Holiday Cheer

I’ve been wracking my brain lately to think of something to submit for this episode of The Handover… And it’s been a tough one. As some of you know, this year hasn’t been the best year for me. And this time of year is pretty rough on me this year. So I keep thinking, Holiday Cheer? When was the last time I felt that?

And it came to me. My first Christmas I was an EMT. I was working for a private IFT EMS agency who did some 911 in three other counties. I was on Christmas Eve and not really enjoying myself too much. I wrote this for EMS Week in 2010, but it works here very well.

–__–__–__–__–__–__–__–__

My partner grumbles as she brings us into the ER bay. Time to get another patient to take home. On this very cold and snowy, very unusual for us in New Mexico, Christmas Eve. “Why are we doing this again?”

I shake my head as we go inside and get our patient for the call, a very nice lady I’ve taken on several occasions for radiation appointments. But now we are called for something different. Something that, while part of my job, can be some of the hardest calls I go on. We are taking her for home hospice. This might very well be the last time I see her. So I am determined to give her as smooth a trip as I can in this horrid weather.

She is out of it for most of the trip, her mental status having slowly degraded over the months, her husband tells me from the front. I remember it’s been at least 3 months since I’ve seen her, and when I last did, she looked nothing like the tiny woman who seems to have wasted away.

It’s slow going, as a lot of the roads are icy coated. We try our very best to minimize bumps and jostles as my patient moans in pain on my stretcher. I just talk to her, reassuring her, as her husband looks back at us from the walkthrough.

All she wanted was to get home and be with her family this one last Christmas. She wouldn’t let them admit her upstairs,” he tells me while smiling at his wife sadly. “She just wants to see her grandchildren smile as they open presents.”

Is the whole family going to be there?” I ask, knowing that all of their children and grandchildren live nearby.

Almost. We have one son flying in from Iraq now. He should be here late tomorrow. She’s hoping to hold on until then,” I notice a few tears roll down his face as he says this.

We eventually get to their gorgeous home, and intact no less, and get my patient covered with a blanket so she doesn’t get wet or cold as we wheel her inside. As we walk in I notice a hospital bed, looking quite obscene, to one side of the Christmas tree. I also notice the whole family is awake, now at 11pm, to greet the family matriarch as she gets home. They just watch as we gently move her over to the bed and get her tucked in and as comfortable as possible.

As we start to step back the family circles around our patient, and you can feel the love flowing in the room. We get our gurney organized and the required signatures for the transport from the husband. I go to her bedside to tell her Merry Christmas when she looks at me and utters her first coherent sentence in the entire time she’s been with me tonight.

Thank you, TJ.”

With just those words, and a last look around, we head back out to the bus. I feel a tear roll down my face now. I look at my partner and say, “This is why we do it, no matter when or what it’s like outside. Sometimes we do make a difference, even if it’s just taking someone home.”

–__–__–__–__–__–__–__–__

After we got done with that call, we heard a ‘Merry Christmas everyone’ come over the radio, and since our board was clear me and my partner headed over to see my then-fiance and my partner’s boyfriend. We all got together at an IHOP and had a Christmas early morning breakfast. That was a morning of nothing but joy for all of us. Even though I was working, and I wouldn’t get to spend Christmas day with my fiance, since she went on shift in Dispatch about the time I got off from work, just having that little bit of time together to enjoy each others company… Well, that’s what Holiday Cheer really is about to me. And it gives me a little bit of comfort and hope that I will start to feel better about the holiday season sooner or later.

Emergency Services Christmas Prayer

I found this and decided it needed to be posted before people head off to start their duty shifts tonight. I’m not very religious but this struck a chord with me.

Emergency Services Christmas Prayer
Please make this, Lord, a silent night
this one night of the year.
No sirens wailing through the dark,
no shouts of hate or fear
No crumpled cars and twisted steel,
no blood and tears that spill.
No messages of grief to take,
to homes that suddenly grow still.
Please, King of Peace, no drunken fights
that wreck the family tree,
And all the dreams of some small child,
who clings, in fear, to me.
Let travelers tread the tinseled streets
safe from assault and harm.
On this night, this special night,
no red lights, no alarms.
I’d like to be at home, Oh Lord,
where spice and cedar scent the air.
I hope the children don’t wake up,
until I can be there.
Please make this Lord, a silent night,
no hate, or hurt, or crime,
But if this cannot be, Oh Lord,
help me get there in time.
Amen
~Author Unknown~

Merry Christmas

Merry Christmas to everyone! I’m hoping those of you who are able to spend time with family are enjoying yourselves and staying safe.

As for me, I’m 400 miles from home and going to be on duty this holiday season. But I’m spending time wiht members of my extended family at the station, and we’re trying to make it the best holiday we can have while still being able to get out the door and ride the trucks when we’re needed.

I wrote this a few years back for a friend. I usually don’t like this kind of thing, but it fits.

——————————————————————

Tonight, when you’re putting the kids to bed and waiting for Santa to come, police officers somewhere are responding to a call for a lost child.

In the morning, when you’re being woken up by excited children, wanting to open presents, a fire station is being woken up by pager tones for a house on fire.

This evening, when you and your family are sitting down to a wonderful Christmas dinner, an ambulance crew is sitting out on a street corner treating a patient having a heart attack.

Tonight when you lay down to bed, thinking of what a wonderful day you have had with your family, an Emergency Department at the hospital is waist deep in patients waiting to be seen.

Enjoy your time with your family, but while you are sitting down to say a prayer, remember the Public Safety and Emergency Services workers out there and say a prayer to keep them safe, and that they get to go home at the end of their shifts. We work all hours, and give up precious moments with our own families, so if something bad happens to you and yours we can be there to respond and help.

When you’re driving down the road to a relatives, and see an emergency vehicle behind you with lights flashing and sirens blaring, pull over to the right and give them room to move. The life they are rushing to help could be one of your family members in need.

————————————————————–

To my Emergency Services and Public Safety family, thank you for taking the time away from your family, and staying on duty to help with whatever you are asked. Stay safe and make it home to your family this holiday season. It’s been a bad couple weeks for our brothers and sisters, let’s not let the roll of honor get any longer.

Ten Songs

Well… I want to write stuff, but nothing is coming easily right now, so I’m gonna play a blog game. Shamelessly almost stolen, but really borrowed, from Cicatrix. She did 10 country songs, but I’m going to branch out to just 10 songs from my Zune playlist that have the most hits. Each of them means something to me. And by the way, this list will bring home that, while I’m very much straight, I tend to have a sappy streak in me. I could care less if you judge me for it, because the people who’s opinion I care about don’t judge me for anything.

10) Jason Aldean – Keep the Girl – Jason Aldean is one of my favorite country artists, and this song hits me especially after my relationship with my ex-fiance. One of the reasons we split up was because I was chasing my dreams of being a medic, and wanting to get out of ABQ. It really is, as the song says, is a double edged sword. I picked the road, let’s hope I made the right choice.

9) Jason Michael Carroll – Let Me Go – Another one of my favorite country artists who doesn’t ever seem to get enough play on the major radio stations. This one is another relationship song for me. Right after I failed out of school on my explosives engineering degree, I felt like I wasn’t going anywhere, and that the girl I’d been dating since I was a senior and she was a junior should basically forget about me when she went off to college. This is a newer song, but it was an odd experience to hear it for the first time, since it was pretty much how I felt several years ago when all this was happening.

8) Darius Rucker – I hope They Get to Me in Time – For any EMS providers, please listen to the song, and watch the fan video I linked to. It hits me hard as a first responder, and I’ll really just let the song speak for itself. Although I will add, I’ve loved Darius Rucker since he was performing with Hootie and the Blowfish.

7) Jason Aldean – I Use What I Got – This past year I’ve had things go wrong left and right, and been told no at every turn. This song helped keep me going, as corny as that sounds, because it’s about the way I was feeling. I did everything I could, used every bit of experience, education, and skills to find myself a job, to find myself a niche. It looks like, for the moment, I’ve found it.

6) The Fray – How to Save a Life – This one is an obvious one for my EMS friends, as well as the first non-country song on the list so far. It also has a deeper meaning for me. Back when I was in high school, I suffered with depression for a couple of years, and so did several of my friends. In fact one of my best friends in HS tried to kill herself, and I took it upon myself to try and help her through everything after that, even to the detriment of my own mental wellbeing. I still say it was worth it, but it was a rough time for me.

And this picture kinda is what I realized afterwards (From my favorite all-time webcomic XKCD)

5) Carrie Underwood – What Can I Say – This song applies to the two serious relationships I’ve had. My ex-fiance and my HS senior girlfriend. I really wish everything hadn’t gone the way it had, as I am just now starting to renew friendships with both of them and finding out how special they are, which is what led me to dating them, as just a friend.

4) Lady Antebellum – Hello World – I was flip flopping back and forth about which of 4 Lady A songs to put since they were all tied with the same # of plays for this one. I picked Hello World. It’s their newest single, and an incredible piece. The video hits home for me, but I love this group in general, so if you haven’t listened to them and you like country, you should.

3) Skillet – Those Nights – Another non-country song on the list. This song brings back memories similar to How to Save a Life. Plus I love Skillet :)

2) Thrice – The Artist in the Ambulance – What EMS provider hasn’t heard this song? I love it, for more reasons than it involves us. The beat is infectious, lyrics are good, and overall it’s a fun song :)

1) Carolina Rain – The Man I’ve Been Looking For – This song is rare enough I can’t find a video of it anywhere. I like this group, and they had two decent singles out there before they disappeared. This song is one that I’ve listened to at every hard point in my life since I was a freshman in college. It’s my essential get back on your feet song for reasons I can’t really describe. I know it’s out there for download as an MP3 though, so you should listen to it.

Well, that’s it. Not the best post, but I had fun with it :)

What’s the worst that could happen?

First off, a note to everyone. This post has been written over several days, so I apologize for any rough parts. This isn’t quite where I pictured this post to going, and there will most likely be a second part coming eventually. But first, I’ve got a post for The Handover to get done, and a blog game that our lovely Cicatrix posted up that she gave me permission to use. So without any more rambling, the post:

Ok, to my two or three readers who expect something EMS, you’re mostly going to be dissapointed. That little difference in rural EMS of not running calls compared to urban EMS has reared it’s ugly head. My service is not running too many calls right now, it seems my black cloud has slightly worn off. Hopefully that changes for my next shift.

So other than that, it’s been a busy weekend for me. I worked a 12 on Thursday during the day and an on call shift that night. From my opening, I’m sure you can probably guess how many calls we ran on that one. Yep. Just one. And we were canceled before we even hit the scene. So I was actually able to get some sleep, which was a good thing, cause Friday was a long day.

Friday consisted of trying to get my car inspected so I can get it registered here in TX. It’s actually kind of nice to not be afraid of getting pulled over cause my tags were two months out of date. I’ve been procrastinating for some time about getting it done, but since I was going to spend the majority of Friday and Saturday driving, I figured it was about time to do it, especially since I was going through the only little town I’ve ever seen that ticketed my while driving an ambulance.

Why would I be spending most of my weekend driving you ask? Well, I had to drive to Clovis, NM on Friday. My New Mexico state EMT-I test was at 0900 on Saturday morning. I figured that even though I am working in TX, my proximity to NM and maybe working part time just across the border might make it a handy time to have my full NM EMT-I cert (I’ve had a provisional EMT-I cert in NM since I did the transition course this summer, but as I found, no one will hire you with a provisional certification). And if those reasons aren’t good enough, I had already paid to take the state test :) So I might as well.

Have you ever driven in West TX/East NM? No? Well let me describe it to you. Lets start with the landscape. Flat. With a primary color of ‘dying plant brown’, but some ‘puke green’ highlights here and there. Then toss in ‘towns.’ I though I lived in a small town, but a lot of these places you literally can blink and miss them. Then lay down the road. Almost all straight, but with exactly 9 slight curves on the trip up there. I think I counted 14 stop signs/lights during the trip too. I could almost lock my steering wheel straight ahead, and take a nap for the duration of the trip. So when I say it’s a boring drive, trust me, it’s really^3 boring.

So I get up there and into my hotel. Figure I want to hunt around for a beer and a burger so I can study some more. I found out my ex-fiance and her husband, my ex-partner are both going to be there. She was testing for recert for her NM EMT-B since she let it expire. That’s another reason for the beer. It’s really going to be the first time I sit down and talk with them after everythign that has happened in the past.

So I eat, and drink, and study, and drink. Finally I decide that if I don’t know this crap by now, I’m not gonna pass anyway. So I took out the studying bit and just went to surfing the net and drinking beer. Hey it worked. And I relaxed a bit.

But people, if you have to take a major test the next day, don’t get too drunk that you wake up feeling like your head is going to explode. It’s not a good frame of mind. I went to the hotel’s complimentary breakfast to try and eat something pretty bland, when I see the couple I didn’t want to see till after the test walk in. I had no idea they were staying at the same hotel I was. This was going to be a more interesting day than I had originally thought.

I say hi to her, gave her a hug. I ignore him. I’m still hurt by what I see as him betraying me, his partner. We worked together for months and he managed to stab me in the back. Me and her talk a little, just small talk about how her parents are doing, how’s my old service treating people, the coming test. That sort of thing. Soon enough the time has come for us to head over to the local community college to take our state tests.

It all seemed like a blur, but I walked out of the test feeling good about it. That could be a bad thing, since every time I felt good about a test in P-school, I wound up not getting very high marks on it. But maybe this will be a good start to this next batch of learning and testing I’ll be doing with my second go about medic school.

I find myself sitting across the table at an iHop from them a few hours later… Just like old times when we all worked together. It’s an odd feeling. We talk about what we want for our futures. I find out that my ex and her husband are trying to have a baby, and she is talking about going to school for her Doctor of Oriental Medicine. He is still talking about Medical School, and one in NM has pretty much already accepted him.

We started talking about what I wanna do. They both were happy to hear me decide that I wanted to do the BS-EMS Critical Care at UNM. Then he said something that stopped me in my tracks, “You know, that degree was made so UNM could try to attract more EMS providers into their medical school. Have you thought about going on to that?” I couldn’t say much, just shook my head no. I just told him that I didn’t think I could do it, that it was just a dream I had.

“After working with you for almost a year, I think you can do it. There’s no harm in trying. Talk to your old hospital, they have been having trouble keeping Emergency Medicine docs in their Emergency Departments. What’s the worst that could happen?” Hearing those words come out of the mouth of a man that I dislike, who dislikes me just as much made me stop and think about it. After all, if someone who doesn’t even like me, but knew what I could do thought I could do something like this…

It’s a similar situation like a fellow blogger had. She was talking to a friend at work and the same thing hit her. I don’t know what to do at this point. I did call my old hospital to talk to their ED director. He told me that they could very well work out a deal with me if I get undergrad out of the way and get accepted into the City Medical School. I’m just flabergasted that anyone would think I can do it.

I love being a field provider, a ditch doctor as some people call EMS. But the idea of being able to get to the top of the system and try to get change to happen for the field I love is a strong pull to doing it.

After all, what’s the worst that could happen?

98% sheer boredom, 2%…

I’m starting to think that down here my most used sentence on calls is “Does anyone here speak English?” Makes me realize that for the communication portion of my AAS I’ll definitely be taking Spanish to at least get some basic conversational skills to help me out in the field.

We had a call the other night that highlighted the fact that there is a large percentage of our population here in BFE that has never bothered to learn to speak English. We get called out for a simple fall out of bed. Should be nothing major, right? Well, we get waved down at the address (Ah the infamous Bystanders Sign language) and start to head in. We leave the cot in the bus for a bit, and just take the first in bag with us.

I walk into the door, still pulling on my gloves, and just about stop in my tracks as I see the patient. Something just doesn’t look right.”Hey there,” I say to the husband, “What seems to be the problem tonight?” As if I can’t see that his wife is sitting on the floor after falling out of bed. Never hurts to ask anyways.

“Umm… No English,” Were the only words that he said. Great… I think to myself, this is going to be an interesting call, since the old man doesn’t speak Spanish either. I kneel down beside the woman on the ground. She’s pale, diaphoretic, and just seems to be flailing around. She can’t focus on me at all, and just withdraws a little when I give the webbing between her thumb and index finger a pinch. I do a quick trauma sweep and don’t see anything that could cause too many problems.

“Lets get her on the bed so we can take a look at her.” I tell my partner, who technically is the senior of us two since he’s a medic, plus the senior medic at the service. But he seems to be letting me run the calls more and more and just getting involved when something needs done that I can’t do. I don’t really mind that too much since I need the contact hours since I’m starting medic school in a month or so.

He just comes around to grab her under the arms while I grab her legs, and we heave her up onto her bed. With her on the bed, she’s in a little bit better light, and I can take a quick look at her. She looks even more pale with full light hitting her, so I look at my partner and ask him to bring the cot in.

I break open our first in bag and quickly pull out a pulseox, BP cuff, and the glucometer. I look at the husband and, knowing it might be useless, ask, “Does she have any medicines? Umm… Pills, shots… Medicinos?” I fall back on the old joke in NM of adding ‘o’ to the end of every word to make it Spanish. Amazingly enough this time, it works. He gets a big smile on his face and goes into the kitchen and starts rummaging around like he’s looking for something.

That never works, I think to myself, shaking my head. Oh well, maybe I’ll have some good luck on this one. I quickly inflate the BP cuff to my usual 150, and slip my stethoscope in and listen. I immediately hear the heartbeat in my ears, so I keep inflating until I hear nothing.

Uh oh, 190. Not good. I think as I slowly let air out and listen for the change in sound to let me know I’ve got a full blood pressure measurement. 190 over 110… This doesn’t look too good for her right now. Look down at the sat, it doesn’t look too bad. 96% on room air, pulse showing as 95, and a quick grab at her wrist confirms it to be in about that area.

I hear the husband still looking for whatever he thought I asked for, hopefully it’ll be the medications she’s on, so I can have some idea of her medical history. Right now I’m wondering if she might have a history of hypertension or heart troubles, since right now my number one concern based on her presentation is a stroke. I hear my partner get the cot in the front door and we quickly move her over to the cot. I let him know what I’ve got, and he agrees with me about my concern. Looking her over again it almost looks like she has some facial drooping on one side, but since we can’t get her to do the other parts of the stroke scale, it’s kind of hard to say for sure if that’s what we’re dealing with.

The husband finally comes out of the kitchen clutching a little soft sided cooler, like the ones I brought my lunch in every day for my first try at medic school. He smiles as he hands it to me, and I open it up in a rush to see just what conditions she might be dealing with. As I look into the bag, I feel like an idiot. A bottle of Metformin and a Novalog pen are staring up at me from the very top.

I snag the CBG kit from where my partner had left it, without getting a sugar I guess, and quickly grabbed a sugar level from the patient. Yea, 20… That might explain some of these signs.

Digging again into the jump bag yields a little white box, which I toss onto the bed, along with a syringe and a couple of needles, and an alcohol prep. I drag the vial of sterile water up into the syringe and inject it into the vial of powdered Glucagon. The old man sees what I am doing and grabs out a bag of NS and a line set and gets it set up and looking for a vein on his side.

I get the newly reconstituted Glucagon all ready to go and as I’m switching needles so I can give it to the patient I notice my partner has gotten a line and is taping it down. Once I stab the syringe of medication into her arm, I toss him a box of D50 and he goes to work pushing it.

Within 30 seconds of the start of the D50 being pushed, she starts to come around. She has that very confused look on her face that a lot of people experiencing hypoglycemic incidents get when they wake up to several strange men standing around their living room. As we’re trying to explain what happened, our other truck shows up, with one of the crew able to speak Spanish.

Great timing, why couldn’t you have been here ten minutes ago?! Oh well, at least now we know she’s telling us she doesn’t want to go with us. After all, kidnapping is highly frowned upon by the authorities.

————————————-_____—————————-

And by the way, the high BP was cause by non-compliance with HTN meds… and for the record, don’t take your AM dose of insulin at night with your nightly dose because you forgot it in the morning. Do that and pretty good chance you’ll be waking up to strange people staring over you when you wake up.

All in all the last week has been a good week. I’ve had good calls, including one ROSC code, that have helped me remember why I love my job. I love the challenge of figuring out why someone is down and out, of trying to get someone out of a car without hurting them too much and get them to the hospital safely, of helping family understand what we are doing to their loved one and why. The days of constant waiting, of cleaning trucks and stations with nothing to break the boredom, I can put up with those kinds of days because of days like this. Good calls that get me thinking and working hard. Calls that make me put the knowledge I have to the test, and look up more after calls to double check that I know the latest on treatment modalities. And of course, calls like I’ve had, where I can’t do what I know is needed to be done because I’m not a paramedic… They just spur me on more to keep going and get more education. And I’m counting down the days until I can be back into that classroom and start on the #questforthediscopatch.

Huh… What do I with that?

I had a rude awakening during a call today (my first call after being cleared to run lead in fact). We got dispatched out to a psych call. Basically to do a medical clearance so she could be committed. PD was already on scene when we got there, so we jsut took some vitals and did a quick once over. Problem… According to PD we had to wait for the case worker to show up with the paperwork we needed to transport against the patient’s will.

This call, just sitting there and trying to keep a patient who is very agitated calm, showed me that I have a lot to learn when it comes to dealing with psych patients. If she had been a medical patient I would have felt very comfortable treating her, same to a lesser degree for trauma. But since there was nothing physically wrong with her, I was at a loss on waht to do.

Guess it goes to show that you are never done learning.