You Wanna Hear a Story?

I spent the summer running ambulance like it was my full-time job. Mostly because my actual full-time job became an 'eliminated position' in June. This resulted in 37 (thirty-seven) interfacility transfers in one quarter, sometimes as many as three a week. I spent most of Labor Day weekend in the back of a Horton.

Which is fine.

Sometimes there are great stretches of time in this endeavor where nothing much happens. It was a summer of cardiac rhythm disturbances and possible CVAs. There was the odd car accident. But last Friday night was a reminder of why I have a special place in my heart for people who make poor life choices on a regular basis.

00:35. We're called out to assist an airmedical agency, and on the way we find out its a 'hot load'-- we have to get the patient at the hospital and take him directly to the helipad so he can be on his way. This usually means that whatever is going on is pretty serious and there isn't time to pick up the helicopter crew, ferry them to the hospital, let them dink around and then wrap the patient in what I call the 'flying burrito wrapper' (their fancy insulated blankie) and take them back to he helipad. I know the ER's been quiet, so I'm interested to know what's up.

We get there, and the ER is quiet indeed, except for our patient, a twenty-something man in plaid boxers who I can tell either just engaged in a tearful confession of some kind with the Paramedic holding pretty vicious direct pressure on his right wrist, or he's drunk.
Oh, goody.
I step behind this Paramedic in an attempt to figure out why he's holding this young man's wrist so tightly. After all, he seems boisterous, and possibly inebriated, but not particularly violent.

Oh.

Peeking around a stack of four by fours is a deep cut that seems to go most of the way around his wrist. Four more packs of gauze sit stacked beside him and he asks me to open them. "Three of them should do it." Yikes. I open the packs and watch them wrap the wound. I sense a story coming.

"So what happened?" The paramedic asks as we drive to the helipad.

"Oh, man. You wanna hear a story? So, like, we were drinking and whatnot, and I, like, fell off the porch and caught my hand on the white things, you know the white things between the windows? And, like, my hand went through it. And I fell. And blood, like, shot out like four feet."

He offered further information.

"But, you know? Okay. You wanna hear this? Last year, like, my friends and I were partying, and drinking and whatnot, and I, you know, passed out on the sidewalk. And you know what the cop did? He TOOK ME TO THE HOSPITAL. What a DICK."

(What was he supposed to do? Put cones around him so no one would trip?)

"Thirty five hundred dollars. Man. That sucked."

"You ain't seen nothing yet," the Paramedic said. "Wait until you get the helicopter bill."

We waited, listening for the distant drone of his ride coming in over the lake. The patient coughed long and deep.

"That doesn't sound to good, are you sick?" I asked.

"Nah, its...you wanna hear this? Okay, so about a week ago I was siphoning some diesel fuel and I got some in my lungs. I guess I should have them check that shit out too while I'm at the hospital."

"So, you were just going to let that go and see how it worked out?" by now the Paramedic has that look on his face that tells me I'm going to be spending the next few minutes trying hard not to laugh. "Do you ever think about, like, staying home?"

What would we do on a Friday night if he did?

<><><><><><><><>

In other news, most of you already know that I lost a job in the beginning of the summer. Some of you may NOT know that I got a new job that I have a feeling may contribute some content to this blog, though from a different 'angle'.....I'm a 9-1-1 dispatcher in training.
Yep, I'm learning to work the other side of the radio....police stuff, protocols, geography, computer aided dispatch, its a whole new world. I love it-- the co-workers, the work, even the wonky schedule is cool.

Poor life-choice makers...holla. You already have my digits.

Better Living Through Chemistry

I don't want this third cup of coffee. But I'm going to drink it anyway.

Besides, I need something to take the pill with. I hold it in my fingers, wondering whether my feeling better has more to do with feeling like I'm doing something than the actual medical action of this particular drug. I decide it doesn't really matter, that improvement is improvement and whatever dispels the dark is welcome.

I see skinny, tanned, shirtless country boys everywhere, ones like the one we loaded to fly a few weeks ago. The first crew onscene found him standing uncertainly next to a wrecked car, cradling his arm, his shoulder not so much dislocated as relocated. They had to ask him if he was in the wreck. "Which car were you in, sweetheart?" she asked. He pointed to the one wheels up in the middle of the road. He'd been asleep in the back seat, ejected somehow without a scratch on him, except for the shoulder. Twenty years old and terrified of needles. All I could do is stroke the five square inches of velvety crewcut that was not encircled with c-spine stabilizing plastic and vinyl and say over and over, "Its going to be okay, it'll only take a second, you have a great vein there, just relax." I wondered at the sinewy length of him and just how he was ejected without more damage. A perfect jacknife dive out of a broken window. The car was small. With every MVA my grasp of physics becomes less science, more mystery and chance, possibly miracle. Possibly. That accident put my skills in perspective. The damage was done. We cleaned up the mess. Maybe, maybe, we prevented more damage.

You walk out of EMT class with your certificate and your patch and think (secretly) that you are going to save the world. You stare hard at strangers whose perfusion seems questionable, watch them make their tentative way up sidewalks, down steps that never seemed so precarious. You shake your head at bikers gliding bareheaded through intersections. It doesn't take long to learn that your ceremonial duties are limited to cleaning up the aftermath of someone else's choices, or asking questions and bearing witness to forces of time and disease beyond all control, particularly yours.

Later on, after my third cup of coffee, I step to the front of the church and receive the cup, the throaty rumble of motorcycles behind me, headed to their destinations. Perhaps I am headed the same way in a hail of sound and flashing lights, though with a swallow of sacred wine and the knowledge that I do not save anyone, not even myself.

Contempt

It was bound to happen eventually.

Saturday, the latest in a string of early risings, only this time for no reason. Last year I watched dozens of racing bikes hum down an ill-advised hill at an even more ill-advised speed. There were no crashes. But we were there. This time there were no crashes (as far as I know), but we were not there since the rest of the crew didn't show. My powers of invisibility were great yesterday, my questions met with shrugs and blank stares, turning away to more interesting conversation, punctuated by the occasional unreturned phone call. I completed some other tasks as the darkness descended. I was angry, but not because of this. It was time to go home. I had to walk a few blocks through merriment I wanted no part of just to find the person who had parked me in.

I hate people, I thought.

I tasted that thought, contemplative, settling into it like an ominous easy chair, pressing my shoulder blades into its sumptuous upholstery, my elbows resting on its portentous girth.

I don't know what other people do when they feel this way. Actually, I take that back. I do know what they do. They drink and fight and fall down and take things they shouldn't or buy things they shouldn't or otherwise do what they shouldn't to avoid the feeling, push back the sucking dark. Sometimes we have to go after them, get them out, wrap them up and strap them down, feeling for damage while they search our faces with anxious eyes, attempting hope and excuses for trying and failing to ride the tide. I opted to hide in the house. Hating people pretty much means you should avoid them for a little while. It definitely implies that, at least in the short term, you should probably not attempt to render quality emergency medical service. I ignored a text for a transfer, knowing no drivers were available anyway. I pulled my pager out of my waistband and shoved it in my purse, thumbing it off as it went. Off went the phone. 1R-259 is OOS, I wanted to write on the whiteboard in the garage. Only I have to do my own warranty work.

Today may be better only because I'm still in the house. But its better. One by one necessary chores get done. I'm at least willing to look out the window, and I may even go out there, soon. I know this sabbatical is short, no more than a day. There are things to do, you see. Obligations to the family I adopted and persuaded to set a place for me, the brothers, the sisters (maybe), the God who watches over us, shaking His head, protecting what we do not treasure.

Overheard on the Bus

Its only May, and my collection of DUI humans grows by the week. I had considered waiting until the end of the summer and doing a wrap up of all of the fun conversations I've had with alcohol-fueled drivers but I can't wait until August or I will forget them all.

First, I'm glad they had a mock DUI at the high school. They should have made parental attendance a condition of graduation. So far this summer every single one of my drunk-wrecked has been between 45-55 years old. Post-boomers: Get your crap together. Seriously.

Exhibit One: Love the One You're With, if in fact you are with her.

Patient: "Did I cause an accident?" (He rammed his car into a tree. There was a large bottle of vodka rolling around on the floor of the car.)

Me: "You had an accident, sir." (I'm holding his head while others are coming in from the other side to get him in a KED.)

Patient: "How is my truck? Did I have an accident?"

Paramedic: "You ARE the accident, partner. Just hang on and we'll get you out."

Later, in the ambulance: "Did I wreck my truck? Is Amanda* okay?"

Paramedic: "We aren't the police, so we don't care, but how much have you had to drink tonight, partner?"

Patient: "6 or 7 shots. Why?"

Paramedic: "Because you were driving a Dodge Neon and Amanda's not with you."

Patient: "OH MY GOD! I WRECKED MY MOTHER'S CAR!!"
__________________________________________________

Exhibit Two: In which its more important to look good than to feel good.

The patient failed to negotiate a 'T', rolled through the stop sign, and rolled his truck several times. When we got there, he'd self-extricated and the truck was on its roof.

Patient: "Oh, shit. My truck."

Paramedic: "We aren't the cops, so we don't care....but how much have you had to drink tonight, partner?" (See a theme? We get to say this a lot.)

Patient: mutters something about just a couple of beers, then turns to me earnestly and says
"Oh man, is my face all messed up?"

Me: "No sir, you are just fine, just a little cut on your head."

Patient. "Oh, good." I guess his modeling career is safe. "Man, that ditch, man. It just...." (Just what, jumped up and grabbed you?)

Later on...as we're bringing him out of the ambulance.....

Patient: "Well, that's the rodeo."
____________________________________________________

Exhibit three: Getting your story straight isn't always enough

We arrive to find a large motorcycle leaning carefully on the embankment with two guys sitting beside it looking for all the world like two kids who got caught stealing in a candy store. Neither of them will look at us directly. Not much debris other than a broken amber turn signal lens, a wristwatch, and a pair of glasses. Both refuse treatment, which seems fine for the one guy but the other one's forehead is busted pretty good and he's trying to nonchalantly swab the blood off with a headwrap. I'm thinking five stitches minimum. We start filling out the refusal paperwork. (Translation: we start killing time until the state police arrive.)

One guy starts to tell us how they were coming up the road and jeez, there was a deer. Just come out of nowhere & ran right into the back of the bike. Ran off that way. And so we called someone to come and get us and while we were waiting, we had a couple beers. Four beers. Apiece.

Now. This scene was about a five minute ride from town. We were enroute probably no more than four minutes after the call went out. So in nine minutes, these gentlemen did the deer tango, got the bike off the road, called a friend, hopped a squat, and had four beers apiece. Because nothing says Miller Time like a close encounter with wildlife. I suppose they were careful to stash the empties back in the saddlebags for recycling because I didn't see eight empty cans anywhere around. Gentlemen: Do not piss on my leg and tell me its raining.

I hand my guy a handful of 2 X 2s for his head. I take a walk in the direction of travel and see a thirty foot long scrape on the blacktop that extends from the apex of the curve and starts just over a rough spot and I get an idea that's where things went tits up for these two and no deer were harmed in the making of this film.

Refusal forms complete, we wait. Oddly, the ride they called does not arrive. But the staties do.
I can honestly say I've never been in the kind of trouble that involves the state police; once a very kind Delaware State Trooper gave me a ride to my office when my car broke down on a busy and dangerous stretch of highway. So I can't say what it is about that slow saunter across the road from the black and white car that changes things for a patient/victim/defendant, but suddenly, the deer story was abandoned in favor of a finger-pointing meltdown over who was actually driving. I had walked away but I overheard one of the troopers saying something like "Okay. So I'm gonna ask you ONE MORE TIME...."

State troopers have the magic touch when it comes to getting impaired folks to get in the ambulance. Its called the "You can come with us" speech. As in: "You have two choices: You can go with them or you can COME WITH US." Its downright miraculous how people have a sudden awareness of pain they had not noticed to that point and elect an ambulance transport. Our busted head guy did us one or two better.

As soon as he was immobilzed he started shaking. It wasn't so much an involuntary tremble as it looked like he was reprising Tom Cruise's role in Cocktail. Then it started:

"Oh man. I'm gonna go back to prison. I don't wanna go back there. Please don't send me back to the Gulf. (the hell?) I don't wanna go back. Three times was enough."

"Sir, we're just taking you to the hospital to get you taken care of."

This refrain is repeated all the way to the hospital. In between he manages to tell us he has PTSD, he broke his back in the exact same place three times, and suddenly his back hurts an awful lot. Despite my very best efforts with a handlight I cannot get his pupils any smaller than dimes. All the way to the hospital we have to assure him many times we are not shipping him back to the Gulf. I get his arm out of his leather coat without complaint so I can get a BP but as soon as the ED nurses touch him he shrieks like they set him on fire.

He ends up being released with a couple of stitches in his head.

Its only May.

Department of Vehicular Awesomeness

I'm too lazy to cross-post. So I will just give you the link to my new post over here, wherein we talk of ambulance-related happiness.