30 January 2006

The Sunday Stroll

30 January 2006

"The Sunday Stroll"

You know, no matter where in the country you are in EMS, there is the simplicity of knowing that some things never change.  A chest pain in the city is a chest pain in the country. Abdominal pain is abdominal pain.  And it is just as easy to wreck your car in the counrty as it is in the city.

Now, the severity as to "nature of call" varies somewhat, no matter where you go, those calls will always come.

Then there is that one paticular type of patient that no matter where you go and how rural you are, they seem to follow suit and violate your air space disrupting all that is in their paths.

We call them psych patients.

It is a given, almost a science, that these people whom, staticically come from the bigger cities, tend to migrate into the desolate, yet more personable areas of habitiat known as the small town.  Every so often, it is required in EMS to play cowboy and wrestle up the one who gets away from the herd and send them back to a place that is more suitable for their needs.

I think I may need a cowboy hat for this one.

0558 Hours

In EMS, there are certain gifts that are donned upon us from time to time.  Getting to eat a full meal uninterupted, finishing a whole movie from start to finish without interuption, and sleeping more than 4 hours in a row.  Things like this makes you wonder what you have done right and if you can do them again for similar results. 

Rolling over, I pulled the blanket a little more snuggly as the unseasonably warm weather that graced us earlier in the day had fallen back to the norm for this time of year. 

Dreaming of....um.....well, I don't remember what I was dreaming of, I was met by a UFO which awoke me from my sleep.  Turning over, I identified the object that had nailed me squarely in the head.  It was Dar's pillow, and boy, does she have good aim.

Thinking I may have fallen too deep asleep and started to snore, I apologized to her in the only language that I speak at this time of night. Mumble.

"Get up, we have a call" she told me sitting in the chair at our table putting her boots on and stealing a piece of my gum that I left on the table.

Rolling over, I looked at the clock to see a bunch of zeros with a six in front of them. This call was timed perfectly in the wee hours of the morning.  Perfectly to short me 30 minutes of sleep that I had the alarm set for.  

Wiping the sleep from my body and eyes, I got dressed while Dar went upstairs to get the address information as to where we were going.

Making my way out to the truck, I was tossed a portable radio and the destination of our call...the police station.

Cool.....

Not that going on a call at six in the morning was outstanding, but it was one of the only places that I knew how to get to, so I drove.

Calling en route, Dar told me the "nature of the call" I had to replay what she had said in my head.  Psych patient? Here in the country?  Wow...I thought I had escaped the brash world of pyscosis when I moved down to the country. Nope.

Walking in to the cop shop that was just around the corner (literally), there were three people there. Two of them were cops. So, I guess by process of elimination, it was easy to depict which person was going for a ride.

In front of me was an older female sitting in a chair with the distinct look of disgust on her face.  Dar went with the cop to find out the deal, I was left to make friends with the weary traveler. 

"So, how you doing this morning?" I asked trying to be polite.

"I hate all these damn cops, why don't they just leave me alone." She grimiced out.

Could you blame her.

"Are you hurt anywhere?" I asked.

"My feet hurt." She replied.

"From what?" I shot back.

"All this walking." She told me.

"How long have you been walking?" Curiosity starting to get to me.

"For two days." She said without missing a beat.

Okay...walking for two days.....QUICK....first thing that comes to your mind...don't think...just blurt it out.....

...............

..............

.............

Times up.

For me.........

 

 

Yep folks...... Run Forrest....Run.

Like you didn't either!!!!!!

"Where did you start out ma'am?" I inquired.

"Oberlin" She told me.

"Well, where you trying to get to?" I asked.

"Home" she replied.

"Well, where do you live?" I inquired.

"40th and Chestnut." She told me.

"In Cleveland?!?!?" asking in suprise.

"No, in Elyria." Telling me like I was dumb.

"You mean 40 Chestnut?" I asked trying to correct her.

"Yeah, that's it" she stated.

Now, to everyone else in the room, this was just a normal address that seems legit. To me, I knew a little more than they did.  The address she gave is a halfway house for one of the local crisis centers that deal with mental illness.

Also, at this point, I am really trying to hold it together and not laugh out loud at the misfortunes of direction for this woman.

Let me paint you a picture here.

 

Okay...

The Blue is where the patient started from.

The Green is where she was going.

The Red is where she ended up.

Really trying to keep my composure, I looked at her and asked,

"You DO know that you walked 20 miles in the wrong direction?" I snickered.

If looks could kill, I think I would be zipped in a bag right now.

Getting pulled aside, it was brought to my attention that this young lady had been at the mental illness treatment center getting treatment when she just left.  A known psych patient, she had not been on her meds for quite sometime. Making her imbalanced and somewhat snotty.

This went on for another five minutes or so until it was time to go.

Convincing her (a polite way of lying to her) she needed to go to the hospital to get looked at for the soreness in her feet, we coaxed her out to the parking lot and to the squad.  Half way through the parking lot, she decided to look up and see our squad.

"I ain't going in that" she screamed at the top of her voice.

Lady, what did you think I was going to come in?

"Well, unless you want to get into a police car and go somewhere you don't really want to be in, I suggest that you get in and go along with the program." I told her.

Speaking the early morning language of mumble (see, I am not the only one who knows it) she got into the truck and sat on the bench seat.

I looked at Dar and told her to drive fast...I knew this was going to be a eventful ride.

The conversation and small talk were very limited and really uneventful...until we got inside the hospital.

Placing her in a room, I walked out to finish my report and in came the registration girl asking some basic questions, which started to create a scene.

By this point, I have lot my patience with her. I got up too early, My shift was almost up, and I have not had coffee.

Walking into her room, she seem more aggitated than before, so I laid the law down for her.

"Listen,  did you know sound travels at over 600 MPH? She is 6 feet from you. She can hear you, so you don't have to scream.  You need to calm down and let them do their jobs. The faster you get with it, the faster you get out of here (I had my fingers crossed at this time.) Now, don't give them a hard time and they won't give you one."

She sat there...dejected.

Gathering my stuff, we made it back to the squad and onto the station where we could get our stuff and get out of Dodge before the next migration hit.

It never ceases to amaze me. The things that you find in EMS.  Like the saying goes "wherever you go, there you are".   It doesn't matter if your call volume is 1 call a day or 100 calls a day, the people are always going to challenge us and our ability to adapt to the enviornment around where we are. 

It's more than a way of life...it is an absolution.

Rounding Third and Heading Home,

M-

 

The New Blog

30 January 2006

"The New Blog"

Welp, I did it.

As promised, I have created a new blog that brings my feeble little mind outside the realm of the Paramedicine world.

I have only an intro written for it but I hope that you will go to it and visit as often as you do here. 

There will be a bonus episode of "Life as a Paramedic" today so stay tuned.

But for now, come and see the series spin off.

The View from the Cheap Seats

Rounding Third and Heading Home,

M-

28 January 2006

Joe vs. The Volcano

28 Jan 2006

"Joe vs. The Volcano"

Man, it is good to be back. Taking a couple months off to recooperate, move, and start a new job refreshes the batteries both physically and mentally.  Later on down the road I will get into what is new and improved but for now....let's get back to the action.

Before I go on, I have to tell you a little about the new company I am with.  I am working as a paramedic in a rural area that has only one squad on duty at a time...for 200+ square miles.  Response times are well into the double digits and getting to a hospital is even farther sometimes.  However, it really doesn't matter if you are in the city, as I was, or in the country, as I am now, people will never change. If they do change, then I guess that would leave me with nothing to write about.

0934 Hours

Working 48 straight hours used to be like playing russian roulette with a loaded gun when I worked back in the city.  Doing as many as 18 calls in a 24 hour shift had me thankful that I didn't have a concealed weapon at times as I would have spent the entire ammunition clip on some idiot who called the squad because his doctor couldn't see him till 4 PM and he didn't think he should have to wait for that gout that has infected his feet.  Double that, add lack of sleep, food, and being in the same uniform for longer than a lot of women own a pair of shoes, and you have a recipie for disaster and one really disgruntled paramedic.

Now....fast forward to now.

The area where I work now is in the middle of the sticks...literally.

I thought that working a 48 out here would be against my better judgement seeing the years of doing it before only left me bitter and disheartened from being ripped apart like string cheese in a nursery school.  But the money is important so I did it.

Day one.

Number of calls......

ZERO.

Nada....

Zilch....

None.

Boy, that was weird.  I don't even think the phone rang once while I was there. 

Now, I know what you are thinking.  This is good, just sit down, relax, enjoy yourself, and pretend that you are working for a fire department. (Sorry B,  You know how it is).

This is all good, yes?

NO!!!!

I get bored easy.   Checking the truck, washing it, DRYING it, and cleaning the station only took about a hour. For the remaining 23, I watched TV or slept.  There is no internet out here and my cell phone doesn't get a signal.

Good thing I bought a PSP the day before I started....just for that reason.

 This is it in case you were wondering what it is.

So, moving on (because I tend to wander), the next person came in and the second half started shortly after 0700.  Hopefully, we will get SOMETHING or I will be bald on my way home after pulling out my hair from sheer boredom.

My prayers were answered a couple hours after the shift change.

Getting a call for a man who "is having a stroke", we went to the squad to start off on our journey somewhere in the south eastern part of our district.

Now, it is really important to get your game face on early out here in the country for a number of reasons.

First, location.   We are, at average,  15 miles from the closest medical facility.  Even lights and sirens, you are looking at about 10 to 15 minutes (unless you are one of those paramedic/EMT's who drive so fast that you end up at the hospital BEFORE the event happened.)

Second, is location.  Because of where we are, there is no support.  Working in the city, the fire department went wherever we went so an extra set of hands were always within reach. Whether they were good hand or taking up space remained to be seen, but at least they were there. Out here in the boonies, we have to call for fire, which has to respond from home, then to the station, then to the scene. By this time, I could have the person dead, buried, given the eulogy, had the little after party with those finger sandwiches that get all over your hands, and visited the deceased twice.  It is not is their fault, it is just the way it is.

Finally, location. (see a theme here).  Being in the county, no one's house is right off the road and NOTHING is paved which means that you are going off roading.  No use trying to stay clean, you are guarunteed to get dirty. Oh, and no one's address is EVER on the mailbox. I won't start on that.

So, anyways...(If you are still here, I applaude you. I would have fallen asleep reading this about three paragraphs ago).

We enter the house and are directed to a back room where our patient, a male, sits in a chair totally with it and just by lookingat him, looks to have no distress at all.

Asking how he is doing, he acknowledges us and states that he feels fine and has really no idea why we are here.

"Because you had a stroke!!!"

The voice came from behind us and for that matter...over us too.

Looking over my left shoulder, I was met be a female who was obviously the care giver for this gentleman, who strolled in with that authoritative swagger that I have encounted oh so many times working in the city.  You know the one, it is that "Okay, this is what you are going to do" kinda walk.

Take a deep breath here, we know how I get.

"Well ma'am, what makes you think he has had a stroke?" I politely asked.

"He was up and then all of a sudden he started to drool, he didn't even know he was doing it and he doesn't remember doing it either." She told me as if she had diagnosed the problem through her Elton John sized glasses on her face (and I am talking about 1970's Elton John) well before we got there.

Performing a neuro exam, my partner began to get vitals.  Even after two of the "push/pull" type test, I had come to the conclusion that this man was stroke free..at least for now.

"Ma'am, do you have a list of his meds that I can look at?" Again I was polite.

"Why do you need to see them?" As if I asked her to borrow ten dollars.

"Just to see what he is on." I replied.

"I can tell you what he is on, you don't need the list." She scorned out.

Okay, for all you new readers out there, let me tell you a little about my work ethic and my attitude towards my job. 

I always put my patient's needs first and will always respect them and who they are...until you push my buttons.  I have a two and out rule. I will be nice to you initially, and if you are rude or demeaning, I will be nice to you still after that. But if you are still spiteful and mean, I take the gloves off. There are exceptions to the rule, but I don't think you really want to know what they are.

This lady had pushed my buttons...and there is no reset on this one.

"Just get me the list ma'am." I told here with most of the niceness out of my voice.

Disgruntled, she got up to get me the list.

Interviewing the patient even further, it showed that he seemed quite fine and his only problem that I could see was his sister who is the caregiver come to find out.

Coming back into the room, the sister had his list of meds....on her PDA.

Reaching out for the PDA, she quickly grabbed it back.

C'mon lady, I am not five years old and I am not going to drop your stupid little computer that makes you look like you are some sort of Bill Gates in the hills of despair out here.

Then the hits just kept on coming.

"He needs to go to Elyria Memorial." She commanded to me.

Here is the deal. Elyria Memorial or EMH is where I used to go with all my patients...when I worked in Elyria. I know the hospital and I know the system.   But now, that hospital is 25 miles away.  See where I am going here.

My partner tried to explain to the night owl (it's the glasses) that we are the only truck in pretty much the county and that would be a little far for us to go. Her explanation was good and for the most part, very true.

"Well, he is going there, his doctors are there and that is where he is going." She sternly yelled at my partner.

Okay, this would have waived the two and out rule.  I was getting quite pissed and it was time to lay down some control before we got steam-rolled.

"Ma'am......No." I said.

"Excuse me????" She asked with a sarcastic clarification.

"I said no. (what part didn't you understand) If he is having a stroke, which he is not, I am not going to bounce him from county to county because his doctor is at a specific hospital.  It is not in his best interest and if something goes wrong along the way (pfft, yeah, right) I don't want to take that chance of having to be out of the way of a hospital I passed so you can go to where your doctor has privleges."  I was fuming by now.

"Well, I don't want him going to any of the other hospitals.  He needs to go to EMH and that is final." She looked at me as if I was some young blood she could intimidate.

"Ma'am, this is not open for discussion." I told her.

Just when you thought it was going to get worse and fire was going to come from the heaven's, a ray of light shone through and some order restored.

"I really don't want to go at all." The patient spoke.

"Oh, you need to go, you had a stroke." His sister told him.

"He didn't have a stroke, he had a TIA (no health lessons today)." I told her.

"Well, that is the same thing." she said as if she was informing me.

"Umm...no it is not."I replied.

"Yes, it is" She began to start up again.

"No..it isn't, I mean with my 14 years in the field and all the training I have had, I am sure that your knowledge is far excceding of mine seeing you have a PDA with a medical program on it." I blurted out.  Hey come on....I am beyond repair at this time.

"I don't want to go, get whatever you need me to sign and I will sign it" the patient said polietly to us giving an evil look at his sister.

Making this short (my wrist are hurting from typing) he made an appointment with his doctor to go in that day and get checked out.  He never went with us and I am fortunate for that.  Last thing I needed was a person who saw one too many episodes of ER and think she is a neurologist.  Lord help us.

I only did 2 calls in the 48 hours which is going to take some getting used to but hey, I slept all night...two nights straight.  I wonder what they did at the old job that night...

I, soon, will be starting a second journal which is about...well...nothing. Just the things that I question in life and how I react to them. I will still have this one active as it has taken a life of it's own. I will let you know when that will happen. I hope you will come and visit it.

Until then...thank you all for your letters and support. It sure is good to be back.

Rounding Third and Heading Home,

M-

24 January 2006

The Sequel

24 Jan 2006

"The Sequel"

I'm Baaaaaaaaaaaaaaaaack.............

There will be more to come in the next week.

Hey if Jack Bauer from "24" can come back from the dead....why can't I.

Rounding Third and Heading Home,

M-