Hey guys and gals!
I've got a post up at my new site. I figured I'd update here for a few times with a reminder that I've moved in case anyone missed it!
Take care out there,
Sam
11.28.2008
11.23.2008
New Site
It seems to be the thing to do in medblogs nowadays! First, Cheating Death became Medic Three. Then Epi moved her blog to an amazing new site.
Now, you can add me to the list. I'm not getting rid of this site, taking it down, or anything like that. I moved all my links, entries, etc. to a new site, though. I now have the domain http://samtheemt.com.
It's all ready to go. I hope you guys like it; let me know what you think! I'll be updating regularly there now.
Take care out there,
Sam
Now, you can add me to the list. I'm not getting rid of this site, taking it down, or anything like that. I moved all my links, entries, etc. to a new site, though. I now have the domain http://samtheemt.com.
It's all ready to go. I hope you guys like it; let me know what you think! I'll be updating regularly there now.
Take care out there,
Sam
11.21.2008
Mama Who Bore Me
Her hand is cold as it makes contact with my face. She's looking right at me with these cloudy green eyes, lost in her overdosed haze. I'm supporting most of her weight as she tries to pee before we go. I'm literally her rock right now.
"Sarah," she says longingly as she strokes my face, "Sarah I'm so sorry."
She smells like my mom. Her hair is long enough that it reminds me of playing with my mom's hair as I sat behind her on the couch. A burning wetness stings behind my eyes, and I force it back.
In a moment of lucidity, she snaps.
"Oh GOD just go, just let me die, Sam. Jesus just go, I just want to die, I took all these pills and I just want to die."
I help her up from the toilet, pulling her pants up while juggling her weight with the basket I hold for her as she tries to vomit. I flush the toilet with my foot, and bear hug her all the way out to the stretcher.
"My husband doesn't love me. I asked him for a divorce. He knows I want to die, he told me to just fucking take the pills and get it over with and just do it. He has a death wish for me."
"Mary, we're going to take you to the hospital now."
I don't even have a set of vitals on her. Eric and Jake wheel the stretcher out to the ambulance as Mary clutches my hand like it's her lifeline. Without letting go, I climb into the back with Jake as Eric heads for the driver's seat. She keeps looking at me without seeing me.
She sees her daughter, Sarah.
"Sarah, I just love you so much, you and your brother, you know? I'm so, so sorry. You're so beautiful. You've gotten so much older since I saw you last. And your hair, it's so long."
She stops, her head hitting the stretcher with a thick smacking noise that sickens me.
"Oh god the drugs, Sam, the drugs are kicking in."
"Mary, I need you to stay with me. My partner is going to start and IV on you to give you some fluids and medicine, okay? I'm just putting these stickers on your chest so we can get a picture of your heart and make sure it's okay."
"Okay, okay, I'm trying."
"No one sleeps in the ambulance, isn't that right, Sam," I hear Jake say as he spikes the bag of saline.
"It's the second rule of the ambulance," I say, referencing Frank Pierce's number one rule without letting on.
"I'm here, I'm with you."
I tie the tourniquet around her arm and feel for a vein. It's beautiful, and I know Jake can get it with no problem. I move over so he can stick her, and try to keep her talking.
"Mary? Mary? Mary, stay awake."
She doesn't move. I rub her sternum deeply and she groans, opening her eyes.
"I'm here, I'm awake. Oh, Sarah, you're so pretty."
"No sleeping, Mary, I need you to stay with me right here, right now."
Her head smacks against the stretcher again, and her arm drops.
"Mary," I yell at her as I rub her sternum again, "Mary open your eyes."
She doesn't move. I rub it again, with more force, and she doesn't even flinch.
"FUCK," I yell at Jake as I hurdle over the patient and stretcher in one fell swoop.
"What?"
"She's not breathing."
I pull out the bag-valve mask and rip the plastic off. It floats in the current the heater produces, waving eerily. I hook up the oxygen and drop the stretcher back. I position her, lift her chin, and make a tight seal with the mask.
I watch her oxygen saturation levels rise as I breathe for her, my hands responsible for her life. Jake finishes the IV and pulls out a nasopharyngeal airway to keep her airway patent as I bag her. I see things flying around the back as he applies lubricant to the airway, pulls out suctioning equipment
Every five seconds, I pump a life restoring breath into her body. Jake gets orders for Narcan and pushes it, but there's no result.
She wakes up long enough to pull out the airway as she vomits, and promptly returns to her previous state. I try to hook up the suction and still keep her alive as Jake yells vitals up to Eric to call into the hospital.
My hand is cramping from my grip on her face--on her life. I push the annoyance out of my mind. Bag, I tell myself once every five seconds, but it's not enough. I need the metronomic tattoo I usually get from the bridge we drive. But tonight we go to a different hospital, away from bridges and rivers.
I hum. It's quiet enough that Jake can't hear, but I know that some part of Mary does. It provides me a steady, calm rhythm to which I can bag, and connects Mary to her daughter, at least in my mind.
Mama who bore me
Mama who gave me
No way to handle things
Who made me so bad
Mama, the weeping
Mama, the angels
No sleep in Heaven, or Bethlehem
Some pray that one day
Christ will come a'-callin'
They light a candle
And hope that it glows
And some just lie there
Crying for him to come and find them
But when he comes they don't know how to go
As we arrive at the hospital, I continue the song in my head, too embarrassed to be heard. It's partly out of respect--respect for Mary and Sarah and the sanctity of the bond. I bag her as we change beds, as they expose her indecently on the table.
I allow myself to be pulled out of the room by the current of those around us. Propping myself up against the wall in the EMS room, I close my eyes tightly and shake my head.
"You alright," Eric asks as he comes in.
"Yep," I lie.
"Sarah," she says longingly as she strokes my face, "Sarah I'm so sorry."
She smells like my mom. Her hair is long enough that it reminds me of playing with my mom's hair as I sat behind her on the couch. A burning wetness stings behind my eyes, and I force it back.
In a moment of lucidity, she snaps.
"Oh GOD just go, just let me die, Sam. Jesus just go, I just want to die, I took all these pills and I just want to die."
I help her up from the toilet, pulling her pants up while juggling her weight with the basket I hold for her as she tries to vomit. I flush the toilet with my foot, and bear hug her all the way out to the stretcher.
"My husband doesn't love me. I asked him for a divorce. He knows I want to die, he told me to just fucking take the pills and get it over with and just do it. He has a death wish for me."
"Mary, we're going to take you to the hospital now."
I don't even have a set of vitals on her. Eric and Jake wheel the stretcher out to the ambulance as Mary clutches my hand like it's her lifeline. Without letting go, I climb into the back with Jake as Eric heads for the driver's seat. She keeps looking at me without seeing me.
She sees her daughter, Sarah.
"Sarah, I just love you so much, you and your brother, you know? I'm so, so sorry. You're so beautiful. You've gotten so much older since I saw you last. And your hair, it's so long."
She stops, her head hitting the stretcher with a thick smacking noise that sickens me.
"Oh god the drugs, Sam, the drugs are kicking in."
"Mary, I need you to stay with me. My partner is going to start and IV on you to give you some fluids and medicine, okay? I'm just putting these stickers on your chest so we can get a picture of your heart and make sure it's okay."
"Okay, okay, I'm trying."
"No one sleeps in the ambulance, isn't that right, Sam," I hear Jake say as he spikes the bag of saline.
"It's the second rule of the ambulance," I say, referencing Frank Pierce's number one rule without letting on.
"I'm here, I'm with you."
I tie the tourniquet around her arm and feel for a vein. It's beautiful, and I know Jake can get it with no problem. I move over so he can stick her, and try to keep her talking.
"Mary? Mary? Mary, stay awake."
She doesn't move. I rub her sternum deeply and she groans, opening her eyes.
"I'm here, I'm awake. Oh, Sarah, you're so pretty."
"No sleeping, Mary, I need you to stay with me right here, right now."
Her head smacks against the stretcher again, and her arm drops.
"Mary," I yell at her as I rub her sternum again, "Mary open your eyes."
She doesn't move. I rub it again, with more force, and she doesn't even flinch.
"FUCK," I yell at Jake as I hurdle over the patient and stretcher in one fell swoop.
"What?"
"She's not breathing."
I pull out the bag-valve mask and rip the plastic off. It floats in the current the heater produces, waving eerily. I hook up the oxygen and drop the stretcher back. I position her, lift her chin, and make a tight seal with the mask.
I watch her oxygen saturation levels rise as I breathe for her, my hands responsible for her life. Jake finishes the IV and pulls out a nasopharyngeal airway to keep her airway patent as I bag her. I see things flying around the back as he applies lubricant to the airway, pulls out suctioning equipment
Every five seconds, I pump a life restoring breath into her body. Jake gets orders for Narcan and pushes it, but there's no result.
She wakes up long enough to pull out the airway as she vomits, and promptly returns to her previous state. I try to hook up the suction and still keep her alive as Jake yells vitals up to Eric to call into the hospital.
My hand is cramping from my grip on her face--on her life. I push the annoyance out of my mind. Bag, I tell myself once every five seconds, but it's not enough. I need the metronomic tattoo I usually get from the bridge we drive. But tonight we go to a different hospital, away from bridges and rivers.
I hum. It's quiet enough that Jake can't hear, but I know that some part of Mary does. It provides me a steady, calm rhythm to which I can bag, and connects Mary to her daughter, at least in my mind.
Mama who bore me
Mama who gave me
No way to handle things
Who made me so bad
Mama, the weeping
Mama, the angels
No sleep in Heaven, or Bethlehem
Some pray that one day
Christ will come a'-callin'
They light a candle
And hope that it glows
And some just lie there
Crying for him to come and find them
But when he comes they don't know how to go
As we arrive at the hospital, I continue the song in my head, too embarrassed to be heard. It's partly out of respect--respect for Mary and Sarah and the sanctity of the bond. I bag her as we change beds, as they expose her indecently on the table.
I allow myself to be pulled out of the room by the current of those around us. Propping myself up against the wall in the EMS room, I close my eyes tightly and shake my head.
"You alright," Eric asks as he comes in.
"Yep," I lie.
11.18.2008
Of Cats and STEMIs
The cat is the first thing I notice when we come in the door. Scrawny and motionless, it peers up at me. It's perched contently on the back of a recliner, and as I move closer it tilts its head slightly.
I swear it's animatronic. It looks like some weird statuette of a cat covered in fur that someone would find at a bazaar. In fact, most of the things in this room look like something I'd find at a flea market or carnival.
I introduce myself with the same tired words.
"Hi, my name is Sam, I'm an EMT with the rescue squad. Can you tell me what's going on tonight?"
The cat opens its mouth as if to respond, but I hear a woman speak instead.
"It's my mom. She's having this weird pressure in her chest. Aren't you, Mom?"
I look over to the recliner with the cat and see a woman sitting comfortably. She doesn't seem in any distress, other than a hand placed carelessly on her breast. She doesn't speak.
"She just got like this about thirty minutes ago, and I figured I ought to call." A baby lies fast asleep on the couch next to the daughter.
"Alright, what's your mom's name?"
"Alice."
"Thanks."
"You know, I was thinking about this because the other weekend I had kidney stones, and they hurt a lot, but mom had kidney stones and didn't really complain, and--"
I let the paramedic hear the rest of the story as I start addressing our patient. She speaks to me a little bit, lets me take her vitals, and tells me that she wants to go to the hospital. That's fine by me.
Out of the corner of my eye, I see Drew looking at the cat suspiciously. He moves his finger towards it, and it extends its head to smell. His eyes grow wide, and I stifle a giggle.
I ask Alice some more about her symptoms once we get into the ambulance. She says it only hurts a little bit, but she just feels uneasy. Her blood pressure is sky high, and she does complain of a headache. She says she just doesn't feel quite right.
I look over at the monitor after I finish setting up the 12-lead for the paramedic. It's suddenly quite clear why she's not feeling right. As the strip prints, I set up an IV. Alice's heart muscle is dying, and she needs to be at the hospital now.
Without alarming her, my partner informs Drew that he needs to get us to the emergency room post haste. The red lights flash in the deep blue night, but the siren remains silent in this rural town.
I'm fixing to insert the drip set into a liter bag of saline, when I find myself planted firmly in the IV box.
"Hey Drew," I call up to the front sweetly.
"Yes ma'am?"
"Could you tone it down just a notch? You found me a new home in this pretty orange box."
"10-4, my bad!"
The IV is beautiful, and I do my best to maintain my balance while I hand over the tubing. I've never run a truly emergent call with this paramedic, so I'm trying to get used to his style while effectively help Alice. It proves difficult at best.
My partner gives her four baby aspirin, a sublingual nitro, and a little bit of morphine IV. This is the first obvious ST Elevated Myocardial Infarction (STEMI) I've run, so I try to keep my excitement to a minimum.
Alice says she's feeling much better as he calls the hospital to speak with the doctor. It's weird the way she acts, though. Her movements are small, and she remains relatively motionless on my stretcher. She only speaks when spoken to, and her voice is soft.
A statuette of a woman, Alice is something you'd find in a bazaar. Alice is her cat.
I shake the weird images from my head as we wheel her into the hospital. It's five in the morning, and my mind is playing tricks on me.
"Do you think I can go to work today," she asks the doctor genuinely.
"That'd be a resounding no," I hear someone reply as I make my way back to the EMS room.
"Sorry about the IV box," Drew says as he pats my shoulder.
"Not a problem," I say as I dust my self off dramatically.
"But dude...what was with that cat!?"
I swear it's animatronic. It looks like some weird statuette of a cat covered in fur that someone would find at a bazaar. In fact, most of the things in this room look like something I'd find at a flea market or carnival.
I introduce myself with the same tired words.
"Hi, my name is Sam, I'm an EMT with the rescue squad. Can you tell me what's going on tonight?"
The cat opens its mouth as if to respond, but I hear a woman speak instead.
"It's my mom. She's having this weird pressure in her chest. Aren't you, Mom?"
I look over to the recliner with the cat and see a woman sitting comfortably. She doesn't seem in any distress, other than a hand placed carelessly on her breast. She doesn't speak.
"She just got like this about thirty minutes ago, and I figured I ought to call." A baby lies fast asleep on the couch next to the daughter.
"Alright, what's your mom's name?"
"Alice."
"Thanks."
"You know, I was thinking about this because the other weekend I had kidney stones, and they hurt a lot, but mom had kidney stones and didn't really complain, and--"
I let the paramedic hear the rest of the story as I start addressing our patient. She speaks to me a little bit, lets me take her vitals, and tells me that she wants to go to the hospital. That's fine by me.
Out of the corner of my eye, I see Drew looking at the cat suspiciously. He moves his finger towards it, and it extends its head to smell. His eyes grow wide, and I stifle a giggle.
I ask Alice some more about her symptoms once we get into the ambulance. She says it only hurts a little bit, but she just feels uneasy. Her blood pressure is sky high, and she does complain of a headache. She says she just doesn't feel quite right.
I look over at the monitor after I finish setting up the 12-lead for the paramedic. It's suddenly quite clear why she's not feeling right. As the strip prints, I set up an IV. Alice's heart muscle is dying, and she needs to be at the hospital now.
Without alarming her, my partner informs Drew that he needs to get us to the emergency room post haste. The red lights flash in the deep blue night, but the siren remains silent in this rural town.
I'm fixing to insert the drip set into a liter bag of saline, when I find myself planted firmly in the IV box.
"Hey Drew," I call up to the front sweetly.
"Yes ma'am?"
"Could you tone it down just a notch? You found me a new home in this pretty orange box."
"10-4, my bad!"
The IV is beautiful, and I do my best to maintain my balance while I hand over the tubing. I've never run a truly emergent call with this paramedic, so I'm trying to get used to his style while effectively help Alice. It proves difficult at best.
My partner gives her four baby aspirin, a sublingual nitro, and a little bit of morphine IV. This is the first obvious ST Elevated Myocardial Infarction (STEMI) I've run, so I try to keep my excitement to a minimum.
Alice says she's feeling much better as he calls the hospital to speak with the doctor. It's weird the way she acts, though. Her movements are small, and she remains relatively motionless on my stretcher. She only speaks when spoken to, and her voice is soft.
A statuette of a woman, Alice is something you'd find in a bazaar. Alice is her cat.
I shake the weird images from my head as we wheel her into the hospital. It's five in the morning, and my mind is playing tricks on me.
"Do you think I can go to work today," she asks the doctor genuinely.
"That'd be a resounding no," I hear someone reply as I make my way back to the EMS room.
"Sorry about the IV box," Drew says as he pats my shoulder.
"Not a problem," I say as I dust my self off dramatically.
"But dude...what was with that cat!?"
11.16.2008
The Screaming Bridge
I had a really long conversation with a friend tonight. He made me cry over the image of a solitary green mitten in the snowy sunset. It's okay if you don't understand; mittens shouldn't make people cry, I know this. He inspired me to write the images I see, rather than trying to force them into a story. It was basically exactly what I needed to hear.
Because I've stopped writing. I'm sorry; I'm a delinquent blogger. But for some time, I've just felt uninspired, and really pressured by myself to write about every call and every word.
That's not a fair expectation for me to have of myself. I should seriously stop that.
So I promise you this: when I feel inspired to write, I will write. And when nothing is coming to me, I won't try to muddle through flat words to bring you inspired thoughts.
And eventually, I'll tell you about the screaming bridge.
Take care out there,
Sam
Because I've stopped writing. I'm sorry; I'm a delinquent blogger. But for some time, I've just felt uninspired, and really pressured by myself to write about every call and every word.
That's not a fair expectation for me to have of myself. I should seriously stop that.
So I promise you this: when I feel inspired to write, I will write. And when nothing is coming to me, I won't try to muddle through flat words to bring you inspired thoughts.
And eventually, I'll tell you about the screaming bridge.
Take care out there,
Sam
11.14.2008
Award!
I know I promised a post on that strip. I'll get on it ASAP, but I've just been super drained lately. This is a rough time of the semester, and with trying to volunteer 18 hours a week and work 20...well, you can understand I'm sure.
In any event, I was nominated for this Bookworm Award that's been running the gamut of my favorite medbloggers for a bit now. Thanks so much to Bernice and ParamedicSuperMonkey, two wonderful bloggers. Go give them a read if you haven't already :)
Rules are as follows. Pass it on to five other bloggers, and tell them to open the nearest book to page 56. Write out the fifth sentence on that page, and also the next two to five sentences. The CLOSEST BOOK, NOT YOUR FAVORITE, OR MOST INTELLECTUAL!
Okay...I have two books right on top of one another. The first is Rescue 471 by Peter Canning.
"We get called for an unresponsive diabetic on Brookfield Street."
Second is The Things They Carried by Tim O'Brien. I had a conversation with a friend today (via GChat's awesome new video interface!) about this book, so I dug it out of my bookshelf to reread it :)
"I remember staring at the old man, then at my hands, then at Canada."
Epi, duh. She's phenomenal, and if you haven't read her blog by now, you're seriously missing out.
EE at Backboards and Bandaids. It's so nice to read the musings of another college EMT.
Medic Three aka Cheating Death. He's got some seriously wonderful stuff. Go check it out!
ManchMedic. One of my new favorite blogs. I can't believe I didn't read his before.
Lastly, Witness. This is mainly just so he'll post SOMETHING, but he's a fabulous writer and I love it when he actually does update.
Tonight in the ER, I had a woman who was seriously afraid of needles. She was there with her boyfriend for abdominal pain. The conversation went something like this.
Me:"Hi, my name is--"
Her: "OH MY GOD OH MY GOD ARE YOU GOING TO STICK ME WITH NEEDLES OH GOD!"
Me: "Ma'am, I have to start an IV. The doctor is going to want to give you some fluids and medication to help you with that pain."
Her: *incoherent screaming*
Boyfriend: "Baby, which is going to be worse...this little needle stick or the pain in your stomach?"
Her: "THE NEEDLE!"
Boyfriend: "Then why did we come...?"
She feigned fainting. When her boyfriend let go of her hand, it sort of hesitated in mid-air and then collapsed dramatically on the bed. He rolled his eyes at me, I smiled back at him, and finished what I was doing.
The nurse comes in, looks at me, looks at her, and looks at the boyfriend.
"Hey," she says as she shakes her. She continues feigning this unconsciousness. "Hey, listen. Anytime you want to stop pretending like you're unconscious, that'd be great. I don't have the time to sit around and play with you."
Miraculously, she comes around, mentions something about feeling woozy, and how she hates needles.
It was a great day had by all.
p.s.--My best friend has a legitimate phobia of needles, so I understand people who don't do well with needles. I do my best to be accommodating and take them seriously. But when I have three-year-old patients who deal with it better than they do, and they start acting like they're unconscious...I lose all respect.
Take care out there,
Sam
In any event, I was nominated for this Bookworm Award that's been running the gamut of my favorite medbloggers for a bit now. Thanks so much to Bernice and ParamedicSuperMonkey, two wonderful bloggers. Go give them a read if you haven't already :)
Rules are as follows. Pass it on to five other bloggers, and tell them to open the nearest book to page 56. Write out the fifth sentence on that page, and also the next two to five sentences. The CLOSEST BOOK, NOT YOUR FAVORITE, OR MOST INTELLECTUAL!Okay...I have two books right on top of one another. The first is Rescue 471 by Peter Canning.
"We get called for an unresponsive diabetic on Brookfield Street."
Second is The Things They Carried by Tim O'Brien. I had a conversation with a friend today (via GChat's awesome new video interface!) about this book, so I dug it out of my bookshelf to reread it :)
"I remember staring at the old man, then at my hands, then at Canada."
Epi, duh. She's phenomenal, and if you haven't read her blog by now, you're seriously missing out.
EE at Backboards and Bandaids. It's so nice to read the musings of another college EMT.
Medic Three aka Cheating Death. He's got some seriously wonderful stuff. Go check it out!
ManchMedic. One of my new favorite blogs. I can't believe I didn't read his before.
Lastly, Witness. This is mainly just so he'll post SOMETHING, but he's a fabulous writer and I love it when he actually does update.
Tonight in the ER, I had a woman who was seriously afraid of needles. She was there with her boyfriend for abdominal pain. The conversation went something like this.
Me:"Hi, my name is--"
Her: "OH MY GOD OH MY GOD ARE YOU GOING TO STICK ME WITH NEEDLES OH GOD!"
Me: "Ma'am, I have to start an IV. The doctor is going to want to give you some fluids and medication to help you with that pain."
Her: *incoherent screaming*
Boyfriend: "Baby, which is going to be worse...this little needle stick or the pain in your stomach?"
Her: "THE NEEDLE!"
Boyfriend: "Then why did we come...?"
She feigned fainting. When her boyfriend let go of her hand, it sort of hesitated in mid-air and then collapsed dramatically on the bed. He rolled his eyes at me, I smiled back at him, and finished what I was doing.
The nurse comes in, looks at me, looks at her, and looks at the boyfriend.
"Hey," she says as she shakes her. She continues feigning this unconsciousness. "Hey, listen. Anytime you want to stop pretending like you're unconscious, that'd be great. I don't have the time to sit around and play with you."
Miraculously, she comes around, mentions something about feeling woozy, and how she hates needles.
It was a great day had by all.
p.s.--My best friend has a legitimate phobia of needles, so I understand people who don't do well with needles. I do my best to be accommodating and take them seriously. But when I have three-year-old patients who deal with it better than they do, and they start acting like they're unconscious...I lose all respect.
Take care out there,
Sam
11.08.2008
Things and Stuff
So, I didn't get one of the finalist spots for the blogging scholarship. Oh well! There's always next year, and for now, there are some great blogs nominated. You can see the full list and links to each finalist here. Check them out; maybe you'll find a new, awesome one! Regardless, I'm so excited to see so many young people being active and engaged with their surroundings. I'm sick of the apathy my generation seems to have, and it's nice to see a lot of my peers rejecting that.
Also...our favorite frequent flier that I wrote about here is sort of getting what's coming to her. Apparently they're finishing up the paperwork, and she'll have a warrant for abuse of 911. Let's see if she'll end up moving again.
I've got a post coming on this strip soon:
Also...our favorite frequent flier that I wrote about here is sort of getting what's coming to her. Apparently they're finishing up the paperwork, and she'll have a warrant for abuse of 911. Let's see if she'll end up moving again.
I've got a post coming on this strip soon:
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