Algorithms

His shoulders are slouched and his eyes are heavy with sleep….and something more. The moment I catch sight of him, I realize something is terribly amiss. There’s only one reason that my normally bright-eyed co-worker is in plain clothes in the ER at midnight on Christmas. I catch his eye and his determined march down the hallway slows and eventually stops.

“You know her?” I ask gesturing to my left with my head, indicating the patient I just brought in lying no more than 10 feet away in the hospital bed, an array of medical professionals hurriedly working to stabilize her. He nods in response, more of a quick jerk downward with his head verses a full nod but he seems unable to form words as he looks past me to the lifeless woman nearby. He’s avoiding eye contact. My heart is sinking and the knot in my throat is growing exponentially.

“What happened?” he finally asks, barely above a whisper.

“She told her husband she wasn’t feeling good. Then she collapsed.” I spare him the details for the moment but I know there will be more questions and explanations to come. “I’m sorry,” I mumble. The room is suddenly suffocatingly hot.

“The family is here,” he says, still avoiding eye contact.

“I already let the doctor know,” I reply. “He said he’d be out as soon as he can.”

“I need to go see them,” he tells me, and wanders off in the direction of the waiting room.

In his absence, I realize that I haven’t taken a full breath since I first saw him and I attempt to fill my lungs but the air gags me and I can’t shake the sharp pain that sears through my chest as I watch him amble away.

All the Things I Cannot Say

I haven't posted on here lately because I'm starting to second-guess if blogging is really my thing. I originally started this more as an avenue to try to put into words my thoughts & feelings and convey some of the interesting things that I encounter in my EMS ventures. I never intended that I would have a multitude of readers & I certainly didn't anticipate any feedback from my ramblings.

I have been a lot overwhelmed lately. Most of it is in a good way but I think I've become somewhat jaded as to what an interesting day for me and an interesting day for the rest of the world is. Overall, the things that make my life beautiful and wonderful aren't grand adventures but rather the small things that I find hard to put into words. And, it seems that the small things aren't really what draws people's attention.

End of the Road

Some days, when I least expect it, certain calls mow me down in ways I never thought possible. People ask me sometimes what the worst call I have been on is. I don't usually entertain their morbid curiosity.They are usually looking for grotesque stories that exceed imagination. But most of the time, the gory, blood-filled calls or the cardiac arrests really aren't my worst calls. They are perfunctory and by-the-book. I usually have little, if any. time to interact with my patients on truly critical calls. My worst calls usually are borne from the depths of despair of humanity. The patients who know and are conscious of how awful and hopeless their situation is and yet are unable to do anything about it. Those are the ones that pain me long after I have walked away.
We had one such call the other day. And I want to share it with you, not to wow you with some tale of heroism or adrenalin-fueled lifesaving. I share it with you because I want you to understand the truly tragic calls that never cross anyone's mind when they ask what the worst call ever was.

Tiny Cut

It’s so tiny. You can barely see it there on the side of my finger. Yet it’s implications are huge and the very sight of it terrifies me. The barely visible cut hurts but it’s a psychologically based hurt…not a valid physical pain. I try to tell myself it is just part of the job and that all the tests will come back negative. In the meantime, I am left with a million scenarios and scary possibilities.

Free as a Bird

He's my dad. No one else knows I think of him that way. The same blood runs through us...Type A EMS blood. He has helped me grow to where I am today. He guided me as I took my first faltering steps and watched painfully as I fell down on more occasions than I care to admit. But every time he helped me back up and encouraged me to keep going. In more ways than I can count, he is my hero and I will always look up to him. But today, he is letting me go. He is sending me into the world of paramedicine on my own.

Only 17

She is shaking uncontrollably. Her knees are pulled to her chest and when I address her, she briefly unburies her face from her hands. The face that greets me is far too young to be in her predicament. I know that she doesn't need medical help but the officers onscene aren't going to deal with her so I am left with no choice.
I ask her name and she replies in a small terrified voice. She tells me she is only 17.

Tough Times

“I’m scared,” he tells me. I stare at him slightly dumbfounded but try to continue my assessment. I’m scared too. Terrified in fact…and I’m doing everything in my power not to show it. His fear, on the other hand, is quite genuine and evident by the tears that are sliding down his cheeks and plopping silently onto his orange jump suit. I swallow hard and turn my attention to the deputy nearby, asking about any safety risks with my patient. She is rather unhelpful so I set about the task of getting my patient moved over to our gurney so we can transport him to the hospital. He has had a week of progressively worsening chest pain and he is legitimately scared that his heart is giving out on him. I try to reassure him but the irony is overwhelming. I never imagined at any point in the course of my life that I would be calming an anxious inmate. He obediently moves to my cot and lets the deputies shackle him. In the ambulance, he is somnolent as the tears continue to slide down his cheeks. He is just like any other patient now...vulnerable and terrified...with just me to try to buffer the angst. The trip to the hospital and the tranfer to the medical staff was uneventful, just like most other transports. The after-effect of this one, however, was quite different for me. The last several months have been an array of highs and lows for me. I have now been precepting for 13 months and have, quite frankly, hit the wall. My level of frustration is at an all-time high and I am more than ready to be done with the entire thing. I have had many days that I could care less if I ever get signed off to work independently in our county. It is not that I can't take care of people, it is the fact that I haven't had enough high acuity calls to be able to "prove myself" to my preceptor. And so, the days, weeks & months drag on. Don't get me wrong, I still love being a paramedic, but some days it doesn't seem like enough to cover the frustration that is my life currently. It doesn't help that lately, my personal life has been caving in as well. And so, there I was, staring at my terrified inmate patient, and realizing that, no matter how fed up I was with the world, he needed me to be at the top of my game more than he needed anything else at that moment in time. And it was at that moment in time when I knew that I needed far more of a pick-me-up than I could muster on my own. When I made the call, I'm sure my voice cracked at some point. Even as I drove across town and sat down at the table across from one of my 3 preceptors, I was shaking inside and holding back tears. I was burned out, emotionally drained, and ready to give up. "You know your medicine. I would trust you any day to take care of my family. You just need to get the calls, take charge and you WILL get through this," he told me. We talked for over an hour. I don't think he had any idea how much I needed to hear his words of encouragement. My other 2 preceptors had tried, without much success, to cheer me on. I know they meant well but something about my 3rd preceptor finally hit home. I nearly hugged him when I left that day. I wish you could understand all the terrible things that emergency responders deal with on a daily basis. And at the very same time, I'm glad that you don't have to cope with those types of things. In spite of our best efforts, at the end of the day, we are still only human and, as much as we hate to admit it, we too need help sometimes to get through the tough times. I still have a ways to go in my precepting. But I know now that I am further along than I originally thought I was. The end will come and, when it finally does, I know I have 3 amazing preceptors who will be there to celebrate with me.