken glass.
For dinner tonight, we're having what my son euphemistically refers to as "pasta," but which is really homemade gluten-free mac and cheese. And the babes are screaming for it now. . .better go put on the mama hat again.

agnes rocks

2007-01-27T10:57:00.000-08:00

I was just reading a colleague's posting on nursing homes, and figured I'd add my two cents here. I dredged this posting up from the archives. . . I've worked in 4 different ASAs, and, I'm sorry to say, have found with few exceptions that care in nursing homes is substandard. Notice I did say "with few exceptions." But thank god some of the patients are able to maintain a bit of spunk, eh?

Note: All names and identifying features have been changed so I don't get sued.

I tried writing this blog last night when I got home from work, and kept falling asleep in front of the computer. . .I'd wake up just a little bit and notice weird words up on the screen scattered throughout my sentences. The words looked vaguely like "HEENT" and "NEUROS INTACT" and "MAEW" and "BILAT" and I started realizing that I've been writing so many charts that I'm now literally doing it in my sleep. But. . .again. . .I digress.
So, yesterday, our first call of the day is to a nursing home for a 90 year old patient with respiratory distress and an altered level of consciousness (LOC) with bouts of self-harm.

Huh?

We get to this place I'll call Hopeful Heights or Whispering Willows or Shady Pines or whatever stupid name I can come up with to hide the fact that this is a place where people come to die when their families can't or won't take care of them. This is the place where the male nurse resembles a serial killer or a child molester, take your pick, and the head nurse has track marks and a seriously high tattoo to teeth ratio. Hopeful Heights is not really a happy place. Did I mention it smells like poop?
I should mention that we do have a somewhat jaded view of some of the lesser quality nursing homes. We frequently get called to them in the middle of the night by alarmist nurses and CNAs who insist their patients are in a "coma" and we get there and scare them out of a nice sound sleep and everybody's pissed but the nurse, who claims she just "couldn't wake them up." (Geez, Nurse Ratched, why were you trying to wake them up in the middle of the night, anyway?) Either that or the patient has been sick for five days, complaining of nausea, hasn't eaten, raging fever, and when you get there you don't even ask if they've given anything for the nausea, because you'll get a blank stare, and nobody can tell you anything because "it's not my patient" or "we just had a shift change, so I wasn't here." It's load and go, and you try to figure out on the way why a patient has Tegretol and Ativan on their med list if they've never had a seizure.
Anyway, this little old lady is lying flat on her back under a thin sheet in a room so cold that I'm shivering. I can hear her chatting away with a companion at bedside, but as soon as she catches sight of me and the gurney, she clams up and goes "unconscious." Fairly convincingly, I might add. I say her name, introduce myself, let her know we're taking her to the hospital. Her eyes snap open-- there's a twinkle in there, but I'm not getting all of it just yet-- and she asks, "why?" And I say, "you've been sick." Her hand slowly raises from the bed and (I'm ashamed to say) my first thought is that this little old lady is going to hit me. . .but she points right at me and smiles a little bit and winks. . .and then boops me on the nose. Hmmm. All is not quite as it seems, methinks.
We get her packaged on the gurney, head elevated so she can breathe, under several blankets to warm her up a bit. We get her outside, she looks straight at me, smiles again, and says, "I hate that fucking Hopeful Heights."

Yes, she did too say that.

We go enroute code 1, turn up the heater, get an IV. I start a head to toe and when I check her pupil response I notice that twinkle. I shake my head and can't help but say, "Agnes, you're a rascal, aren't you? A real troublemaker." And she smiles hugely and points at me and says, "no, YOU are." And boops me on the nose again.

When I get old, I wanna be just like Agnes.

NyQuil Hallucinations

2007-01-25T07:52:00.000-08:00

Thought I'd gotten things all taken care of with that job up north. Good people, good organization. I spent a lot of time trying to convince myself that the opportunities far outweighed the fact that I'd be miles from emergency medicine. . .(well. . .not literally, since this place was just down the hill from the hospital. . .but you know what I mean).

So last Thursday I'm minding my own business, buying gummy bears in the grocery store, trying to keep my daughter from filching out of the bulk bins, and my phone rings. It's a friend from the hospital I did all my clinicals at during school. Turns out, they need a paramedic tech in the ER, and they need to know today if it's something I'm interested in.

Well, duh.

So I head in there for an application, and it's like I'm the prodigal daughter returned. It was good to see all the nurses and techs, all the physicians I'd gotten to know so well. I even got hugs, which, really, you can never have too many of. We got all the particulars sorted out, and the head RN said he'd give me a call Monday. Which happened to be the day I was supposed to start up north.

Hmmm. Conundrum. Luckily, the EMS god Tai-ming stepped in. Saturday, I woke up feeling weird-fuzzy-lumpy. A little glazed. Thought it might have been from the illicit pizza I shared with A the night before (he keeps exposing me to gluten, on purpose, I think. I'm pretty sure he just wants the chance to use the Epi 1:1000 he carries in his med bag. But this allergy isn't quite there yet- yeah, my throat gets a little tight, my nose gets all phluggy, but mostly I just get rashy and gassy.) Anyway, Saturday. Did some laundry, but spent most of the time under a blanket, feeling cold. Went home early, went to bed post haste.

Sunday, I woke up. If you can call it that. I wasn't even feeling like death warmed over; I was feeling like death. My cheap digital thermometer, which usually reads me at around 96 degrees, had me at a temp of 104. My arm hair ached, for godsakes! I vaguely remember a friend coming over with meds, Jello, and chicken broth, but mostly I just slept. For 48 hours straight. I actually considered calling 911 because I really, really wanted an IV, but that's generally not a good idea when you know most of the responders. One of my friends from the department called to check on me, said he knew how lousy I was feeling; told me, "agree to an IO and that fluid's yours!" Which I politely declined, thank you very much.

I made it down the stairs yesterday; only had to stop twice to rest. Apparently the job up north is still mine if I want it, but I'm going to have to let them down. I've been wanting this ER tech position for a long time, now. I let it slip away once, and I'm not going to do that again. Great hours, great pay, no need to relocate. It's a beautiful thing.

just another day in the life of. . .

2007-01-09T07:23:00.000-08:00

The call came in yesterday, 1600. An official job offer that originally was contingent on me passing the pee test and the background check. I don't have anything to worry about on either count, but I still get nervous. . .what if somebody screws up on the testing? But no, I passed with flying colors, of course, and I'm offered a job that begins in two weeks, full benefits, insurance within the month. Starting wage is $1 more than I was making doing overtime for the ambulance, and it's an 8-5 M-F kind of gig. The potential for learning is absolutely incredible: I'll be adding to my knowledge every day I go to work, because I will be working in different places every day- urgent care one day, for a neurologist or cardiologist or internist or pediatrician, etc. the next. . .the possibilities are limitless. It's as close as I can come to working in an ambulance, except that, you know, I won't be going into people's houses, and I won't get to drive code-3, and my office won't be this cramped little space (well, maybe it will. . .), and I won't have interfacility transports or emergent MI's or traumas. . . But I will have almost full scope of practice- reading ECGs, injections, IVs. And the whole sleep thing will be nice. Several different fire departments to volunteer for up there, too. I'll be moving that general direction as soon as I can get some money together.
My son's hearing has been steadily declining for the past year, and his speech, once fairly clear, is now muffled and slurred. His autism spectrum disorder is also emerging more and more, and the school district is taking its own sweet time in their evaluation. Over a year, now, and we've seen no results. He's scheduled for a CT scan in the next month or so; who knows where that will lead us?
I woke up early this morning to the sound of my daughter sobbing and the distinctive rattle of the front doorknob jiggling. I couldn't tell where my daughter was- sound carries in this house- and my heart started pounding. I've had two attempted break ins in the last four months (what they want to steal, I have no clue), my car's been broken into twice, gunshots are commonplace (our neighbors rang in the new year with a drive by shooting), and I've had my share of peeping toms. I was afraid to call my daughter's name, so I snuck down the stairs and found her scrabbling at the front door, trying to get out. She was carrying one of her little pink 2 1/2 lb weights, god knows why, and had managed to undo one of the locks. . .thank goodness I had that deadbolt fixed after the last attempted break in, or she would have made it outside. She tells me at breakfast that she dreamed there was a fire in our house. Hazards of having a firefighter for a parent, I suppose- a hyperawareness of burning buildings. My relief was palpable. . .
I wonder sometimes if I will ever find a man strong enough to be my partner. . .I am not the easiest person to get to know, and I don't trust many people. My kids are my first priority, and anyone who can't handle my son's issues is rapidly dismissed from my life. Perhaps that's setting me up for failure, and maybe that's a defense mechanism. Do those of us with all these emotional walls find our way to EMS for a reason? I'm not the only one in this profession with boundaries etched in stone. Is it the hours, really, that prevent us from maintaining close personal relationships, or is that just an excuse? How long has it been since I've been with someone who truly knows me? Depressing to think that it's been years. . .

star spangled blinders and distracting injuries, part 1

2007-01-04T09:26:00.000-08:00

my daughter asked me this morning if I was going to have to go to work on the coast tomorrow or ever again. Her obvious, unadulterated joy at my answer- no- hit me like a punch in the stomach. How much have I missed in the lives of my children in the last 4 months, not to mention the 2 years I was in school? How much have they grown, learned, and learned to live without? A month ago, my boss informed me that my children would just have to suffer while I established a career as a medic, and it was that conversation that led me to give my notice. . .I pray for resiliency in my babies, and desperately hope that somehow, I can be both a good parent and pursue this calling. . .

New Years Day, and my roommate informs me that a) she got my car impounded and b) she will not be able to pay rent for January. At all. Thank goodness that interview went so well yesterday. . .

I've been thinking about some of my most spectacularly failed calls over the course of my internship and FTO time. These are the ones that end up being witchcraft and voodoo, the calls where I've been led down a not-so-rosy path, hook line and sinker. The first, during my internship, went like this:

76 yo female lift assist. Fire department on scene, all EMT-I or higher, calls for medic assistance and transport. They found this african-american woman sitting on the floor of her apartment, right in front of her easy chair. She denies pain, but every so often sighs and grunts. No SOB, pt looks a bit sweaty; my first impression is possibly flu. She says she's been a little sick today. FD states they eased her into a chair and she threw up; they think she might be a bit dehydrated and so they're trying to start a line. She should probably go in to the hospital for a work-up, just in case. They tell me she's remarkably healthy, otherwise; no significant medical hx. While FD keeps poking at her right arm, I slide a quick 20 into her left AC. We get the FD VS- all within normal limits- lower the gurney, and as we stand her up, she leans into me and vomits a tiny bit. She apologizes. We get her in the ambulance, she's still denying pn, denying any significant medical hx. We specify: heart? no. Diabetes? no. Stroke, seizure, lungs, recent illness? no, no, no, no. She's a bit more diaphoretic now, but smiling; still denying pn. Then she tells us she was fine yesterday, but is feeling soooooo weak today; she'd tried to stand up to go to the bathroom and her legs were too wobbly. I glance at my preceptor. We attach the 12-lead; unremarkable. SAO2 93%; lungs clear, no SOB, HR 100, BP 110/75, CBG a bit low at 90. IV established, bag of fluid hung TKO, 2 L O2 via NC. She still grunts occasionally, but we talk about how she's hoping for a sweetheart, someone who knows how to dance and can make her smile, how those two things are all that matters when you get to be her age. C-1 to the hospital, even then only 4 minutes away. We get her in the room, I give my report; the ER doc and all the techs are giving me the "why is she here?" look. I emphasize the sudden onset weakness, look to the pt for confirmation. She suddenly doesn't look so good, and is, in fact, getting more pale by the second. The doc calls for the cardiologist, the imager, everything STAT goddammit now! I grasp the pt's hand, nod briefly at her daughter, who looks familiar. . . leave to go write my chart. I come back for a signature, and I have never seen a black person that pale. . .her face is a gray, ghostly shade, and she looks frightened beyond belief. Her daughter watches, anxious.
Next transport in to the hospital less than 20 minutes later, and she is gone. The tech shrugs, says she coded as we were leaving; nothing they could do, really, with a PE, and her heart twice the size of normal. Her meds list, on file at the hospital, is proof of a dizzying array of conditions: asthma, diabetes, HTN, TIA, arthritis- the list goes on. She's had her flu shot, though, just last week. And I think to myself, as I'm back in quarters, the firefighters teasing me about this first notch in my belt, first patient lost, I think: pulmonary embolism? It was just a lift assist! And I run through all the things I know about PEs-- decreasing SATs in spite of high flow O2, SOB, possible JVD, possible cx pn, possible tachycardia, tachypnea, so many possibles. . .I search frantically through all my books for the golden nugget, the one thing I missed, the one thing I should have seen. I should have known, I should have known. . . I shouldn't have trusted the FD, even though they all are experienced medics, and me just a lowly intern. . .I should have known. . . I should have done a bilateral BP (but you got the IV in the left arm, I think to myself, and they were still poking her right arm. . .), I should have looked in her apartment for meds, I should have asked about recent surgeries, and smoking hx, I shouldn't have trusted the FD's standard RR16. I should have known to ask.
And I find it, the little nugget. . .12% of PE pts will show s1q3t3 on their 12-lead: a small s in lead I, small q in lead III, a flipped t wave in lead III. Did she have it? I don't know, I don't know. I didn't know to look.
Later that night, midnight, I'm off shift, picking up my son from his father's house. I look up as I get out of the car, and I see the daughter sitting on the stoop across the way. That's why she looked so familiar. I don't know what to say to her. I don't know that I can say anything except "I'm sorry. I'm so sorry I couldn't save your mother."

one americano with cream, hold the bingo

2006-12-31T16:40:00.000-08:00

Had my last real C shift two days ago. Every call was bittersweet, because I kept thinking it was going to be the last. Had some interesting ones-- a DOA that initially came in as a code99, and as we raced to the scene, I begged RevMedic for the tube. He looked at me and squinched his eyebrows, and I was steeling myself for a wrestling match to the airway kit when we got to the bedroom and noticed the dependent lividity in the. . .uh. . .patient's limp arm. RevMed called for PD, and I got our things back in the bus. From one end of town to the other, all day long; a new onset CVA in a snazzily dressed lady who, as I was peeling back layers of a slinky evening gown for electrode sites, called herself a paramedic's nightmare. RevMedic snipped her pantyhose at the ankle, slapped on the leg leads, and we went vrooming to the hospital, where RevMedic got a hug for his troubles, and I got. . .nothing. But we went for coffee afterwards, and waited. . .and waited. . .for a girl to finish dressing her tea with at least 10 sugar packets, each individually torn, poured, and stirred. A few other calls during the day, a mildly jarring MVA with a couple of slightly hysterical teens and their even more hysterical mother; a call waaaaaayyyyy down south for general illness in the middle of the night, and then, 3 hours later, a call for something else right across the street from the first. The Rev quipped to the patient, "you should have just flagged us down when we were here earlier. . ." One of those trips, we're heading across the bridge, we get to the other side, flip on lights and sirens, and there's a car. Right there. Lots of room on the right for him to pull off. He keeps driving. In my lane. I go to pass left, forgetting about the VERY LARGE curb-high concrete divider in the middle of the street that knocked a "holy shit!" out of me and something a bit stronger out of The Rev. Judging by the condition of said divider, I am not the first to hit it, but dang, that hurt a little. After my teeth stopped reverberating in my jaw and my heart stopped trying to leap out of my mouth, Reverend cleared his throat and I knew I was going to hear another of his colossal understatements regarding my driving. I'm not sure if his eyes were tearing because he was trying to keep from laughing at me or because he bit his tongue on the touchdown. Had another patient so hypovolemic from emesis that nobody on scene could get a blood pressure, but by the time we got to the hospital, The Rev had a 16 and an 18 in place, fluids running. Up down up down up down all night long. I said my sniffly goodbyes to Reverend and the office staff the next morning, spent a very long time packing my things up, and when I couldn't put it off any longer, grabbed the pager for the on-call car and set out to say goodbye to the town. I stopped and got a pepperminty mocha, then headed to A's to change out of my stinky, slept-in uniform, have a shower, and then hit the town. The beachfront was remarkably busy for a cold winter day; business was booming at the cafe, and my usual lingering over eggs, fruit, and yogurt with strong, hot coffee and a good book was interrupted frequently by the anxious server hovering around tables behind me. Oh, well. After paying my bill, I walked down to the galleries and spent some time meandering. There's just something about the hush of a gallery, the smell of plaster and paint, the creak of the polished wood floors that appeals to me. And then, if I happen to find a piece that grabs me, I love just standing in front of it, soaking in the colors, the composition, the ambiance. I have no idea how long I was in there. I perused some local artists' paintings and photography for a good representation of the ocean, the bridge, or seagulls, all of which I have a special fondness for, but wasn't able to find one that captured the feeling I had in mind.
Next, I headed to a tiny little used bookstore with a crackling wood stove just inside the front door. I dropped a lot more than I should have for books, but what else is new?
Stopped at Fred Meyer for some food, then back to quarters where I spent some time with two of the A-shift crews. A called around 7, saying he was back in town, so I headed over to his place, started watching a movie, and promptly fell asleep. The pager, on scan, woke me several times through the night, but never for a tone out. Took it back to quarters this morning with a heavy heart. . .

going coastal

2006-12-28T10:18:00.000-08:00

Lately, our shifts have been positively dead until dinnertime, when, inevitably, everyone decides they have an emergency at exactly the same time. Last shift, though, the poop started flying around lunchtime, and began with a call from a pediatrician's office asking if we might be willing to take a 20 month old who had inhaled an unspecified something or other up to the children's hospital in Biggest City. E, my partner (my new mantra is WWED?, or "what would E do?"), aka His Sage-ness, aka RevMedic (as he also is licensed to perform weddings, and has done so on shift, but that is another story. . .), had no problem with that, and so we prepared for the long drive Northeast-ward. The pediatrician eventually decided to send the kiddo by Life Flight, and as we assisted that team in packaging the little one, E said, under his breath, "I think I'm glad they're taking him." This kid was not a happy camper.
It seems that nobody can drive these days, including me. RevMedic frequently covers his eyes as we scream through intersections. But at least I pull to the side of the road in my POV when I hear sirens. . . I'm pretty sure someone's put stupid in the water lately, because getting to a call is harrowing, to say the least. Honestly! What is so difficult about "pull to the right and stop"?
We got a call to a supermarket for a seizure. . .guy was postictal, slobbering and gooey, attended by his brother, who apparently has no great love for modern medicine. Don't get me wrong, I'm a firm believer in naturopathic healing, too, but there can be a co-existence between that and allopathic medicine. But we got this patient's VS, recognized him as a previous seizure patient, and E started questioning the brother, who was, to say the least, a poor- and disgruntled- historian. Finally, E rolled his eyes, said, "whatever," and we tried to get the patient on the gurney. The brother went ballistic, calling us snake-oil peddlars, spouting some b.s. about how his sister or cousin or something was kidnapped by a psychiatric cult and he wouldn't let us take his brother to the hospital. . .what's a little seizure? Or two? Nothing he couldn't handle. . . Our patient is swaying on the gurney, and the store manager steps in. . . "these are medically trained professionals, and they'll take care of your brother, sir." Brother snarls, "yeah, trained by monkeys!!" and I'm praying The Reverend didn't hear that one. We get the patient in the ambulance and lock the doors, get our IV and another set of vitals before heading to the hospital, where brother is now strangely reticent, due, probably, to a conversation with police officers called to the scene to remove him.
I gave my notice last month, but my last day keeps getting drawn out. I don't want to leave this company- I love my co-workers, and have found some people near and dear to my heart over on the coast, but finding 24 hour childcare is next to impossible! My boss is scrambling to find some alternatives, and has given me much to think about. . .
Back to work tomorrow, then an on-call shift on Saturday.

oh, elusive somnolence

2006-12-28T09:41:00.000-08:00

It's been a blustery week on the coast. E and I were on shift for that horrendous storm that came through the pacific northwest last thursday. Interestingly enough, none of our 11 patients had storm- related issues, but the weather made for interesting commutes and transports. It's hard keeping your santa hat on in 80 mph wind!
That night, we did have three transfers to our closest big city. The first, in the middle of the day, wasn't so bad, but then the winds hit. Our second out of town transport was code 1 for appendicitis; E and I were in our usual state of wacky hijinks, and the patient looked at us and said, "you guys are married, aren't you?" Which made both E and I pause and made the nurse start convulsing with laughter before she assured the patient that no, we were just partners. We got on our way just a bit after dark, with highway 20 the only road out, and even it was touch and go. There were trees everywhere, uprooted, broken, and the scent of pine got into everything. 10 miles out of town, a tree had fallen across the whole road. Suddenly, several men with chain saws appeared out of nowhere, and I hopped in the back of the ambulance with the patient while E jumped out and dragged tree limbs off the road so we could pass. We were about 30 miles out, and I'm already white knuckle driving through torrential rain and wind at the wild speed of 40 (unheard of for me and my lead foot) when E sticks his head through the partition and says in his most pleasant, conversational tone, "our patient's blood pressure just bottomed out at 60, and her heart rate shot up to 150." And he smiled and batted his eyes at me. And I, quick thinking maven that I am, realized what a baaaaaaaaad thing that was. I was quite comfortable driving at 40, thank you very much, but flipped on the lights and siren, and squeaked, "well, I guess we're going code 3 then, aren't we?" By the time we got to the hospital, my arms were frozen in the 10 and 2 position, my back scoliosed from peering through windshield, and my accelerator foot had a cramp in it from keeping the damn pedal to the floor all the way to Big City. The drive back was a little less stressful, although I tried to slalom through some orange road cones and a very large tree top that slapped the ambulance from bumper to box. I may have shrieked, although I'm not sure. E congratulated me on my spectacular maneuvering, and thanked me for the choice opportunity of near impalement by, as he put it, a very large splinter. I had to ask him later if I had imagined the deer standing by the side of the road, just watching us go by. We made it back and got moved up north to a pitch black town that was eerie in its silence. Downed wires swung across intersections, and the only sign of life was two police officers coffeeklatsching in a parking lot. I was definitely hallucinating by the time we took our third transport to Big City, and thank god E drove us home after a side trip for a triple Americano.
Yesterday's shift was very, very quiet until about 2330, when all hell broke loose. The cops tazered some guy after he wrecked his car and ran, and when we got there the blood from his head ran in rivulets toward the gutters. Initially the guy was completely unresponsive, but when I started talking to him, he opened his eyes and smiled beatifically (or drunkenly, I'm not sure which), and E got a 14 g IV needle (go big or go home!) in the tenth of a mile it took to go to the hospital. We were preparing to take the guy out to Big City when Way Down South erupted in a flurry of activity, and we headed down that way for a medical call. We'd no sooner gotten back to town when we were toned out for a transport to Biggest City from the hospital up north. We headed out from that at 0305 this a.m., and I still have the marks on my forearm where I pinched myself to stay awake on the long drive. Again, E drove back, and we were so exhausted by 0630 that our usual chatter was tempered down to the occasional burst of song. I was even too tired to dance to keep warm while we were fueling, and just stood there, sleeping with my eyes open while E picked absentmindedly at the coating of ice on our side mirrors.
Three kids wanting my attention when I got home, and the roommate suggested a trip to the movie theatre-- a great way to catch some z's while the kids are otherwise occupied. But the movie was "Charlotte's Web," which was one of my very, very favorite books growing up, and I forgot how tired I was. I cried, how I cried when Charlotte died. I am once again reminded of how very much animals can teach us about unconditional love and friendship.
So, tonight is a celebration, girls' night out for C and M and I. If I can stay awake that long. . .no, officer, I haven't had anything to drink. . .I'm just an angel sleepwalking in a sparkly red santa hat.