Skip to content


Space Cadet

1 comment

Lately, I’ve had one theme that has continuously managed to resurface in my day to day life: outer space. Perhaps this is mostly self-induced by reading space-themed books, listening to podcasts by my favorite astrophysicist (What? You don’t have a favorite astrophysicist? Absurd.), finding this awesome website, following the NASA picture of the day, or the fact that I recently transported my favorite patient ever to the hospital. This kid and I were meant to meet.

You see, my favorite patient ever was a nine year old African American kid with glasses and a plainly stated favorite school subject of “Stephen Hawking’s theory of black holes.” One look at this kid, and I knew he was in frequent danger of being stuffed in a locker; this is definitely my kind of kid. I’m pretty fond of nerds in general, but give me a science nerd, and my heart just melts. His single-mom was dangerously trendy and an odd match for her precocious offspring; I definitely didn’t get my nerd-itude from my single-mom, either. This kid and I were having so much fun chit-chatting about science on the way to the hospital, I almost forgot to take care of him.

Growing up, my favorite toy was a cheap, crappy microscope that nearly caused me the loss of a friendship over a critical debate in 1990 with another elementary-school student over whether it was more important to seek medical care or a microscope slide for a sample when presented with an actively bleeding injury. (I stand my ground that she was not going to bleed to death in the time it took me to get a slide and a sample before applying a Ninja Turtles Band-Aid, for the record.) I keep a handheld microscope far more powerful than that piece of crap ever was in my purse these days. My favorite patient ever and I looked at all kinds of stuff with it once we got to the hospital.

I am fascinated by science and technology, and in EMS these are vital topics. I can carry with one arm a machine with a battery power source that is capable of not only showing and reading electrical activity in a living heart, but is also able to defibrillate at various levels of Joules, pace a heart at various speeds and amperage, collect and monitor active CPR data, collect and monitor blood oxygen saturation data, and collect and monitor expiratory carbon dioxide levels. Frankly, this is just freaking amazing considering that 12 lead ECG technology has made great leaps since it was first brought to light in the 1940s.

I often find myself wondering how the technology we use daily without much thought came to it’s current form, and more importantly how can we make it even better? Obviously, countless sources went into creating the technology we have today. Maybe it’s the little nerdy dreamer in me, but I can’t help but think of NASA when it comes to the kind of technology and equipment that will definitely come in handy on an ambulance. In Packing For Mars, Mary Roach wrote:

“If it’s cordless, fireproof, lightweight and strong, miniaturized, or automated, chances are good NASA has had a hand in the technology. We are talking trash compactors, bulletproof vests, high-speed wireless data transfer, implantable heart monitors, cordless power tools, artificial limbs, dustbusters, sports bras, solar panels, invisible braces, computerized insulin pumps, fire-fighters’ masks.”

I don’t doubt that many things conjured up by the brilliant minds prepared to apply science, math, and technology to evaluate the cosmos can make our impacts greater as medics. If the EMS community ever opts to send a representative to check in with the research and technology at NASA, I would like to officially make the statement public that I will happily volunteer.

My New Favorite Song

2 comments

My cousin sent me this video this morning. My cousin is awesome.

Playing well with others

3 comments

Back in the days of the rose colored glasses, before I ever dreamed of any future that did not include a Nobel Prize, I went to college. I had a complete stranger for a roommate in the dorms, and a few weeks before school started, I received some information about her and the opportunity to contact her.

This process turned a completely intimidating theory of a humanoid with weird habits, messy tendencies, and horrible taste in music into a real girl named Susannah with an affinity for country music and deep roots in religion. Perhaps not my kind of girl on the norm, but at least she was no longer a looming, scary archetype of the unknown. SusieQ and I weren’t best friends by any means, but we were comfortable enough for me to hold back her hair the first time she got a hold of some wine coolers.

I work in an agency with a few hundred folks in the field and a fairly normal EMS worthy turnaround rate. I don’t always know who my coworkers are and I suspect the same is true for many of my constituents. I may have more knowledge of many of my colleagues than I did of my college roommate, but SusieQ and I never had to work smoothly together to fight off the Grim Reaper.

Does your agency use any tool for biographical information to brief new partners in advance? Do you prepare a dorm assignment biography in advance? Do you copy the centerfolds’ interviews from Playboy?

If you could know something about your future partner, other than the vague ideas one grasps from others’ gossip and the occasional walk-by greeting in the wash bay, what would you want to know? What would you want them to know about you?

I think I would want to know a few basic things. Their certification level, their comfort level with the job, how long they have been at the agency, where they are from, what they prefer to do to pass the time on shift, and something fun and EMS related.

What do you folks think?

One of ours has done something awesome…

No comments

Firefighter/paramedic/writer/superhero Mark Yost recently got in touch with me about his new book.  He has published his first novel, an ebook available on Amazon called Soft Target.  That is no easy feat, folks.  Amazon’s review says, “the story that unfolds in Soft Target is best described as Tom Clancy meets Backdraft meets 50 Shades of Grey.”  Yowza!  I haven’t had a chance to read it yet, but you can bet I plan to.  There are few things I love more on the planet than getting lost in a great book, let alone one that only costs three bucks.  Go forth and support your fellow working man!

The Ovarian Dilemma

10 comments

The Augusta National Golf Club has been making big news lately because it is currently faced with the ever present Ovarian Dilemma. This is how I understand it: The Masters golf tournament is under way, and Augusta National gets big-time corporate sponsors every year so that they don’t have to air a lot of commercials. Augusta National shows appreciation by offering the CEOs of the sponsoring companies a membership slot in their very conservative and exclusive club.

In a shockingly progressive move, Augusta National extended a membership invitation to an African American person in 1990, which was quite a big deal at the time. Since, race relations within the club have not been a hot-ticket issue to my knowledge. Augusta National does not afford membership opportunities to women, a policy for which they have taken a lot of heat from feminist activists over the years.

IBM typically sponsors the Masters, and the past four CEOs of the company were allotted membership. However, this is the first year that Virginia Rometty has held the position of CEO of IBM. This puts Augusta National once again in the limelight, as Ms. Rometty also happens to be the bearer of a vagina.

At first glance, this appeared to be some of the dumbest crap I have ever heard. Why does anyone care what these anachronistic fools are doing enough to spend any time trying to unravel their motives? Further contemplation shows this enigma is just one example of the still existing gender inequality. Ms. Rometty successfully worked hard and smart, eventually earning the position of CEO, but millions of women continue to get kicked in the proverbial ovaries every time they look toward that glass ceiling. Gender disparity is not an idea or an assumption; it is a tangible fact.

Gender inequality gets instilled in us at an early age. I remember plenty of examples from my childhood, but that was a while ago and times are changing, aren’t they? I’m dubious. In a blatantly unscrupulous attempt to win the debate over whether fire trucks or ambulances are cooler, I brought an entire home daycare out to the ambulance to see the rig, and most importantly, honk the air horn. (I’m shameless, I know.) My partner pointed out to the kids that I am in charge, and a five year old girl said, “but you’re a girl!” She and I had a little girl power talk after that. I told her that lots of people will tell her she can’t do things because she’s a girl. There will be lots of things she will be unable to do as she grows up, but never because she’s a girl. Apparently, I misspoke because I did not take into account the Augusta National Golf Club. She got to honk the air horn, so I don’t think she was thinking about any golf clubs, either.

I recently had a large patient with an altered mental status that we had no choice but to restrain. He started to come to on the way to the hospital, and apologized for his previous behavior although he had no recollection of it. He told me that if I were going to insist on doing this kind of job, I needed “to gain some weight so that [I] could handle some of them big boys.” This guy was every bit of 300 lbs. I told him, “Sugar, I didn’t have a problem getting you under control.” I’ve restrained plenty of people, and I have never had a problem due to my chromosomal arrangement.

The issue here isn’t that women aren’t equipped or deserving, it is the perception that we aren’t. This is a precarious issue to handle. I’m not sure I would want to be in Ms. Rometty’s shoes. On one hand, if Augusta National excludes her, she’s the kid not picked to be on the kickball team in gym class. She will be criticized as a woman who did not fight for gender equality, despite her position as the first female CEO of this powerful company. Besides, who wants to have to bully their way into a club?

On the other hand, if Augusta National extends an invitation to Ms. Rometty, would she even want to accept it? Would she want to pay dues to an antiquated boys club to hang out with a bunch of dinosaurs playing golf? Would she want to be the one who hears conversations peter out as she walks into a room, knowing the topic was based solely on the presence of her uterus? What the hell would that god-awful green jacket go with? I would start by bedazzling the shit out of that blazer; I’d make it read “VAGINA” across the back in rhinestones. This is probably an example of why Ms. Rometty is a CEO and I’m not.

In a just world, Augusta National would invite Ms. Rometty to their exclusive club, and she would reply, “On behalf of IBM as CEO, I thank you for such a prestigious invitation. I understand and respect that you overlooked long standing rules and traditions to include me. On behalf of myself as a woman, I decline your invitation. I am uninterested in being a part of a club that has spent more time and energy focusing on my gender than my accomplishments. I would also like to point out that the green jacket is hideous.” However, this is not a just world.

Would having a female included in an old-fashioned boys’ club change the world? I doubt it. What does change things is having all the Ms. Romettys of the world take the higher ground. Ms. Rometty has not even commented on the situation to the best of my knowledge. Refusing to play dirty is a classy move, I think. Do women in EMS have that restraint? I like to think so, but who knows? It’s hard not to take personal offense when you’re considered second rate for things out of your control sometimes. Sometimes you just want to look a chauvinist in the eye and call him a douche canoe.

Betty White knows best. Picture courtesty of too many places to cite.

 

 

Right-Wing Republicans Everywhere!!!

11 comments

All this talk in the news lately about republicans has me reminiscing.  You see, I didn’t have a typical introduction into EMS.  Actually, several things about me that I consider a fundamental part of my identity aren’t exactly characteristic of professionals in this field; like the fact that I have a vagina, for instance.

 

Fresh out of college, I proudly displayed my Bachelor of Science degree as I worked…in a coffee shop.  I enjoyed working there, but I knew deep down that I would need health insurance one day.  A friend of mine had recently begun volunteering as an EMT, and he double dog dared me to take the EMT class.  I studied forensics in college, and I love evaluating facts and solving a mystery surrounding death.  I couldn’t see a single scenario in which I would want to work with living patients.  I thought living patients are boring and annoying.  The problem is that this was a double dog dare.  One does not balk in the face of a double dog dare.  Plus, I was working at a coffee shop and tutoring a few local kids in math; my time wasn’t exactly in high demand.

 

I enrolled in the next available EMT class, and shortly after graduated top of my class.  I’ve always loved to solve a puzzle, and I was thoroughly surprised to find that every patient has a mystery to solve.  Furthermore, you have to solve it on your feet, in a limited amount of time, in difficult surroundings.  Well, I do love a challenge!  I opted to apply for a job as an EMT, thrilled by the fact that I could get health insurance AND a 401k.  I felt like I was impersonating a grown-up.

 

The job was like nothing I’d ever encountered.  I was completely unprepared for several aspects of emergency medicine, but the single biggest initial shock was my coworkers.  I had never seen so many right-wing republicans in my life.  I felt like Jane Goodall.

 

Many of my coworkers appeared to be right-wing republicans to me, regardless of where they actually fall on the political scale, most likely as a partial result of so much exposure to the liberal side of life.  At first glance, it appeared to me as if the archetypal EMT is molded from a gun-toting, conservative, WASP household with some deep seated connection to emergency and rescue services.  He is a Caucasian male, slightly overweight, and has a bitchin’ mustache with a receding hairline. He typically drives a pickup truck too large for one paltry parking space, often adorned with a toolbox, American flags, at least one star of life, a fire symbol, and an occasional biblical reference.  He has a side job in a manly endeavor like carpentry, logging, auto-mechanics, masonry, or creating testosterone.  He loudly spouts antiquated ideas and references, and he has distaste for new technology he has yet to understand, unless it will calculate drug dosages for him or bring him pornography.

 

My coworkers weren’t exactly prepared for me, either.  I grew up reading comic books and finishing my homework early in a family that only cared for politics when the discussion turned to legalizing marijuana.  My pepper spray is pink, I’d rather read than watch television, and I drive the sissiest pickup truck known to man.  Maybe I didn’t fit in here because I’ve never fit in anywhere, but the differences made me seem like a pariah.  I saw myself as a modern, feminist intellectual with a strong sense of purpose and ethics, but I probably appeared to be an over-educated, bleeding-heart hippie with a snooty lust for literature.

 

A few incidents stand out for sure as extreme:

 

The first time I worked on an ambulance, my field training officer and I went to McDonald’s for lunch.  We sat down at the table, and he prayed before eating his meal.  I’ve never been a religious person and was slightly caught off guard, but I respect his beliefs.  Although I did not participate, I waited in silence for him to finish.  He immediately took on a very serious tone, raised his voice, and told me that I am going to Hell.  I honestly thought he was joking at first, as it seemed so strange to me.  It’s not every day a girl gets condemned.

 

I quickly learned that political commentary is not an invitation for polite discourse. I just spent four years in a liberal arts college, surrounded by geeks, activists, artists, and hippies.  I had grown accustomed to having the opportunity for cerebral conversations about rights, laws, science, technology, art, religion, or politics with nearly anyone I came across, and I was so surrounded by the liberally minded, that I thought that was the norm.  A coworker complained disdainfully about immigrants and “other freeloaders.”  At first mention of the word “socio-economic,” I was told I was “one of those” before I had even made an actual statement.

 

Shockingly, several people with whom I worked not only refrained from recycling, but opposed it.  Recycling seems to me to be one of the easiest ways in which people can reduce their carbon footprint.  All you have to do is put certain kinds of trash in a different receptacle.  I have worked with more than one person who would intentionally throw away empty soda bottles that I had saved in a bag to take home to recycle.  I was once told by someone who threw away a bottle of mine that he did so, “because recycling is just plain stupid.”  I’m sorry, do what?  I never could wrap my head around that.

 

Those examples are pretty extreme, but they’re true.  These days, I don’t feel so much like an outsider.  I may obviously lean a little more left of center than many of my coworkers, but few people stand out as being glaringly right-winged.  For the most part, the little differences are for little more than poking fun nowadays.  I tend to just ignore the extremists; as it turns out, they are the outliers, and they are not limited to EMS.

 

Republican/Parapup Comparison

Utilizing the Second Amendment:

                Republican-Has a multitude of firearms at his disposal.  Knows location and specificities of each gun.

                Parapup-Has pink pepper spray on her key chain.  Now carries pepper spray outside of purse when walking alone after realizing that she would have to ask an assailant to hold on a minute so she could find her keys in her purse to get to her pepper spray.

Identifying One’s Heroes:

                Republican-Actual people in history and athletes

                Parapup-Fictional comic book characters with impossible super powers

Extracurricular Interests:

Republican-Civil war

Parapup-Serial killers

Vehicular Turbulence:

                Republican-Either knows how to fix cars, or knows someone who does

                Parapup-Knows how to turn up the radio louder to mask naughty engine noises

Sports: 

Republican-Enjoys watching NASCAR

Parapup-Enjoys watching NASCAR fans

Fashion forward:

Republican-Accessorizes with camouflage

Parapup-Accessorizes with glitter and rhinestones

Cars:

Republican-Pickup truck takes up two spaces

Parapup-Pickup truck barely takes me to work

Animals:

Republican-Hunts for game

                Parapup-Once hit a cat with my truck. I might have cried.

 

I need to bathe…in turpentine

19 comments

The local men’s shelter is no stranger to anyone in EMS.  The women’s shelter isn’t much better for that matter.  As a female, the men’s shelter is one of my least favorite places on the planet.  While many gentlemen utilizing the facility are likely the down-on-their-luck folks in need of a hand while they are trying their hardest to get their lives together, enough men stand out as complete and total creepers to leave a lasting impression.

My first trip to the men’s shelter occurred when I was a wee baby EMT.  While my partner assessed a man with a non-emergent complaint, a commotion arose a little further away.  A few of the shelter’s occupants began to yell that a man couldn’t breathe. Someone pulled at my arm saying that another patient was there and needed help.  Well, that’s exactly what I do!

My partner stayed with the present patient and I took off to assess a potentially new patient with a breathing problem.  I forged through the crowd, an EMT on a mission, to reach my patient.  A person was yelling over the cacophony of the public area and directing me to a person bent over in the tripod position.  As I approach the person fully prepared to save the damn day, he looks up at me with a sparsely toothed grin and says, “I need you to give me mouth to mouth, sweet thing.”

Suddenly, it seemed as if the entire facility burst into laughter.  People made kissing faces at me and smacked their lips.  I felt like I was having one of the dreams I used to have in high school in which I show up in the auditorium naked, and everyone is laughing and pointing at me.  Homeless men made fun of me for being female and taking my job seriously.  Fantastic.

I can’t think of a single time I have ever made a trip to the men’s shelter in which I didn’t encounter some sort of cat-calling, kissing noises, propositions, or some other degrading deed.  I’m certainly not special in this regard.  I’d love to think I have some sort of stunning beauty and charm that renders men incapable of controlling their verbiage, but I’m pretty sure they’re just douche canoes.   I’ve discovered that any response at all on my part merely exacerbates the situation and only serves to put me in a foul mood.

The best way I’ve heard of handling this particular jackassery comes from a coworker’s last trip to the men’s shelter while working with a female partner.  The two were making their way through the crowd, when the inevitable howling began.  He heard an occupant say, “Come over here and give me a kiss!” Being the variety of EMT that wears XL gloves (that fit), he nipped the situation in the bud with, “I got your kiss right here, baby!  Who wants one?” It always warms my heart to hear of a potentially nasty scenario handled with enough proportional humor and grace to diffuse it entirely.

This was a particularly crowded afternoon, and the occupants were milling about freely as I pushed my way through with the stretcher.  Some folks were feeling unusually free spirited, and the obnoxious response to my chromosomal arrangement was extraordinarily enhanced.  Despite the fact that I could feel many pairs of eyes on me and hear plenty of unnecessary comments*, I employed my usual tactic of giving no response and limiting my eye contact to the back of my partner’s head in front of me.

People were meandering all around me, which camouflaged the movement in my periphery. Unexpectedly, an arm reached out from the crowd, hooked around my waist, pulled me toward him, and landed a completely unsolicited, whiskered, alcohol soaked, and unbathed kiss on my right cheek.  Oh. My. God. FUCKING GROSS.

I was completely at a loss.  On one hand, I know that any response will get the crowd involved and encourage their behavior.  On the other hand, I want to bitch slap this motherfucker.  I just got face raped by a drunk guy with poor hygiene and a forehead a tattoo.  I just told him, “Keep your oropharynx to yourself, man.”

This particular vagabond has quite the history.  Seriously, everyone knows this guy; even the general public.  The first time I met him was at a restaurant on shift, whereupon he offered my hand in marriage to a dude who bought him a sandwich.  Since then, he has been on my stretcher numerous times.  He has asked me to marry him no less than three times.  He has sung to me on a few occasions.  He once got mad at me and gave me the silent treatment the entire trip to the hospital.  He even cussed me out once.  It’s been one of the more stable relationships in my life, until now.  Now, I just feel dirty and a little violated.

The only time I have ever come close to this level of gross-itude was another unusual situation.  I picked up a panhandler on whose behalf the police requested medical attention.  He was experiencing chest pain and had a medical history warranting further evaluation; he appeared to be a legitimate medical patient and I did not suspect otherwise.  I arrived, got my patient situated, did an ECG, and treated him with medications.

I primed an IV line in preparation of obtaining IV access.  This was all routine, run-of-the-mill stuff…business as usual.  He shifted around a bit, and rearranged his clothing in the process.  He placed his jacket in his lap.  I placed his left arm over my leg and tied a tourniquet, when I noticed his right arm rhythmically moving under the jacket.  Oh, hell no.  Please tell me this man is not jerking it in my ambulance.  “Sir, what are you doing?”

He took his left hand, grabbed my thigh, and said, “Baby, I’m not doing anything,” and moaned.  He MOANED.  He is definitely jacking off in my ambulance.  They did not cover this in paramedic school.  I have no protocol for masturbation; onanism is not mentioned anywhere in my protocol book.

I told him to keep his hands where I could see them, and I moved to the captain’s chair behind the stretcher.  Screw the IV.  If the nitropaste on his chest drops his blood pressure and he passes out, so be it.  I know what to do about that.

My partner and I went for emergency cupcakes following the creeper incident.  We parked the ambulance in front of a swanky dessert bar.  As we approached the bar, the bartender said he was unsure if we were allowed to park our ambulance in front of the store.  I told him, “Listen.  Some dude just whacked it in my ambulance, and I need a cupcake like you wouldn’t believe.”

His eyes went wide. “Yes, ma’am.  Right away.”

 

*I even heard the ever classy command, “Show me your tits!” That was unusually vulgar, even for the men’s shelter.

FOB

22 comments

A great partnership is a beautiful thing.  A twelve hour shift can be very long when you spend it in the cab of an ambulance with someone with whom you do not get along.  By and large, I have been very lucky to have been paired with partners who are great people over the years.  I’ve heard many-a-horror story of partnerships gone awry, but other than a religious fanatic who often lectured me about my future as a demon in hell who inevitably lost his marbles and quit over the radio, I have never experienced much more than mild snafus.

I’m fairly certain I’ve been the obnoxious one on the truck most of the time.  Let’s face it; saying I’m quirky is a bit of an understatement.  As of right now, I am wearing a Wonder Woman bracelet, I have a Super Awesome trading card in my pocket, and my pet zombie Vince is nestled snugly in the dashboard handle.  I’m blond, I’m bubbly, I’m silly, I occasionally fix poor punctuation on posted signs, and they know me at most of the comic book stores in my city.  That stated, I don’t tolerate rudeness, maliciousness, or subpar treatment.  I use every opportunity to learn.  I may be a bit of a goofball, but I give it everything I’ve got on every call.  Putting it nicely, I can be a lot for a partner to handle.

Explaining the partner relationship to non-EMS folk is a bit of a challenge at best.  Most of the time when I reference my partner, people generally assume I’m a lesbian.  Frankly, it’s not completely unlike dating someone.  If a quarter of your time is spent with a person while experiencing drastic emotional and physical highs and lows, a relationship will build regardless of the orientation.  It tends to be the type of relationship in which all clothes are kept on and cuddling is kept to a strict minimum.  There are no big or little spoons on the ambulance.  I’ve heard tale of partners taking their relationship to a physical level on shift, which makes me shudder.  Ambulances are gross.  Ick.

I recently took a new shift and assignment, forcing me to part ways from my most recent partner.  While I have an exciting, new endeavor awaiting me, I can’t help but reminisce about the fun times I’ve had.  My last partner, FOB, took the news of my shift change well, despite that he told me he wasn’t ready to start partner dating again.  FOB (Fresh Off the Boat) gained his name because of the sheer inapplicability of the term; A Cuban by birth, he’s been in the States the vast majority of his life.  I started calling him FOB in lieu of “my partner” to non-EMS friends to make them refrain from questioning my sexuality, and it sort of stuck.  In addition to being a generally awesome dude, FOB is a very smart EMT with badass language skills and a great sense of humor.  I laughed at work every day with FOB.

FOB’s latino lusciousness occasionally crept up in conversation, and for this I was more than a little jealous.  What do I have?  Caucasian caution?  Lame.  FOB took pity on my boring WASPy racial heritage and gave me the title of honorary Cuban.  Once on a call at the home of a Hispanic family, FOB and I dealt with a frantic wife of a patient too inebriated to speak for himself.  Our patient’s poor wife was very flustered and struggling to find her words in English, despite the fact that she spoke English quite well under normal circumstances.  She consistently became frustrated with herself trying to report to me in English.  Ever the levelheaded provider, FOB told her, “It’s okay.  You can speak to her in Spanish.  She’s Cuban.”  Following that statement, everyone on scene appeared to do a collective head tilt of confusion.  With my alabaster skin, blue eyes, and blond hair, everyone was shocked to hear of my latina lusciousness.

FOB never failed to make me laugh with one liners:

Following a call in which we treated an unusually well-endowed lady with symptoms warranting a 12 lead ECG: “That 12 lead was all blind.  Those titties were so big, I had to use the force.”

Pulling out of the parking lot in the ambulance: “This truck has more miles than Madonna.”

After a domestic violence call in which the victim was well known for violence toward responding personnel: “What’s wrong with America when a nice lady like that can’t drink her 40 in peace?”

After pronouncing a man dead that was the victim of an obviously gang related shooting: “You know, this probably wouldn’t have happened if he joined a book club instead.”

 

Someone let these fools save lives.

Ah, FOB.  There’s always overtime.

I Found The Key!

14 comments

As a paramedic, I have encountered more adipose than I ever imagined possible. I suppose prior to joining EMS, I was always aware of obesity as an epidemic, but I had no reason to encounter many downright spherically shaped people. I never expected to voluntarily hold employment at which I not only get to see the morbidly obese regularly, but I also encounter some of the unexpected byproducts of vast girth.

Today, I treated a woman of advanced mass with a myriad of health problems. In the process of rearranging some of her bountiful tissue to place leads for an accurate ECG reading, and I found under her left breast…a key. A single, isolated key.

I said, “Ma’am, this looks like the kind of thing you’re going to want to hold onto,” while handing it to her. Her face lit up. “This is my house key! I’ve been looking for this! Thank you!” I’m certainly glad I was able to help my patient with a problem, but entrapped key extraction was not a service I had anticipated providing.

I understand the concept of using one’s breasts as an excellent place for storage. I tuck my pepper spray in my cleavage when I go for long jogs, and I’m not above sticking some cash in there when I don’t want to carry my wallet. Typically, one also needs a bra to assist with this kind of storage.My patient needed not be limited by such troublesome clothing. She could store, and subsequently lose her house key in her bosom without trouble.

I’ve given it a fair amount of thought, and I still can’t decide if this is a pro or a con to morbid obesity. On one hand, you can store things without even using the elasticity of a bra, but you also run the risk of losing necessary objects. I’m completely ambivalent.

My neighbor thinks I’m crazy

4 comments

I realize it’s been a while since I’ve posted, but I’m apparently working on a vicious case of writers’ block. While I try to string some words together in sentence form, I present a story from my life that has nothing to do with EMS at all, but entertains me. In the meantime, wish me luck.

My Neighbor Thinks I’m Crazy

I have a neighbor that thinks I’m crazy, due to two incidents in which he may have viewed my actions completely out of context and the fact that I come from a long line of women endowed with an element of ridiculousness.

Incident #1: I’m sitting on the porch of my apartment at 1 AM reading a book and enjoying an adult beverage, when I see out of the corner of my eye an unidentified shiny object moving slowly near the next alcove over. I try to ignore the object, telling myself it is of no consequence to me, but as a person with a confirmed overactive imagination, I begin the inevitable process of envisioning the myriad of things this object could be. I imagine scenarios in which it is an alien, a robot, and an animal in distress, among other things. I take my dog out, so I can get a better look from afar, and my sweet puppy sees the unidentified object and barks at it. Completely discarding the fact my dog barks at empty boxes and bags, I took this as a sign that I absolutely must investigate further. After all, it is shiny and I’m pretty much always attracted to and distracted by shiny things. What if this object presents a hazard to myself and those around, and I am the lone person who can prevent calamity? One can simply not sit idly by during a situation as daunting as this, so I conclude action must be taken.

As a paramedic, I know safety is imperative, so I opt to take the proper precautions. To my lovely ensemble of my red terrycloth bathrobe and messy hair, I add combat boots and my headlight (I know I look like a ridiculous miner with a bright light strapped to my forehead, but I don’t care. That shit is useful, and no one can convince me otherwise. I acquired this headlight after making fun of my mom for wearing hers, then discovering the joys of hands free light sources. I’m well on my way to starting a headlight revolution.). I begin my stake out by approaching the alcove from the front of the building and skulking my way to the back toward the object in question.

A neighbor, obviously immune to my stealthy approach, opens his door and gives me a look that can only be interpreted as a combination of fear and incredulousness. This is a look I have come to call the “I better not get too close to my crazy neighbor” look. I make a poor attempt in a hushed voice enlighten my neighbor to the situation at hand, as I realize the more I tell him while decked out in my bathrobe, combat boots, and headlight, only serves to make me appear mentally unstable. He slowly shuts the door to his apartment, watching me with a dubious look throughout. None of the heroic scenarios I’d imagined included any question of my sanity, but I discard the brief encounter and continue my investigation.

Once I approach the object, I discover a largely deflated and dying green helium balloon low to the ground and blowing gently in the wind. Crisis averted, I retreat to my apartment with a touch of chagrin, laughing at myself.

Incident #2: A few weeks later, following an evening out with friends, I come home to settle into my usual spot on my porch at 1 AM, book in hand. I look to the right of my favorite antigravity chair and see what appears to be a baby snake right beside me. It is so small, I have to get a closer look to make sure it isn’t a worm. I grew up in a rural enough area to know the difference between poisonous and non-poisonous snakes, and this appears to be a pretty generic black snake. Black snakes do a lot of good at keeping disease ridden rodents at bay, and my compassionate nature prevents me from having any desire to kill this snake, but I do want it off my patio. I come up with a plan to sweep the snake into a dust pan and flip it into the nearby woods.

Safety in mind, I prepare for my mission. I’m wearing jeans and a tank top, which will suffice, but I add my combat boots, tactical gloves, and my headlight. I arm myself with a broom in one hand, and a dust pan in the other. I rearrange my patio furniture for better access, and I position myself in a crouch so I can slowly approach the reptile while scaring it as little as possible. While I’m crouched and ready for action, my aforementioned neighbor has apparently taken this moment to walk his dog behind the apartment complex, giving himself a direct view of what he must believe is his crazy neighbor, while the snake is conveniently hidden behind a blue bin that I use as an outdoor table. I briefly consider my options, and I decide that I don’t have much to gain since he already thinks I’m insane and alerting him to the presence of the snake may only serve to freak him out more. I opt to stay as still as possible, thinking maybe he won’t notice me crouched, armed, with a bright halogen light strapped to my forehead if I don’t move. (Yeah, like a dinosaur. We can’t all be geniuses while thinking on our feet.) Suffice it to say he not only noticed me, but completely altered his path, turning about face and walking his dog in the other direction altogether. I freed the snake without any complications or encounters with the momma snake that can’t possibly be terribly far.

I decide I probably shouldn’t inform my neighbor that I’m tasked with saving lives on a daily basis, which turns out not to be an issue, because whenever I see him when we are both walking our dogs, he crosses the parking lot or goes in another direction. I’ve opted to play it up instead, waving and giving him my best crazy eyes and big smile look at every opportunity.

This is a public service announcement

16 comments

Ladies and gentlemen, in EMS and Fire there is a growing trend that is very real, unavoidable, and frankly unnerving. It would appear as if mustaches have become more than a facial accessory for those of EMSosaurus and Fire Fossil generation. As a result of this observation, I’ve come to the conclusion that more attention should be given to such a hairy topic.

What exactly is the soup strainer appeal? Is it sex appeal? Is it the only accessory that men on the job can get away with? Does it have to do with paying homage to the great mustaches of yesteryear? As someone who has never possessed the ability to grow a ‘stache, I’d never given them much thought until recently. There is clearly a lot of territory to cover here.

EMS and Fire folk tend to steer clear of the full beard or goatee because of regulations concerning respirators, so the lack of other, more widely accepted and fashionable facial hair is obvious. Legend has it that firemen originally grew mustaches as a form of personal protection. According to this incredibly non-academic website and several people I asked, firemen grew long mustaches back in the days predating modern equipment to use the hair to filter out particulates in the smoky air in which they were engulfed on the job. Mustaches may have once played a role in safety on the job, but that does not explain the modern day fixation.

I’ve interviewed a fair amount of my ‘stache sporting friends and coworkers about their mustaches, and I seem to find two pervasive themes: “I’m too lazy to shave” and “I keep it because I‘ve always had it.” I don’t understand either of these concepts. First of all, being “too lazy” to shave is pretty much negated since you’re forced to shave the rest of your face. I can tell you that when I’m in, I’m all in; I have never shaved my legs with the exception of one shin. Lazy and ridiculous are not synonymous. Secondly, you haven’t “always had it.” I’m trying to picture a cherubic baby, who after being rinsed of goo and blood wears a Nascar worthy mustache. That’s not how things work, gentlemen. You would have been labeled a prophet or a demon directly; as you’re currently working with me now, you are neither.

While contemplating the topic, I called up the wise sage with whom I discuss important matters at hand. During the discussion, my mom told me, “When making out with a dude with a mustache, there’s always the one wild hair that bothers me the most. Sure, the rest of the hairs are conforming, but the one hair finds its way up my nose and tickles like hell. The mustache seemed like a good idea in the late 80s, but who wants to make out with a chick who’s sneezing? Maybe I’m just allergic to mustaches.” That’s right, boys. My mom says women are allergic to mustaches, and my mom knows all kinds of useful stuff. She’s also been known to make up things to suit her wants, but I’m going to let that slide in this case.

Ambulance Driver is the only guy I asked that boldly admitted his mustache’s intent.  “When I was 25, I wore my goatee because I thought it helped me pick up hot older chicks. Now that I’m closer to 45, and all the hot older chicks are nursing home patients with fevers, I wear my ‘stache in solidarity with my EMT brothers who are stepped on by The Man, deprived of their rights to cultivate glorious handlebar mustaches like all the firefighters.”  Far be it for me to depreciate a man’s political statement.  Damn The Man!

It was also brought to my attention by a friend that “a man is DEFINED by his facial hair,” and he also submitted this evidence. Funny, all this time I thought men were defined by their penis size.

I would have liked to take pictures of people I know with mustaches and criticize them, but they were kind enough to allow me to interview them while knowing full well I intend to make fun of them on the internet. Instead, I have provided pictures from the internet of celebrities who are accustomed to being mocked. These are the people you are emulating:

Ted Nugent

Hide yo’ kids, hide yo’ wife, and hide yo’ husband, cuz Ted Nugent rapin’ errybody out here.

Tom Selleck

Tom, you are not fooling anyone with that phone. We all know it isn’t a cell phone, and you aren’t taking a call from your beloved grandmother to display your wholesomeness. You are topless on the beach and you probably need to let your parole officer know your whereabouts.

Mario

Eventually he got the princess. However, he had to abscond several castles and defeat many-a-foe to get to her heart. When one has a mustache of that caliber, one must make up for it in various other grand gestures. Incidentally, he was probably the first human she’d seen in a long, long time. After being held captive by a dragon-turtle hybrid for a while, a lady’s mustache tolerance can only be sufficiently lessened. Princess Peach was likely thrilled merely to see someone who didn’t want to wear her skin.

Salvador Dali

I’m not going to dignify this creeper with a proper caption.

Richard Pryor

“Ladies, check out how unassuming I am in my bath of foam peanuts. There’s even a red bow to indicate I’m God’s gift to women!” FAIL.

Ron Jeremy 

Ron Jeremy got a lot of hot tail. What the previous sentence is lacking is the fact that Ron Jeremy got a lot of ass from libidinous chicks who were being paid to do naughty, naughty things with him. The beautiful women acquiesced because drugs don’t buy themselves and word on the street is Ron Jeremy has a magnificent dong.

The Village People

Wow. There’s so much to say about this montage. Let’s start counterclockwise. Leather Guy, if you come any closer to me, I will be forced to beat you with your chains. Rochelle told me the story behind the restraining order, and I’m not buying your plea. Officer, I’ve worked with a lot of policemen and have never seen anyone other than yourself in that pose. I’m not even sure what you’re trying to accomplish. Are you threatening me? I will kick you in the larynx if you so much as twitch before I’m 20 feet away. Cowboy, it’s okay to be a virgin. Embrace it. No one is going to sleep with you, so you might as well own your virginity. Have you considered joining a monastery? Stay away from the cows. I know you think they love you back, but it is illegal to love livestock like you do. Construction worker, I appreciate your gold helmet, but stop touching yourself in that lascivious manner. I will be forced to contact OSHA, who will undoubtedly not care for your fabulousness. Indian and Soldier, I have much to say about you both, but you do not pertain to my topic. (Non sequitur: You are really working the interpretative dance, Indian. Keep up the strong work!)

In the event Captain Wines of Iron Firemen finds his way to this post, I’d like to go on record saying that I in no way, shape, or form have mustache envy. My informal polls proved pretty much unanimously that women with mustaches are not well received.

Oh, no. Parapup does not rock the ‘stache.

***************************************************************************

In semi-related news, a Google search of firemen with mustaches led me to a timeline of mustache fires. Obviously, this was not my intent, but I never realized mustaches were so flammable. The mere concept got me a little giddy, but that’s primarily because I’m morbid, warped, and sleep deprived.

High Stress, Low Class

5 comments

When the adrenaline is flowing, it is more than a challenge to keep my cool at times.  I’m not a confrontational person, but when a person interferes with my patient care, I can be a little hotheaded.  I’d love to be able to say I am the calm in the stress induced storm of an emergency, but I’d be a bold-faced liar.  I don’t know of a single person who hasn’t let their frustrations show in the heat of the moment. I’ve certainly borne the brunt of others’ rage in times of high stress on more than a few occasions.  Now that I’ve grown into the paramedic role, I’ve found that I’m no different.

Historically, I haven’t always been diplomatic when people interfere with my patient care. As it stands, I’m the only person I know who threatened to kick a police officer in the face, albeit in a joking tone, and didn’t get arrested.  I’ve doled out more than a few empty, ridiculous threats to get my point across.  I’ve said plenty of other things I’m not proud of, but I probably shouldn’t admit them publicly.

In paramedic school, we were put through the proverbial ringer of high stress situations.  We had airway obstacle courses, in which we had to perform under strobe lights and loud music.  We had impressive mock MCIs: a meth lab explosion, a train wreck with hazmat qualities, a house fire with multiple patients, multiple patient farming accidents, a building collapse with fire and trapped responders, swift water rescue, high angle rescue, and many multiple vehicle accidents.  We had complicated scenarios, in which we performed demanding tasks like CPR, controlling difficult airways, and handling multiple critical patients, while reciting acronyms and definitions.  I still recite drug dosages, classifications, indications, and contraindications while I jog out of habit.  My instructors tried their hardest to prepare us for the worst by exploiting our weakest points.  They’d make us overcome various states of equipment failure, force us to become skilled in the art of adapt and overcome, stress us out, and push us to the limit.  They even stole my equipment once because I left it unattended.  Despite all that preparation, I can sometimes feel my heart try to beat out of my chest on calls when the stakes are high.

Recently, I had my first pediatric code.  It’s no stretch of the imagination to state a child in cardiac arrest is one of the most efficient ways to induce a big, fat adrenaline rush for any emergency responder.  Everyone on scene was frazzled.  No one likes a dead kid.  I couldn’t get first responders to cooperate on even the smallest things very well, like moving the patient from a cramped bedroom into the spacious living room.

The problem wasn’t that they were bad at their job or that they were dealing with a female paramedic arriving to take control of the scene; the predicament was that the gravity of the situation was downright distracting.  I tried to be calm and collected, to keep my thoughts straight and my voice level, but when everyone else in the room is tense to the point of disruption, it is easy to become irritated.   My heart may be beating at SVT worthy rates, but I try like hell not to show it, which is not always successful.

I intubated the toddler with a small endotracheal tube and tied it down with twill tape.  A fireman was ready with the BVM to resume ventilations.  I told him to place his free hand over the child’s mouth to hold the tube in place, to keep it from dislodging.  I turned away to give a dose of epinephrine, and looked back to see he had let go of the tube and had accidentally pushed the hub of the tube to the patient’s lips.  *Gasp* My tube! Checking breath sounds, I found the tube was lodged in the right mainstem of the lungs, so I readjusted it.

I said, “It is really important that you hold the tube in place with your hand right here.  Remember the airway is paramount with pediatrics, and it is very easy to slip downward or out because there isn’t much room for error.”  I turned away to give a dose of atropine, and looked up to the same problem as before.  Holy crap!  Do not slap this man.  Good paramedics do not abuse their first responders. Again, I readjusted the tube, insuring it was in its proper position.  I tried to will myself to grow more functioning arms like a Hindu goddess, but that was unsuccessful.  Why can’t I have more arms? I said, “I really need you to hold this tube in place, because this tape isn’t working worth a crap.  You are doing a very important job, and if you need someone else to take it over, we can do that.  This tube may be this kid’s only real chance for survival.”  He said he was fine, and I believed him.  A few seconds later, I turned around to see him start to grab for something again, but he looked up at me and mouthed “Sorry.” Do not make me a murderer today, sir.

Walking to the ambulance with the stretcher, while first responders were doing CPR and ventilating, I held the tube in place at the patient’s mouth.  Within earshot of the five people surrounding the stretcher, I told the fireman in a semi-joking tone, “We’re all jazzed up here, but if you let go of my tube one more time, I’m going to kick you in the solar plexus.  If you don’t, I’ll be your best friend and send your kids birthday and Christmas presents.  If you need to switch out, tell me now.” He said he was fine; it was just his first pediatric code and he was understandably a little “freaked out.”  I didn’t tell him it was mine, too.  We loaded the patient in the ambulance, and I checked to make sure the tube was still in place before allowing him to hold it again.

On the way to the hospital, I noticed the hub of the tube was almost in the patient’s mouth, and I finally lost my cool.  I listened for breath sounds and heard nothing, but I did hear epigastric sounds.  He lost my tube. I transformed from a stressed paramedic to a pissed off megabitch in a nanosecond.

I planted my feet and took a stance I learned from playing too much Mortal Kombat in my youth.  With a punch square to the jaw, blood and two teeth flew across the ambulance.  I landed an uppercut to his chin and followed it with a right hook to the kidney when he doubled over, both solid hits.  The words “BAM!” and “POW!” appeared in the air in jagged bubbles of sound effect.  While performing CPR, the other responder in the ambulance announced in a low pitched, demanding voice, “FINISH HIM!”  One solid round house kick to the solar plexus sent him flying through the air, pushing the back doors of the ambulance open with force, and he flew out of the ambulance and onto the highway at 75 mph.  At least, that’s what happened in my head.

In reality, I took a moment to yell something that sounds an awful lot like mother trucker in addition to a string of expletives, while stomping my feet hissy fit style and grabbing a new BVM out of the cabinet, because we’d left the mask on scene.  I reassembled the intubation equipment, choosing a slightly larger endotracheal tube that I hoped like hell would fit.  I re-intubated the patient, forcing the larger tube in, as the correct sized tube was no longer useful. I said, “I don’t have the *BLEEP*ing dexterity in my toes to push drugs, so you’re going to have to hold this *BLEEP* *BLEEP* tube in place like your life depends on it. I don’t have enough *BLEEP* on this truck to intubate this kid again.”  And let go, he did not.  He even looked over at me for approval before releasing the tube in the hands of hospital staff.

Upon arrival at the hospital, the physician was “beyond impressed” that I’d managed to secure a 4.5 size ET tube.  I told him I had a little help, while glancing over at the first responder, who looked like a hurt puppy.  Afterward, I apologized to him for behaving like an asshole.  I finally told him it was my first pediatric code as a paramedic, and it took just about everything I had to hold myself together and put my training to use.  I told him I know what it’s like to be in his shoes, and while it will never get easier, he’ll have a better hold on the situation next time.  I assured him that despite the snafus, we did everything we could for the child (a mantra I had to keep repeating to myself as well).  He accepted my apology very well, and I truly hope he doesn’t hold my behavior against me, or other paramedics for that matter.  Granted, he doesn’t know that in my head, I beat the crap out of him.

For both of us, it was a horrible notch under our belts.  Perhaps next time each of us will be better prepared.  I’m certainly not the only responder who can be affected by what we encounter on the job, and I was the new EMT with the deer-in-headlights look in this very situation once upon a time.  The first time I saw a child in cardiac arrest, I was completely distracted by the one thought that kept circulating: This isn’t supposed to happen. I think we both learned a lot from that call.  I learned to trust my instincts a little better, make people trade positions when they show signs of insufficiency, and that I need to be much more civilized under pressure, while he learned paramedics can be jerks when you lose their tubes.

It’s a Man’s World

37 comments

Despite the fact that XX chromosomal arrangement makes up just over half of the world’s population, we ladies represent a mere 27.1% of EMS field personnel, according to data collected in 2007 by the National Registry of Emergency Medical Services’ think-tank. This doesn’t come as a shock to most folks whose idea of a typical day at the office includes lights, sirens, blood, and guts. While gender equality has been growing with remarkable speed over the last half century, in the big, bad, primarily testosterone based world of EMS, owning ovaries can certainly bring its own sets of challenges, advantages, and moments of hilarity.

It is not uncommon for me to be the only female present on a scene. I primarily work with a male partner, and it would appear as if the city fire department that typically responds with us has an even wider male to female ratio. There are obvious benefits to this scenario. As the only female, I’m usually the smallest and most flexible in the group, which means that I am typically the likely choice to crawl into a busted up vehicle or climb through an open window to get to a patient, all of which I love to do.

On the flipside, as the only female on a scene, I’m usually the one designated to take a peek when childbirth is deemed imminent and pretty much every other scenario involving “lady parts.” While I am trained to assist in childbirth and various problems that may arise, I am not well versed in other people’s vaginas. I think a friend of mine summed up my feelings on this phenomenon when she was the only female on a scene in which she was elected to check a pregnant patient for crowning. She forged ahead boldly, viewing the only vagina she had ever seen that she wasn’t born with. The patient asked her what she saw, and she said, “I don’t see a baby, but it doesn’t look anything like mine.”

I have one dog and zero offspring. At the age of 27, this suits me just fine (although my mom is showing definite signs of an attempt to plant seeds she hopes to flower into a desire for motherhood. She recently told me, “You know how I always said the best thing about pregnancy was getting to go wherever I wanted at a Black Sabbath concert? I take it back. It ended with me having you, and you turned out pretty cool.”). The best advocate for birth control I’ve ever encountered was my clinical rotations through Labor and Delivery as a mere paramecium during paramedic school.

I’ll save you the ridiculously gory details, but just know I left positive that whoever coined childbirth as “a miracle” is a sadistic asshole with a sick sense of humor. I have a very strong stomach; I studied human decomposition in college and consider a day in which I see someone’s brain awesome. Watching and participating in the birth of a human being was the only time I ever got queasy at the sight of something…right up until I went into the surgical area to see a cesarean section, where I nearly passed out. The Labor and Delivery department of a hospital cleverly disguises the gruesome nature of their trade by covering it in stuffed animals, balloons, and happy, gender appropriate colors. I’m onto their secret. When I show up on a scene, no one knows that even thinking about my previous experience gives me shudders, and everyone automatically looks directly at me as if to say, “You there, with the vagina! You’ve got the owner’s manual on this equipment and getting a parasite out, right?” It kind of makes it unfair that testicular examinations are so rarely called for in my field.

Playing well with others can be particularly challenging from the perspective of the only female on scene. Shockingly often, I get automatically passed over to receive a report from first responders, and female coworkers have told me they frequently encounter the same phenomenon. One of my friends likes to use this opportunity to ask her male partner in a sweet, soft “girl voice” what he’d like “little ole me to do” to save the patient suffering from a critical condition, just to get to see the priceless looks on the faces of her EMT-Basic partner and first responders.

Often times, I encounter reluctance from my male constituents when presented with a female doing manual labor. I’ve been asked enough times to be relieved of carrying equipment to have a standard response on hand when they are persistent: “Well, I have something kind of heavy on each side, so if you take one of those away, I’ll probably fall over. It would really help me out if you could carry my stethoscope, though.” Luckily, I work with enough folks with great senses of humor to go along with it and keep from getting offended. I actually was once pulled aside and thanked by a Fire Captain for lifting my own stretcher, which led me to wonder what other women on the job are doing that made me worthy of gratitude for doing my job.

On the bright side of being assumed weak, feeble, powerless, and incompetent, there’s really only room for improvement when the bar is set that low. That stated, I can’t help but feel my girl power pride swell when I’m on the scene with a female firefighter or partner and we’re the ones getting stuff done. I can only imagine how much harder female firefighters and policewomen have had to work to prove they are capable; I can’t help but think of them as superheroines.

Not being taken seriously can be a drain on the soul of a woman trying to make her way in a man’s world, which I doubt is something limited to the ladies of EMS. One woman who has worked in my agency pretty much since it was formed considers her breast reduction surgery a life altering change from a career standpoint. While not all male coworkers treated her poorly prior, she noticed an obvious shift in which people started to look her in her big, brown…eyes.

Which brings us to romance. EMS is an incestuous subset of society; we have long shifts and unconventional hours that most people have difficulty understanding. It can be quite the challenge for a lady crazy enough to do a job like this to find someone willing to put up with her, so it’s no surprise that we often turn to our own kind. I’m guilty of it. Twice. While my forays into the extracurricular studies weren’t what most would see as successful, plenty of relationships in EMS work. The problem with searching for that end goal in such an exclusive community is the concept that one must kiss a few frogs before finding a prince still applies, but instead of being a frog kisser, you’re deemed a “Medic Mattress.” Obviously, we ladies love being given such esteemed titles; feel free to call each other by such designations. Of course women with high stress, low pay employment that qualifies them as adrenaline junkies would never karate chop someone in the neck for referring to them by such a crass moniker. We’re sugar and spice and everything nice.

While dating within your field has the obvious benefits of understanding each other’s stress and hours, there are plenty of disadvantages. A policewoman recently told me that she dated one of her coworkers for a while, until he began showing up on her calls and being overly protective. She was once insulted by a civilian, and nearly immediately the offender was viciously attacked by gravity and a flight of stairs, with some assistance from her boyfriend at the time. When men are told their whole lives to be knights in shining armor, it must be a bit of a challenge for them to separate themselves from that mindset on the job, despite the fact that the woman they are dating may be able to handle herself accordingly. Let us not forget the men in our field are adrenaline seekers with God complexes, too.

We ladies have a tendency to be tougher on each other than the guys are on us. Girl on girl crime is pretty rampant in EMS; chances are decent that a girl whose actions may be misconstrued to give the ladies a bad reputation will get blackballed. Personally, I’m no exception. If you work with me and you find yourself letting men do your share of the manual labor, you will either get better, or I will make your life miserable on general principle. For instance, after a long shift, I was teaching a new, female trainee to change out the big oxygen tank on the ambulance. The M tank on an ambulance is about 40 or so pounds of awkward metal and compressed air, and replacing it is feasible as a one person job. When I told the new girl that we had to remove the old tank and lift the new one into the ambulance, her eyes grew wide and she said, “Maybe we should get one of these big, strong men to do it.” Aw, hell naw. My partner, who is responsible for actually training her, knew immediately to retreat as I do not take kindly to such attitudes. He slunk away just in time to escape me yelling at her, “You have a VAGINA, not a DISABILITY!” Despite my frustration, we changed the oxygen cylinder and she eventually grew into a functioning female EMT, lifting stretchers, equipment, and oxygen tanks.

As a female responder, some awkward situations will come up on rare occasions. I was once in a patient’s home in which she had hit an emergency button, prompting the entire cavalry of police, fire, and medic staff to respond to this unknown emergency. Basically, she had fallen and couldn’t get up due to morbid obesity, and was stranded on the ground like a turtle on its back. We cancelled any further response, but one police officer did not get that memo. He came in, saw we didn’t need his assistance, and began to leave after a brief chat with my male partner. On his way out, apparently, he saw me for the first time and said, “OOOOOOOOOOOOH! Look at the pretty medic!” Like I’m an exhibit in a zoo. And here on our tour of the homo sapiens exhibit, you can see the female medicus blondinus in action. Please observe how she attends to her patient while wearing the least flattering uniform of the twenty-first century. What a fascinating creature! I’m not sure of the proper protocol in handling such a bizarre remark with grace, so I elbowed a trainee, a tall, masculine African American EMT, and told him he should thank the officer for complimenting him. The officer was not amused, but I guess you can’t win ‘em all.

A friend of mine has quite possibly the most impressive story to tell concerning being a female in EMS. This woman looks like a Barbie doll and is both brilliant and tough as nails. She ran a 911 call in a strip club where the female dancers were dressed in costumes intended to imitate uniforms. As she was carrying equipment into the club, a very intoxicated patron who apparently was unaware of any present emergency, mistook her for an exotic dancer and stuffed a $20 bill into her shirt while slurring his request for a lap dance. The manager of the club was embarrassed and incredibly apologetic. He asked her if he could do anything to alleviate the incident and she told him with a deadpan facial expression, “Well, you could collect all my dollars for me.”

The strange isn’t limited to heterosexual paramedics and EMTs, either. Another friend of mine, who would doubtfully ever be mistaken for someone who dates the opposite sex recently had a routine transfer of an old man, afflicted with dementia and useless, contracted T-Rex arms. He asked her if she was, “one of them bull-daggers.” Completely taken aback and slightly amused at the situation, she answered, “Yes, sir, I am.” The man suddenly found enough strength and flexibility in a T-Rex arm to open-palm slap her in the face. What do you do when an old, bed bound man who is not mentally coherent slaps you in the face? According to my friend, you sit there with your mouth open in shock and call your friends later to laugh about it.

In my research to discover any present articles on women in EMS, I found something that took me completely aback. A quick Google search brought me to a 2008 Women of EMS calendar, depicting paramedics and EMTs scantily clad in bathing suits or bras with bunker pants.

Photos courtesy of http://www.womenofems.com/
 

My initial, kneejerk response to this was something along the lines of outrage. Then I began to think of the double standard in using sex as a fundraising tool in public safety; I find it perfectly acceptable for men to be depicted in sexually explicit ways to raise money for the benevolent funds of fire and police systems. Why should women be any different? Despite my quest for equality, I couldn’t manage to bring myself to think of these images as anything other than a setback for women in public safety. I’ve come up with an alternate solution: perhaps there should be a calendar showing women of EMS directly after they run demanding calls. I imagine a centerfold showing a female paramedic with her messy helmet hair matted to her head with sweat following the extraction of a patient from a vehicle, blood on her shirt, standing in front of the open doors of an ambulance with equipment and blood everywhere, and a quote of “Aw, man! I got brain on my pants again!”

Female fire fighters and policewomen shouldn’t feel left out. I found skanky calendars for you guys, too. I actually found one fundraiser calendar depicting female police from Spain posing as criminals, which I found much more entertaining and artistic than minimally dressed women being suggestive while lying on a disgusting ambulance floor.

America’s Female Firefighters

Policewomen posing as criminals

I also found this douche-canoe’s website if anybody feels up to writing some hate mail. I couldn’t bring myself to take him seriously enough to actually be angry, personally.

Life Lessons Learned While Ambulancing

2 comments

On romance: The fairy tales have it wrong. True love is finding someone whose belongings (including expensive electronics) you can throw off of a three story balcony, who will in turn choke you into unconsciousness while you are 33 weeks pregnant with their child. 

On sanity: Hallucinating the devil is after you or running naked through an upper-middle class neighborhood until the police tackle you is very crazy.  As it turns out, I’m doing just fine comparatively. 

On physics: Two objects cannot occupy the same space at the same time.  Fences beware.  My ambulance is bigger than you, and I really suck at using reverse gear.

On gravity: When rolling a stretcher with a patient on it, allowing it to get off kilter is not a good idea.  It will flip, and you will probably not be able to catch it.  Your back will hurt for days from the effort.  Furthermore, it scares the crap out of the person on the stretcher.

On obesity: Fat people are fucking heavy.  My back hurts just thinking about it.

On mistaken identities: Most of the ambulances look pretty much the same; avoid getting in the wrong one at the hospital or on mass casualty incidents.  Also avoid checking off, putting your gear and belongings in, and sitting/waiting for your crew while growing irritated at their tardiness in the wrong ambulance, while your crew is in the right one, waiting for you. 

On diabetes: Keeping a tub full of cookies by your bed is not a cure for diabetes.  Who knew? 

On navigating: Sometimes, I get lost.  If I can find the nearest coffee shop or book store, I’ll find my way back on track.  

On linguistics: It is imperative to be fluent in the medical dialect of the people you treat.  Bonus points for saying “vomick” with a straight face the most times on a scene.  My partner holds the record, as I had to step outside to laugh hysterically. 

On misogyny: I’m trained to treat illnesses, perform challenging skills, think on my feet, and pick your fat ass up.  I also have ovaries.  Deal with it, as I can also restrain people if I see fit. 

On fashion: Bringing up bedazzling your turn out gear at a meeting will not impress your superiors.  Offering the ultimatum of either putting one’s name or JUICY on the rear of one’s tactical pants in rhinestones only serves to make it worse.  My superiors have opted to exchange our turnout gear for a bright yellow version, which is no consolation at all.  I continue to believe that I should be allowed to sparkle at all times. 

Also on fashion: Human feces is never an acceptable accessory, and it totally clashes with my rhinestone shades.  I may never forgive the lady that shat on me, despite the fact that she was unconscious. 

On fine dining: A slushee and a bag of white cheddar popcorn from a gas station is a pretty decent meal on a busy day.

Also on fine dining: If you get a chance to grab a meal at a soul food restaurant, the employees will likely treat you very well.  They know what they eat, and they know they’ll probably need you in the near future. 

On distorted self images: Just because one sees herself as a superheroine does not mean the rest of the world does.  They may see her as the blonde, pigtailed spaz she appears to be, despite the underlying truth. 

On great partners: Only the best partners are wise and thoughtful enough to crank up the volume on the radio when Lady Gaga is airing, so that you can simultaneously treat your patient and shake yo’ thang. 

On downtime: If a civilian calls 911 to report and complain about a paramedic shopping on shift, they should truly hope the dispatcher answering the call isn’t the very same person who is receiving freebies from the sale.  A buy three, get three free sale at Bath and Body Works IS an emergency.  Everyone knows that. 

On diversity: Stupidity knows no race, age, creed, color, religion, or social status, but it is consistent job security for me.

On kidnapping: Kidnapping and torturing your pet zombie is an entertaining, acceptable, and valuable way for your coworkers to spend their time between calls, particularly if they spend all day sending you picture messages, such as these.

 Photos courtesy of Gabe and KC.

On playing well with others:  What is the first thing you do when you arrive on scene?  Immediately decide who you will trip as bait in the event the patient turns out to be a reanimated zombie, obviously.  When, and I do say when, the zombie apocalypse comes, who do you think will be among the first wave of people attacked?  If you guessed the paramedic attempting to intubate, with their face and hands directly in the face and mouth of the “dead” guy without vital signs, you would be correct.  There’s going to be hordes of zombies somnambulating about in full paramedic, first responder, and police uniforms and turnout gear.  I don’t know about you, but I’m not going down like that.  Scene safety?  It can wait.  Need for additional resources?  I’ll let you know in a minute.  General impression of the patient?  I’ll get to it.  Zombie bait?  I’m all over that right away.  If the patient reanimates, I need to know who I’m pushing down.  The misogynistic hosedragger who refuses to look me in the eye and reports blood pressures as 120/80 without ever having touched the patient, or the fireman who pulls his weight as works with you as a team?  Easy choice.  What if zombification occurs at the hospital?  You have to choose between the mean, burnt out nurse that berates you for bringing a patient despite the fact transporting patients is pretty much what you do even if you don’t get to use any cool skills or equipment, and the tech who always smiles, helps you move a patient to the bed, and doubles as a roller derby girl in her spare time.  I think you know who I want on my team. 

I know what you’re thinking, “Um, Parapup is kind of off her rocker on this topic.”  Well, guess what you’ll be thinking once you get bit, die a painful death, and reanimate as a zombie: BRAAAAAAINS! 

The Wheels on the Bus…

1 comment

A few months ago, the EMS personnel of Mecklenburg County lost a dear and beloved post.  Legend has it that Post 50 was attacked by a renegade ambulance.  Post 50 was never known for being structurally sound, but was a great place to take a nap and was near a plethora of decent places to grab a meal.  It was close enough to the highway that one was likely to get a decent trauma there, and it is no secret that the crazies on the north end of the county are nothing short of spectacular.  As homage to the memory of post 50, I’ve opted to write of the things we EMS folk encounter while driving a beast of an ambulance.  Rest in peace, Post 50. 

Photo courtesy of www.wcnc.com.

 

 

The Wheels on the Bus…

 

For reasons completely unknown to me, the general public seems to acknowledge that “ambulance drivers” are professionals impervious to other drivers, weather and road conditions, distraction by shiny objects or attractive joggers, and the laws of physics.  Statistically, it makes sense that emergency personnel are involved in less collisions that the general public because there are less emergency vehicles by comparison.  That stated, when it happens to us, we pretty much always make the news, so there is no excuse for members of the populace to believe ambulances are safer than their own vehicles; regardless, this appears to be the case. 

During a snowstorm earlier this year, several people I treated had called 911 for mundane flu-like symptoms because they weren’t comfortable driving to the hospital.  I can understand feeling uncomfortable driving in less than ideal conditions, but I fail to understand reasoning riding backward on a stretcher in a box of potential shrapnel weighing a couple tons, surrounded by loosely restrained potential projectiles, driven by people who likely chose their profession because they think gruesome stuff is cool as a viable alternative.  I also don’t understand going to the emergency room for the flu, but that is not my decision to make either.  In my agency, we have systems in place to assist us with such situations.  Despite our typically moderate climate, we have chains that can flow beneath the tires to add traction; sometimes they even function!

For the few non-EMS readers, I’m going to let you in on a little secret: we’re every bit as incompetent as the rest of you retards out there.  I can’t speak for my coworkers or other emergency personnel, but I can honestly say with total confidence that I am just not that great of a driver. 

When I turn on the lights and sirens, I’m extremely attentive.  I make it a point to know where every vehicle is and their approximate speeds, constantly looking out for danger.  I realize using the lights and sirens is precarious in and of itself, and I see myself as almost a guardian to those in other vehicles, regardless of how much they refuse to get the hell out of my way.  (For the record, the protocol is to pull to the right.  Unless you’re in England or Australia, in which case I have no idea what you’re supposed to do.) 

Once the blinky lights and blaring sirens are off, and I’m no longer the shiniest thing around, I regress into my usual shitty driver self.  I get it honestly; my mom is a terrible driver.  I’ve actually had conversations with her discussing the hazards of playing Tetris while driving.  I won’t even get into my grandmother’s inattentive driving or my aunt’s refusal to admit her belief that streetlights don’t apply to her, regardless of video documentation.  I hail from a long line of awful drivers.  I fiddle with the radio dial.  I know that my phone is in my pocket, and I have to actively fight the urge to access it.  Whatever bizarre topic piques my interest can easily cause me to drive directly past a street on which I needed to turn.  A really striking jogger runs by with no shirt on and the next thing I know, I have to stand on the brake pedal to keep from flattening the car in front of me.  I once saw a double rainbow and enjoyed the sight until my partner reprimanded me from the back of the ambulance, and I realized I was busted.   I’m susceptible to all the minutiae that cause people to play bumper cars with one another every day.  I’ve even discovered that if you opt to drive your ambulance into a field after a day of rain, your supervisor will laugh at you when he/she comes to pull you out of the muddy hole you’ve created.   

Reverse gear, however, remains the bane of my existence.  I’ve seen Snatch; I understand the principle that when you are backing up, things come at you from behind.  At my agency, the policy is that your partner gets out of the truck to assist you and make sure you don’t hit anything.  Needless to say, this policy is in place for a reason: the ambulance is big, and we hit stuff all the time. 

My usual partner likes to back drivers up by moving his arm around in the direction one needs to turn the wheel, which can be quite the deceptive move.  One day in the ambulance, a new hire, FNG, was attempting to park, with my partner backing him up. 

FNG asks me, who is reading a book in the backseat, “Which way am I supposed to turn?  I don’t understand what he’s doing.”

“Is he motioning for you to Wax On or Wax Off?”

“Um, I don’t really know.  I’m looking at him in the side mirror and I think he’s getting frustrated with me.”

“I usually just turn the way that makes the most sense and go very slowly.  If he really starts flailing, stop, you went the wrong way.”

FNG got us parked without incident, but I have had an episode in which I was not as lucky.  In an affluent part of town, a brand new fire station was built, and my agency was given the opportunity to post there.  This fire station is abnormally pretty, and I’d heard nearly half a million dollars were attributed to art alone.  Naturally, it was dark and raining, but I was working with a partner who feared no weather, and got out of the truck to back me up.  While reversing into the designated parking space, my partner held up her hands to indicate I didn’t have much room to move.  I saw her gesture, my brain made a more creative interpretation, and I continued to reverse-directly into an incredibly expensive fence.  Once I heard metal crunching, I stopped, parked, and got out of the truck to assess the situation.  Firemen came out of the station to point and laugh, and informed me that while I wasn’t the firs
t person to hit the fence, I certainly did the most damage.  Since that incident, a bumper was installed to make the space what my supervisor called “Parapup-proof.”

My favorite ambulance mishap story comes from a friend I’ll call Evelyn Couch, who used to work in a non-emergency transport service.  Evelyn was driving a van-style ambulance to take a hospice patient who was well on his way out of this form of existence to a nursing home to which a hospital had turfed him.  Evelyn approached the nursing home, surveyed the canopy, and realized they may not fit underneath.  She relayed this to her partner in the back, ever the compassionate caregiver, who said something along the lines of, “Just get us in there so he doesn’t die back here on me.” 

Evelyn carefully pulled forward to be rewarded with the unmistakable sound of crunching.  They were able to unload the patient into the facility with stable enough vital signs.  Once they exited the canopy, Evelyn noticed the light bar on top of the ambulance, which is typically perpendicular to the length, was completely parallel.  Via discussion, the team decided that the best course of action was to pretend like nothing unusual had happened. 

Upon arrival at the station, Evelyn was greeted by an angry, red-faced supervisor, “Evelyn Couch!  Do you notice anything wrong with that ambulance?!”

“Well, it could really use a wash.”

“Anything else, Evelyn?”

“I think there’s a scratch in the paint.”  Evelyn’s supervisor failed to see the humor in the situation, and she eventually gained employment where her keen sense of humor and timing is appreciated. 

                                                                                                                    

What I’ve learned from my vehicular misfortunes and the tales of my cohorts’ is that we all screw up.  None of us are immune to accident or calamity, and I’m appreciative that I haven’t caused anyone injury.  After all, the end goal is to help people, but sometimes things get in the way of that aspiration, ineptitude for instance. 

Vigilante Medic Saves the Day

2 comments

My day started off with a slightly unusual call: I was sent to the aid of a young man with penile pain associated with a probable STD. Outstanding. As a heterosexual female, I have no interest in penises infected with sexually transmitted diseases, but when duty calls, I must answer, and I try to do so with grace and respect. The patient was probably not hoping to have a discussion about his penile discharge with a twenty-something year old blond female, but I honestly have no idea what goes through the minds of people who call 911 for these things. After all, the ghetto is an amazing place with a totally different definition of emergency than the rest of the world, regardless of the vehicle parked in the driveway. He had no reservations about speaking freely to me of his affliction, and after a brief consideration of making the new guy in training on our truck take a peek, I decided to wholeheartedly trust the patient’s description of his junk. Simply put, I didn’t want to look.

The patient politely asked if his “little brother” could accompany him to the hospital. I took a look at the individual, appropriately outfitted in an incredibly oversized shirt, sagging jean shorts, and an impressive swagger. He appeared to be a young teenager, and I immediately decided he was harmless. Perhaps this young one would learn a valuable lesson on the importance of the use of prophylactics. “Sure, but he’ll have to ride in the front and wear his seatbelt.” My crew and I took them both to the hospital, where the staff and I shared a laugh at the absurdity of the “emergent” situation. The day prior, I treated a man having a heart attack and a woman experiencing ventricular tachycardia, both of whom I decided would be just fine by ghetto standards.

While driving the ambulance to the hospital during the next call of the day, I was singing along to the radio, and I realized the passenger seat visor looked unusually empty. The universal garage door opener was present, but the spot where I typically clip my iPod was empty. I replayed the events of the day in my head: I came to work, be-bopped around the wash bay, and checked off the ambulance equipment listening to my “Happy” playlist. None of this was unusual. My partner, Vigilante Medic, is accustomed to finding me in the box of the ambulance shaking my thang or occasionally rocking the air guitar. I’m fairly certain he’s never seen me use the laryngoscope as a microphone, but I do tend to keep that show strictly between myself and my imaginary fans. I distinctly remembered standing on the running board of the ambulance, wrapping my headphones around the iPod, and clipping it to the passenger visor.

Upon arrival to the hospital, I immediately asked Vigilante Medic if he moved my iPod. He’s always looking out for me, I trust him completely, and it isn’t offensive or peculiar for him to get into my personal items. He told me he made sure my book bag was zipped and my Kindle (I’m a woman utterly dependent on technology) was put away before anyone entered the ambulance, but he didn’t think to look for my iPod. I scoured the ambulance, finding remnants of crews past and our belongings, but no sign of my iPod. If Vigilante Medic did not move my iPod, only one person was capable of taking it. I was enveloped in emotions of fury, horror, and personal violation, but the only thing that escaped my lips was, “That little ghetto fucker!” I personally gave this premature hoodlum permission to ride in the cab of my ambulance, which is my safe haven for 12 hour shifts, and he stole from me.

I called the hospital to which I took Penis Guy, and they told me he had been discharged with ample time to leave the premises. I called my supervisor, who has always been a wealth of wisdom, and he gave me his condolences and advised me to make a police report. I then called our communications department, who connected me to the non-emergency police line (we may be county funded, but we’re not strictly ghetto). The police department offered to send an officer to the hospital to take my report, but I declined, knowing first hand that with a growing murder rate and gang activity, our vice division has much better things to do than fuss over my stolen iPod. I had no proof that Penis Guy’s “little brother” stole from me, but I had more than reasonable suspicion. I was told I’d be contacted within ten days. Vigilante Medic found me at the ambulance with a furrowed brow and a pouting, quivering bottom lip.

Incidentally, this is not my first encounter with iPod thievery. My last iPod was stolen from my personal vehicle at my former apartment complex. I responded with a passive-aggressive note stating:

Dear Douchebag That Stole My iPod,

I hope you choke.

Love,

Tiff

Apparently, the letter I wrote, made 200 copies of, and distributed happily at that apartment complex was not well received given the response I got accusing me of threats. I moved within a week.

Vigilante Medic proposed an alternate route entirely, “If it were my iPod, I would show up with my biker friends tomorrow, and take back what’s mine.” We knew precisely where the hoodlum in question was picked up, and it was a fathomable assumption he would be there tomorrow. I tried to picture showing up in the ‘hood the next day, me leading a posse of my girlfriends each weighing in less than 140 pounds with an affinity for reading. I saw myself at the head of a group of Caucasian girls decked out in glitter shrieking, “If you don’t give me back my iPod, we’ll squeal in very high pitched tones, asshole!” We may look cute in proper lighting, but I don’t think vigilante justice suits us. I’m pretty sure I’d just injure myself if I tried to wield a gun, considering sometimes I fall down attempting to step out of the ambulance. I couldn’t conjure up a single scenario in which a situation of this caliber concluded in my favor. I’m more of the passive-aggressive letter writing type.

Inspired by the situation at hand, Vigilante Medic inquired our supervisor of potential legality issues, then called the communication department requesting a trip back to the ghetto. Communication informed him that the area was covered, but managed to assign us to the area anyway, putting an end in my mind to the age old idea that our dispatchers “aren’t looking out for us.”

I drove straight to the house where Penis Guy lives, in front of which Vigilante Medic, New Guy, and I strode out of the ambulance on a mission. We probably looked more like two dudes in uniforms with a chick looking around as if her head is on a swivel stick thinking, “Are we going to get shot today?” We were met by the father of Penis Guy, who informed us that the perpetrator was not his son, but he would be more than willing to assist us in locating him. At this point, I let Vigilante Medic do all the talking; I was stuck in the mode of thinking is the scene safe? I had one hand prepared to hit the emergency button on my radio and was constantly scanning the area for a potential gunmen or hoodlum wielding a knife. This was not an answer to a 911 call, I was completely out of my element, and I was scared.

Penis Guy’s father enlisted the help of Penis Guy, who was suddenly furious and quickly gaining my respect. Penis Guy told us he saw that exact iPod, my stolen iPod, and dialed into a cordless phone. He spoke into the telephone in a manner of incredulousness, anger, and exasperation that made me think I had judged his intellect and morality completely inaccurately. He demanded that my iPod be returned immediately, informed us of the whereabouts of the thief, and told us that it would be returned without delay or struggle.

I drove the ambulance to a gas station down the street, where we were
met by the prepubescent bandit. I saw him walking, and he was shorter and scrawnier than me. I’d barely noticed him on scene originally, but was now realizing the thug I’d built in my mind was far different from this diminutive creature. Finally, someone I can pick on. I approached him with an outstretched palm, and he reached into his right pocket, placed my iPod in my hand, and begun to walk off. I heard Vigilante Medic say, “That’s not good enough.”

The young thug turned and said, “Sorry” while looking at his feet.

I told him, “You need to look me in the eye and apologize.”

He looked up only with his eyes, “Sorry.”

“Do you understand the gravity of the situation? I was helping your friend, and you stole from me while I was doing that. I choose to have a job where I help people in distress, I don’t get paid much, and you stole directly from me. I made a police report and I’m not convinced I should call and cancel it.” I held the young crook’s gaze and tried not to lose faith in humanity. “Have you learned anything from this?”

“Yes,” he said to his feet again.

I turned and walked back to my ambulance muttering, “This little jerk hasn’t learned shit,” and thrilled that I’d regained an item I thought was indisputably lost forever. I pushed the appropriate buttons on the iPod and found that of all the angry music on my iPod, the perpetrator had been listening to, or trying to hock an iPod playing Adele. Seriously? He would have been more suited to tune into The Clash’s version of I Fought The Law and The Law Won, but in his case the lyrics would have had to been rearranged to the effect of “I Fought The Medics and The Medics won.”

Drugs, Dad, and Rock and Roll

6 comments

Some calls get under your skin and shake your soul to the very core. Children in distress are always a challenge to the caretaker emotionally, and facing death can take a toll on one as well. More often than I’d like to admit, the debilitating feelings of inadequacy, helplessness, and fury have overtaken me when I’ve encountered abuse, neglect, death, and other situations out of my control. Sometimes patients and their problems just hit too close to home and force you to face fears and issues you’ve spent your entire life burying.

I recently was dispatched to a cardiac arrest, in which my unit was the first to arrive. I drove to this call completely mentally prepared to face death and attempt to combat it on behalf of another human being. I walked into a middle class house to find a young woman unconscious and barely breathing. She’s not dead, but it is not surprising that her family thought she was. She is in her early 20s, Caucasian, thin, dressed in a tank top and jeans, with long hair and a pretty face. Her family tells us that she was just released the day prior from a rehabilitation facility, in which she was treated for heroin use.

I’ve never done serious drugs, which I completely accredit to the fact that I’ve spent the majority of my life terrified of them. My mother raised me as a single mom, and has dallied in drugs and a darker culture enough to know and recognize all the signs; simply put, I couldn’t get away with that kind of shit. My mother has seen firsthand the toll drugs can take on a person’s life and how much harder said person has to work to overcome even the most basic of life’s responsibilities and tasks. She refused to allow me to assume that disability. As a teenager at the height of my mischievousness, any time I tried to deceive or outsmart my mom, she quickly and efficiently put an end to it. I once came home with some friends stoned and honestly believed she didn’t know. The next day at a video store, I picked up a copy of Dazed and Confused, and asked my mom if she’d seen it. Her response: “Yeah, when you and your friends came in last night.” Following the realization that I was not savvy after all, my mother taught me all about drugs, making sure that I would be informed when I inevitably encountered them. She answered my inquiries with brute honesty, never omitting the good, bad, funny or sad. It was like having a personalized in-house D.A.R.E. program, but this one actually worked.

While my mother instilled truth and warnings about drug use in me, my father was a fine example of why. My father has always been involved in my life, despite his divorce from my mother when I was an infant. His poison of choice is cocaine, although he has experience in other endeavors. His demeanor has always been evasive, defensive, and cagey toward the topic until recently. Over the years, I watched him hurt himself and other people with his drug use, and I’ve had my heart broken a seemingly infinite number of times by my dad because of drugs. I distinctly remember being shocked that my dad was different that those of my friends, and even more shocked and hurt when I found out chiefly why. I found him impossible to understand, but I continuously tried because he was my father and a fundamentally good person despite it all. I listened to him tell me it wasn’t a problem and he could and would stop whenever he wanted. I learned to protect myself from pain and heartache when he didn’t show up, forgot about me, ignored me, or became angry at me for no reason. I learned to hope, but not believe him every time he told me he was quitting.

Recently, my dad has given up drugs. I have been struggling with wholeheartedly believing him as a result of the failed attempts in the past. In the past few years, he developed hallucinations that nearly drove him to insanity, lost his marriage, and lost his home. While he is not solely responsible for the misfortunes that have taken the limelight in his life, he appears to have come to terms with his role. He and I have had long conversations about things that actually matter for the first time in my life. He asked me, “How did I end up with a daughter who is so good, when other people that didn’t do the things I did have bad kids?” I have no answer, and I’m not totally convinced I’m all that good. I often view myself as damaged and weird. I think what he means is that I take care of myself, don’t get into trouble, and don’t do drugs. My mother played a huge role in that, but she’s fallible and so am I.

When I saw that unconscious girl who just relapsed, I saw myself. We’re around the same age, dress similarly, and both clearly are fighting our own demons. In some alternate universe, she and I would be in opposite positions. For reasons I can’t fully explain, I didn’t do drugs and she did. I assembled Narcan, the antidote for heroin and my partner administered it nasally. The girl began to wake up a long minute after we gave her the medication. We stopped breathing for her and took out the OPA, an instrument used to hold back the tongue during ventilation. She sat up and looked straight at me, doe eyed and terrified. I told her that she overdosed and almost died. She cried and told me that wasn’t possible. It seemed that most of the people in the room despised that girl. They saw her as a pathetic and weak drug addict who couldn’t hack it sober for a day, while I held her and told her it was going to be okay. Every molecule of my body ached for both her and me.

I know that it is virtually impossible to quit a drug without episodes of relapses that are sometimes more dangerous than using regularly. I have spent my entire life enclosed in a veil of humor, distrust, and doubt as a method of self preservation that has leaked into nearly all aspects of my life, and even now I can’t allow myself to be totally unprotected. I keep in the back of my mind that most addicts relapse at some point, and I try to prepare myself in the event it happens to my dad. That girl almost died as a result of a relapse, but didn’t because someone called 911 and we showed up. We were able to breathe for her and give her a medication that saved her life. She forced me to face a huge obstacle I’ve pushed into the deepest crevices of my subconscious and come to terms with the fact that there is no wonderdrug like Narcan to combat cocaine.

Zombie

7 comments

My partner and I are dispatched to a headache; this is our third headache call of the day, all of which were supremely boring. While I give my headache patients the best care I can, insuring they have no signs of an impending stroke, considering all aspects of the condition, and keeping them as comfortable as possible, I’d rounded out my previous call by looking longingly out the ambulance window, watching my coworkers wheel critical, medicated, intubated patients into the hospital, seeing my colleagues’ cheeks flushed with the excitement of their call. I want that excitement! I want to make a difference in someone’s life, but here I am on the way to another mundane headache call. What’s a girl got to do to get some neuro deficits around here?

As my partner and I pull up to an apartment complex, a first responder approaches to inform us that the patient is on the third floor, there’s no elevator, and his vitals check out fine. My partner and I roll our eyes in tandem as we mentally prepare ourselves for another monotonous experience and waste of valuable resources.

Three flights ascended, we determine the patient is stable, has no priority symptoms, and our equipment will not be necessary. In fact, the patient turns out to be such a nice person, I feel kind of like a jerk for secretly wanting to be with critical patients instead. I prepare the ambulance for a routine headache call, meticulously laying out all the things I think we might need, while my partner (who is pretty much the best paramedic on the planet and my role model) stays with the patient. I prime an IV line, turn on the oxygen tank, lay out the glucometer and blood pressure cuff, and by the time I start spying specks of dirt and spot cleaning, I realize everyone has been gone far too long. What the hell is going on up there? About the time I poke my head out of the back doors of the ambulance, a first responder comes running toward me yelling, “He passed out! We need it all!”

I scramble the equipment back together in a flash, and the first responder and I make the three story hike once again. I arrive to an unconscious, breathing patient, who has been positioned with his feet up to increase bloodflow to his brain. I quickly apply oxygen and put him on the cardiac monitor.

My partner and I simultaneously look at the monitor, look at each other, look at the patient, and look at the monitor once again, with similar blatant quizzical facial expressions. The monitor shows clear and obvious ventricular fibrillation, a non-perfusing lethal rhythm. The patient is breathing, moaning, and moving his head. We frantically double and triple check the cables, convinced there is an error. The fire department must think we’ve lost our minds. We can’t find a pulse, and we absolutely must initiate CPR. My partner prepares to shock the patient, and I perform a chest compression. The patient retorts with a clearly audible “Ow!” I have done plenty of CPR, but never on anyone who is capable of informing me that it hurts. Furthermore, I’ve never in my life seen a dead guy breathe, moan, or move on his own accord. My partner and I lock eyes, and I know we’re thinking the same thing: there’s only one explanation for this—he’s a zombie.

We actually have a cardiac arrest bag full of all kinds of goodies just for this occasion, but I didn’t think to bring it. No one thought we had a dead guy on our hands, what with all the signs of life, so we’ll have to make do with what we have. My partner sends 150 Joules of electricity into the zombie’s chest, which he clearly does not like, judging by the sound he makes. The man turns purple from the nipple line up, a textbook sign of a pulmonary embolism. I continue to perform CPR, while concurrently instructing first responders to prepare equipment.

My partner says he’s going to start an IV in a vein in the man’s neck. I have someone take over CPR, and I practically tackle my partner, which is my standard response when he’s about to do a cool procedure I’ve never done. I insert a large bore catheter in the zombie’s external jugular vein, with my partner expertly walking me through the motions.

After a few more minutes of CPR, code drugs, and defibrillation, while not being distracted by the obvious life-like state of our dead guy (for which the American Heart Association did not prepare us AT ALL), he gets a pulse back. That is to say, our zombie is now un-dead, which goes against all the comic books I devoured as a nerdy, antisocial kid. While this is obviously great for the patient, the return of spontaneous circulation also works out nicely for us, because there was no freaking way we were going to make it down three narrow flights of stairs and do CPR.

A 12 lead ECG shows the patient is also having a monster of a heart attack. So, to sum it up thus far, we have a formerly dead guy who appeared remarkably alive while dead with a possible stroke, pulmonary embolism, and big fat myocardial infarction (that’s just a fancy way of saying heart attack). This is all my fault; I pouted and wished for excitement, and the EMS gods came through with alarming alacrity.

En route to the hospital, we do the zombie-CPR-shock-drugs-un-die dance a few more times. At one point, I’m performing CPR again (I love to do CPR. There’s something thrilling about being a physically fit girl doing manual labor in a largely male dominated field, when big burly dudes say, “Need me to take over for you?” saying and honestly meaning, “No, thanks. I’m good.”) and my partner contemplates aloud, “Because he is having an MI, perhaps the epinephrine will be too much of a strain on his heart and make it worse.”

“True,” I respond, proud of the fact that I can talk and do chest compressions, “but having no pulse at all is probably the larger of the evils.”

“Good point,” he says. He pushes another round of drugs, and I get another break from CPR.

Upon arrival at the hospital, the ED staff has the delight of encountering the same bizarre circumstances as we did, and again, he regains a pulse. Doctors, nurses, and techs are all astonished, while my partner and I play the role of the experienced wise ones in this unusual scenario; after all, this is old news for us by now. The staff takes him, un-dead again, upstairs where he will undergo tests and catheterization to try to combat the zombie trifecta.

**************************************************

The next day, my partner and I take a non-critical patient to triage at the same hospital. My partner suggests we investigate the patient’s outcome, and I eagerly agree. We mosey up to the ICU, trying to give the perception that we belong here, despite the obvious contrast of our uniforms, radios, boots, and shiny badges to the hospital staff’s comfortable scrubs and tennis shoes.

We find a nurse, explain who we are and what we are looking for. The nurse tells us, “Sure! He’s doing great and he’ll probably be discharged by the end of the week. He’s awake if you want to go see him.”

He’s awake. This is far better than either of us had imagined. Honestly, we came to find out if he was dead or a vegetable, but this man is awake.

My partner knocks on the door gently, and he and I enter the patient’s room, mouths agape at the conscious man who is clearly not on life support. The patient looks at us and says, “Well, judging by the uniforms, you must be the people who saved my life. The doctors say that if you hadn’t have been there and done what you did, I wouldn’t be here.”

We stayed and chatted with a man that died in front of us the day before, which is the single greatest experience I may ever have in my career. All his faculties are intact, and he has even managed to retain his sense of hu
mor. I’m more astounded than I was when he was a zombie, but I kept that to myself.

“You know, I’m really sore from it all. I’d like to know what mammoth of a man you had doing CPR on me,” he tells us.

My partner looks at me, and I feel a girl-power grin that starts from my gut and works its way up. “For the most part, I did the CPR. You didn’t seem to like it much then, but it was better than the alternative.”

“Well, thank you both.”

The intense school, the paltry paycheck, the abusive patients, the generalized assholes, and all the crap that goes along with EMS, after seeing that man alive, was worth it.

My Rumor Is Better Than Your Rumor

2 comments

Gossip is common in any group of people, found in every profession and every culture I’ve ever had the pleasure of encountering. In the world of emergency medicine, we could put daytime television to shame. Many of those involved in EMS tend to be thrill seekers by nature; we typically find ourselves in this line of work because we want to stare the Grim Reaper in the face and tell him to BRING IT ON. As a direct side effect of this personality type, we are an incestuous subset of society, complete with our own tales of who’s dating whom, who’s screwing whom, who’s screwed whom over, and so on. In an agency of a few hundred field personnel, ample opportunities are put forth to raise turmoil in the dreaded rumor mill. I am no exception; I dated a colleague I encountered closely in my employer funded paramedic program. Scandalous! These tales range from completely truthful, vaguely based in partial truths, and completely fictitious.

I experienced my claim to urban EMS fame with my very own rumor during paramedic school, a year and a half into employment at the agency, and a few months into the paramedic program. Until this point, I’d managed to stay under the proverbial rumor radar, largely by keeping my nose tucked safely into whatever book I’d gotten my hands on that week, with minimum fraternization with my coworkers. As a mere paramecium, I was completely engulfed in the world of learning paramedicine, and had little time or energy remaining for anything remotely indecent, however tempting.

The county my agency has the delight to serve is also provided with a fine publication called The Slammer, available primarily at superior establishments located in the hearts of our many ghettos. This may seem odd upon initial examination, but is an excellent way to keep up with the recent activities of loved and/or despised family members, cohorts, and acquaintances. I am simply giddy at the occasional glimpse of a high school classmate, although it is much more likely to catch a snapshot of the recent arrest of a frequent flier of the EMS variety.

Unbeknownst to me, The Slammer had published the latest arrest of a young lady who shares my first and last name, but is in an entirely different line of employment as myself. While not a dead ringer, Tiffany’s mugshot does not necessarily look unlike me: she’s young, Caucasian, and blond. Listed directly under the black and white photo are the allegations against her—Prostitution and Crimes Against Nature.

This particular edition of The Slammer was circulated during the opposite shift as the one I worked prior to enrolling into paramedic school. That is to say, employees of that shift were familiar with my name and had merely a vague idea of my appearance, as our paths rarely crossed. Presumably, a coworker and ardent reader of The Slammer purchased a copy, found “me,” and produced the “evidence” to the supervisor on duty, who was not particularly familiar with nor had never actually met me. The supervisor on duty then called my direct supervisor, Paramom, who was enjoying an adult beverage on her well deserved weekend off work. As I understand it, Paramom’s reaction to “my” crime was: “Are you sure? Tiff’s in paramedic school. I really don’t think she has time to hook.”

Meanwhile, “I” was cut out of that particular edition of The Slammer, and the tabloid was left at the logistics window, free to be perused by at least one member of every crew that must wait at that window for the necessary items that are required for every ambulance. While a hole in a publication that reports criminal arrests may have seemed inconspicuous to some, inclined inquiring minds had the ability to fill the void with minimum investigative efforts.

My personal rumor was brought to my attention by Paramom, who approached me during my usually anticlimactic lunch break during school. I was having a pretty fantastic day. All morning, I’d received smiles and salutations from paramedics and EMTs alike that typically ignored me or viewed me as an unobtrusive piece of the scenery. Obviously, I thought I was having an extraordinarily great hair day. Paramom casually sat at the table in the office kitchen as I shoveled in another forkful of the weekend’s leftovers, “So, did you have an exciting weekend?”

“Not really. I’m having a tough time getting all of these drug dosages down, but I think I’ll get it if I keep at it. There’s just a lot to absorb.”

Paramom asks me with a nervous laugh, “I see. So, you definitely weren’t incarcerated on your weekend off?”

When I applied at my agency, in addition to all jobs I’ve applied for in the past, I’ve been asked about the possibility of a criminal record as a formality. I’ve been subjected to standard background checks and known company policy requires full disclosure of criminal charges. I have, however, never been asked in a straightforward manner about any criminal activity, particularly when some details have been quite clearly established. It has simply never come up, and I was not entirely sure of the proper social protocol; I settled with nearly choking on my reheated pasta. “Um, no. I’m fairly certain I would have remembered that.”

Paramom proceeded to fill me in on her interesting telephone call that seemed too absurd to investigate over the weekend, but had to be addressed as a matter of course. She also informed me that she had yet to actually see the “evidence” in person. We set off to acquire our own copy of The Slammer, conveniently sold at the gas station next to our agency (we’re county funded). A few pages in, there “I” was, in all “my” mugshot glory, nestled in the middle of a section specifically dedicated to sexual crimes. Her middle name was different than mine, putting a definite end to the investigation in an official capacity on the spot. “What exactly constitutes a crime against nature?” I asked Paramom, but even in her infinite wisdom, she was dumbfounded. On the bright side, my namesake was definitely the hottest prostitute published that week.

My classmates and friends teased me with a vigor that occasionally resurfaces to this day. With Paramom’s blessing, I made no efforts to squash the rumor with the field crews. I cat walked the wash bays with my head held high and an extra swagger in my step. In an agency of a few hundred people, I had my very own rumor, which I didn’t even need to fuel with my own offensive behavior. Simply put, I had made it.

The Dichotomy of Crazy

No comments

Crazy presents itself in many forms. My own particular brand of crazy is a bizarre form of serially monogamous relationships despite my intense fear of commitment. I’m fully aware of the oxymoronic nature of myself, but self-psychoanalysis is for another time all together. I find it much more entertaining to ponder the craziness found in others than attempt to interpret and treat the psycho within. Through what I consider to be deep thought (I’m blond, it hurts, you know), I’ve come to the conclusion that the crazy I’ve encountered on the job is split into a fairly distinct dichotomy: Good (or at least not a danger to the world and its populace) Crazy and Bad Crazy.

Good Crazies and I get along very well, perhaps due to the “it takes one to know one” theory. Good Crazies and I can see eye to eye and get to the hospital without physical restraints, threats of/attempts at bodily harm, or the sudden inescapable desire to unbuckle oneself from the seatbelts on the stretcher and fling oneself out of the back of the ambulance at 55 miles per hour on the highway. We may even share a laugh, a common interest in books/music/serial killers, or a personal epiphany into the insight of mankind. People of the Good Crazy variety tend to see me, decked out in pigtails, with big blue eyes and girl-next-door freckles, as the kind and loving creature I try to portray my image to be, and immediately assess that I am not only far from a threat, but willing and able to help them. Good Crazies get my personal specialty, 50cc of love: hand holding and head patting as necessary.

Examples of Good Crazy:

Alzheimer’s Patient Who Seems To Have Developed Tourette Syndrome: This patient is almost always a delight for me. You just can’t be mad at them. You can be annoyed with the nursing home staff for calling 911 and reporting that the patient has an altered mental status, despite the fact that their normal mental status is indistinguishable from an altered one, but not at the patient. Furthermore, every time they drop the F-Bomb, it gives me the giggles like nitrous oxide. There’s just nothing like a 200 year old lady swearing like a sailor. I realize how hard this must be the patient’s family members, but if I spend much time analyzing the true misfortune of my patients, I’ll spend the rest of my life munching on serotonin reuptake inhibitors.

Mentally Handicapped, But Incorrigibly Happy Kid: I walk into the room and this kid (or technically adult as the case may be, but they always strike me as kids) just BEAMS at me with a smile that could replace the sun. I introduce myself and ask if we can be friends, and they always want to be my friend. People who want my friendship may be appealing from a person with all their mental faculties, but people who have been dealt a seriously shitty hand and have a sunny outlook are impossible not to adore. I realize that perhaps they’re incapable of knowing the nature of their illness, but I can’t force myself to care. They actually want to be my friend for no reason (perhaps this requires another self-psychoanalysis in the future, but I digress)!

The Happy Drunk: While it is obnoxious to continuously take people to an emergency room when they are clearly not having an emergency, it’s apparently unavoidable. If I must transport a drunk, I infinitely prefer The Happy Drunk, which is not to be mistaken with The Drunk That Vomited Red Wine On Me And Now I Can’t Even Smell It Anymore Without Feeling Nauseous. They may take for freakin’ ever to load into the ambulance because they feel the need to say goodbye to everyone on first response and stumble around incessantly, but they don’t throw punches or insult public safety personnel. They even laugh at their own slurring, inability to speak a clear sentence, and hiccups. The Happy Drunk is occasionally homeless, and this is his or her primary escape from the harsh reality of the world, for which I can’t really blame them. I suppose The Happy Drunk takes me back to my days in college, where I didn’t realize my EMS training had begun by taking care of my friends who frequently morphed into The Happy Drunk. In fact, I have been The Happy Drunk, just never in an ambulance.

The Schizophrenic Lady Who Puts Lipstick All Around Her Eye Like Petey The Dog, Or Other Harmless Aberrant Behavior: Bystanders only called 911 because this patient is clearly off her rocker, and they have no clue what to do. Think about it: you see someone with blatant atypical behavior, but do you really know if they’ll go off on you if you ask about it? Bystanders don’t see this patient normally, because they tend to be tucked safely away in the care of family members or mental institutions. They see someone painting their face in hot pink and babbling incoherently and have no idea what to make of it. When I show up, I compliment the color and let her know if she missed a spot. In retort, we have a peaceful ride conversing about the nice Martian she met last week.

Bad Crazy, on the other hand, is the total opposite, and even worse, they see right through my docile appearance. Bad Crazies know I’m not totally sane (who in EMS is, anyway?), and they thrive on it. They love to pick fights, force us into physically restraining them (without even acknowledging how handy I am with soft restraints! Jerks!), or make grand accusations of our intentions/races/religions/sexual preferences/possibilities of demonic nature or possession. Bad Crazies will NOT accept even my most compelling charm, which quite frankly, annoys the crap out of me. Well, that and sometimes they try to hurt me, which sucks for obvious reasons.

Examples of Bad Crazy:

The Patient Who Makes Really Ineffective Suicide Attempts Regularly: This patient either has the IQ of a fencepost or is really searching for attention, not an end to their existence as they know it. This patient only falls into the Bad Crazy category because they’re hurting the people who care about them, albeit emotionally. Cutting your finger, taking a dose of an over the counter medication that is less than the recommended dose, jumping out of a window on the first floor of a building, banging your head onto a concrete wall (but not hard enough to leave a mark), stabbing yourself in the leg with a pencil, refusing to take your vitamins, taking your prescribed medications when and as you are instructed (seriously), scratching your forearm with a dull knife, or staring at the sun will probably not kill you. These patients typically need either a stage complete with spotlights or Darwinian intervention. Better luck next time.

The Paranoid Schizophrenic Conspiracist: These people are very mentally ill, usually with a multitude of psychiatric disorders, and typically have experienced such awful things in life that their mind literally surrendered. These people know for a fact that myself, my crew, and all first responders and police officers are all minions to those orchestrating an elaborate scheme to “get” them. Granted, it doesn’t help my case that the patient was full body tackled by a police officer to get under my care in the first place, but you simply cannot run half naked, at top speed, through the back yards of a middle-upper class neighborhood; people frown on that kind of thing. Logic is of no use with these patients. My oxygen is really noxious gas, my lancet for checking glucose levels is actually a poison dart, and my blood pressure cuff is a cleverly disguised torture device. These patients are highly unpredictable and are so intensely fearful that they honestly believe I can and will hurt them. They interpret my attempt at a calm voice as a ruse and my ambulance as an embodiment of the evil that is set to destroy them. I can’t entirely blame them…if you were actually looking at a hallucination of “El Diablo,” how can you not believe higher powers are looking to destroy you? After all,
seeing is believing, right?

The Dimwitted Criminal: This particular type of patient exists largely to make me feel of superior intellect. This patient dons stylish house arrest anklet, yet led the highway patrol on a high speed chase for no apparent reason, hit the car of a passerby at an off ramp, took off on foot, got bit in the leg by a dog from the canine unit, and fails to see the irony in the fact that I forgot to put my phone on vibrate and The Clash’s “I Fought the Law, and the Law Won” rings from the pocket at my right breast. Nicely done, Dimwitted Criminal, you may have just won yourself a stay at the big house! I see the biggest injustice as the fact that these delinquents always seem to procreate; can the spawn of those responsible for keeping prison recidivism rates exceptionally high really stand a chance at success in life?

The Mean Drunk: I despise The Mean Drunk. The Mean Drunk has poured alcohol down his throat in whatever form he/she can find every waking minute of every day, regardless of the fact that the juice makes them grow horns and spit fire. The Mean Drunk knows that he or she is a raging asshole under the influence, and probably wouldn’t be such a dick if he/she quit drinking mouthwash every day, but just doesn’t care. The Mean Drunk is full of threats of violence, and occasionally acts them out. He/she flails about, swinging fists and feet, yelling threats and insults, spitting and refusing to cooperate. Really, Mean Drunk, I’m practically Aryan in appearance; it just doesn’t make much sense to call me the N-word. Also, please keep your HIV, Hepatitis, TB, or other communicable disease laced saliva to yourself. On occasion, The Mean Drunk picks me out of all the people available as his victim, which never fails to baffle me; aside from an emaciated teenaged fireman, I am likely the smallest person on a scene, and I wear my hair in pigtails regularly…PIGTAILS! “I’m gonna rearrange your pretty little face!” Yeah, Mean Drunk, you said that last week, and guess what! Face. Still. In. Tact. Seriously, Mean Drunk, this whole slowly killing your liver ordeal is for the birds; just aspirate your vomit and die already. Perhaps the most disturbing thing of all is that these people don’t actually scare me anymore. Sure, I’ll be more alert, keeping my arms constantly prepared to block a swing or ready to use four point restraints, but I’m no longer afraid. When I was a new EMT, these people scared the crap out of me; these days, I just think these patients are probably why we don’t use paralyzing drugs in my system.

I’ve barely covered the tip of the craziness ice burg in the emergency setting, but I can’t be bothered to write a novella on the experience. Besides, most of it is depressing. The comic book version of myself lifts The Good Crazies effortlessly and compassionately, delivering them to hospitals capable of curing their incurable problems. She protects the world from the Bad Crazies with speed, strength, and intelligence. Of course, the superhero within is a fantasy, so I’ll settle with not being dumbfounded and doing the best I can in whatever situation I find my patients and myself in.

Numero Uno

4 comments

I am a bona fide paramedic; I’ve worked hard to learn about the myriad of disastrous complications the human body can endure and ultimately, what interventions can be made on my part to keep a person alive in the face of abominable circumstances. Essentially, I was ready. Bring on the Grim Reaper-I am ready to stare him down and pull lives from his grimy, heart-stopping, possibly mummified hand! This is honestly how you feel when you’ve been a paramedic for a week: part superhero and part purist. Your heart is full of altruism, your brain is full of knowledge you’ll likely lose from lack of use, and the rest of you is petrified that you’ll kill someone. Ah, the life of a para-pup.

Then it happened: I got my first priority (read: really bad, possibly about to kick it to the next adventure, depending on your particular brand of spirituality) patient. The dispatch came over the radio, and I wasn’t necessarily anticipating anything serious in nature considering the vast majority of the people who call 911 are in no severe distress what-so-ever. The possibility still remained that this person could be in severe distress and I could swoop in and save the day with my knowledge, medications, and equipment. I can nearly see it in frames of a comic book, vibrant colors showing my hair blowing (and possibly a cape, too, for good measure) as I defibrillate the patient’s heart, stopping a lethal rhythm from claiming the life of yet another innocent soul. I intubate the patient with grace and style, protecting his or her airway from the always dreaded aspiration injury. I give life-saving medications through an intravenous line that I have managed to administer without so much as spilling a drop of blood. I can see the sparkle off my teeth as I wheel the patient into the hospital with nothing left for the doctors and nurses to do because I have saved the day. The patient, their family, and doctors and nurses thank me profusely, as they are positive that without my interventions, the patient would have inevitably experienced a harsh and painful death. On top of all that, I have never looked better in my uniform as with the added advantage of a touch of cleavage. My fantasy world quickly comes to a halt as I pull the ambulance into the parking lot of your standard ghetto-fabulous apartment complex.

True to form, the apartment itself matches the façade: smoke wafts through the air, the furniture is minimalist and cheap, untidiness is abundant, evidence of fast-food is scattered throughout the areas I see, and more people appear to live there than the fire code will likely allow. I see my patient sitting upright on a battered couch, her hands on her knees, clearly struggling to suck precious air into her lungs. Shit. Shit! SHIT! I realize two things for certain: if I don’t do something immediately, this woman will die, and I have absolutely no idea what I’m doing. Reality sucks. I can only imagine how I must have looked to my patient: a 26 year old blonde with the color drained from my face, eyes wide and unblinking, frozen. Perhaps she thought that I was fulfilling the agency’s special needs requirements for equal opportunity employment.

Luckily, I’m working today with an experienced paramedic who I would trust with my own life. She’s the real superheroine here, and I find this comforting enough to snap myself out of my stupor. Somehow, my training kicks in, and I become a woman of action, albeit a clumsy woman of action, fumbling with my equipment with shaking hands, mostly unsure of every patient care decision. I call out for the patient to be put on oxygen. Holy crap! The firemen are doing what I say and instead of looking at me like I’m speaking tongues. Well, that’s kind of cool. I listen to breath sounds, note wheezing all over and diminishment in the lower lobes of the lungs. I attach a probe to her finger that reads oxygen saturation levels: 74% and dropping with a high heart rate. The patient is unable to speak and tell me her medical history, but she is relatively young and is able to answer some yes or no questions; I just have to choose them wisely. The patient is able to nod that she has asthma and that this problem came on quickly. She shakes her head when asked if she’s allergic to any medications.

I call to my partner to set up a nebulizer with albuterol, stronger than her home version of the drug. I tell her to toss me the epinephrine, I want it readily available in my pocket. A fireman reads off medication names from a grocery bag full of medications, “albuterol, metformin, hydrochlor-I can’t say that one, but it’s a big word, lasix, and prozac.” Fantastic. Those medications indicate that she could be either having an asthma attack of the worst kind or drowning in her own blood, and if I treat her wrong, I’ll kill her.

I listen to her lungs again and there is no change, her oxygen saturation level is holding steady. We pick her up to put her on my stretcher, and as I put my hand around her left arm, I feel the swoosh of blood that indicates she has a dialysis shunt, and I briefly panic. She could potentially have toxins and fluid backing up in her bloodstream and into her lungs, and the medication I’m giving could be helping her drown if this is the case. Super. “Have you missed any dialysis appointments?” She shakes her head no, and a family member says that she went to dialysis yesterday. Here’s hoping I don’t screw this one up.

It feels like we’ve been here entirely too long, but I know it couldn’t have been more than two or three minutes. We need to get moving immediately, and I ask a fireman to drive the ambulance to the hospital, with what I like to think was politeness and urgency, but probably appeared more along the lines of frazzled bossiness.

Her blood pressure is dangerously high, making me again concerned that I’m treating my patient totally inappropriately. I reconsider and decide that this has asthma written all over it, and I make an active decision to stick to my guns and see what happens. My partner is furiously working to put together the CPAP, a machine that forces air into one’s lungs, while I’m searching for IV access. She yells out to me that the machine isn’t working as I yell that the patient has no IV access. Abandoning paramedicine in lieu of permanently living in my comic book fantasy is looking more appealing by the second. In one arm, her veins have been totally deteriorated by diabetes and high blood pressure, and in the other her veins have been altered by the surgical placement of a dialysis shunt.

I peek up at my patient to see the beginning of The Look. The Look is not a new concept for me. I’ve seen The Look as an EMT-Basic and not directly responsible for doing things like keeping people from dying. Until now, The Look meant I should say to the paramedic, “Hey, you should probably do something about that,” because The Look is typically followed by death. Now I’m the paramedic. Crap. I suggest to my partner that I think it’s time to give epinephrine, but she disagrees. My partner thinks this very strong medication could put too much strain on her heart. That’s a distinct possibility, and by doing this we could give her a heart attack. We agree to hold off on the epinephrine for now, but keep it close by.

My partner is able to rig the CPAP machine with brute force; it leaks, but it works. Good enough. The oxygen does the trick and The Look is gone for good. The patient’s oxygen levels steadily rise until they reach 100%, where they remain. We have managed to alert the hospital prior to our arrival, and as we roll the stretcher into the waiting room, the doctors and nurses immediately get to work. The room is crowded and wires and tubes seem to fling through the air as our equipment is traded out for that of the hospital’s. I manage to relay my report to the room, despite the frenzied activity, without appearing to be a complete idiot, which is no small feat. An experienced nurse is attempting to obtain IV access and I hear her say “She has absolutely no IV sites.” Well, that makes me feel a little better.

As I leave the room, my hair is matted to my head with sweat, I didn’t save the day with grace and style, and I have no tasteful cleavage. I did, however, get the patient to the hospital alive with the invaluable help of an experienced partner and an accommodating fire department. As I replay the events in my head, I remember and remark to my partner that I’m most impressed that we never got distracted by the fact that there was a midget on scene to begin with; she agrees that this is an achievement worth celebrating.

After what seemed like an eternity, I finished the bulk of my written report and documentation. I reentered the patient’s room for a little bit of early follow-up. The patient is sitting up, on continuous nebulizer treatments and finally able to talk. “Honey, did I scare you?” she asks me.

“Yes, ma’am.”

“Don’t worry. You did a good job.” Well, it isn’t people falling at my feet to appreciate my valiant efforts, but I’ll take it.