Please click HERE before reading!
It is the last day in Kaberamaido. I am busy triaging patients, performing basic wound care, and filling hastily written prescriptions. Dr. Bill is taking a break for a change, and enjoying the company of the children. Apparently, myself and the other EMTs have proven ourselves competent and capable healthcare providers, and he has entrusted with us the medical care today. Any serious cases, we are to refer to him, but all Basic Life Support and First Aid type cases we are allowed to take care of on our own.
I am thrilled, as are my fellow pre-medical colleagues. Finally, we get to play Doctor for real.
I am performing an exam on a child from the orphanage. She is a quiet and shy 11 year old, but she speaks English fluently, which is a pleasant and welcomed surprise. She presents with a headache, slight fever, and sore throat. Her vitals are stable, lungs are clear, and seems to be in otherwise relatively good health. I give her two chewable tylenol. I instruct her to stay hydrated, to take a tylenol to bring down the fever and take the other later on that day, to stay out of the sun, and to generally take it easy.
Easy enough, I think to myself.
We triage more patients. We hand out more medication. We write prescriptions. We fill prescriptions. We work until daylight ends, feeling like "real" Doctors.
"I got this," I think to myself.
We are packing up to leave when one of the Matrons motions to us. "Very sick child," she says as she pulls a little girl towards us. It is the patient I handed tylenol to earlier.
I am confused. I could have sworn this was just a headcold. I feel her forehead, and immediately am alarmed. "She is burning up," I think to myself. I grab another tylenol and hand it to her, with water. "Take this." I call over another EMT. "Get Doctor Bill," I said as calmly as I can manage.
Doctor Oscar, the local physician on the ground, arrives. He feels our young patients head. "Too hot!" He exclaims surprised. I agree. Doctor Oscar transports our patient on his motorcycle to his clinic, to watch her overnight. I walk with the other EMTs back to our house.
We later learn that our patient was having an acute malaria attack. She also was HIV/AIDs positive. I feel awful. We missed a huge, gigantic, enormous part of the patient's history, and almost put her in a life-threatening situation. If we had left the orphanage for the day and the patient was overlooked, our mistake could have cost her her life.
But a lesson learned is a lesson learned. No half-hearted medicine. Thorough, patient histories are just as important as filling prescriptions and "active" medicine. We visit our patient the next morning. She is smiling, and sitting up on her own. Her fever went down. She will be okay.
I feel relief. Relief, and guilt. I vow to never let a patient of mine down like that ever again.
Monday, July 7, 2008
Dead On Arrival
Please click HERE before reading!
It is 19:00 hours. I am driving to the weekly Rescue Drill when the pager sounds. Signal 24; Mutual Aid, Water Rescue. I hit the gas without switching on my blue light; I am only a few blocks away, and it's too early for my light to be effective, anyway.
The engines are already waiting outside the firehouse bay. Firefighters scramble to make the trucks. I wait near the ambulance for a Rescue Crew to assemble.
A group of firefighters, and one older EMT jumps onto the rig. I get on with them and we're off.
We get to the marina. The Chief is already on scene, and setting up a command post for centrallized radio communications. Firefighters and a few select rescue members hop onto the rescue boats. The Dive Team arrives, and gear is loaded onto the boats. After limited delays, the two boats are off.
I stay behind, with the ambulance and the Rescue Crew stationed with the ambulance. I stand next to the Chief and listen to the radios. Chief begins speaking with the local police department, and establishes connection with the U.S. Coast Guard. Together, they establish a search pattern in the water, centralized around a large bridge connecting the mainland to the beach. My first thought is carwreck. Ejection; Fast & Simple.
But, as I look towards the bridge I see that traffic is moving. MY theory is shot to pieces. What the hell happened? I wonder to myself.
Chief gets a message from the Police Department. "We just got a call from the mother..." The radio spits and crackles. The Truth emerges.
Our victim, a 19 year old female, was dropped off at the base of the bridge by friends of hers, and then left there per her request. She walked up to the center of the bridge, called her mother who lives about an hour and a half away, told her mother she was jumping, and then jumped.
I turn to look at the water.
Suicide.
It's windy outside. I become acutely aware of the sensation the cold, salty air leaves as it beats at my exposed skin. I watch the water.
45 minutes pass and no sign of our victim. We wait... An hour passes. Two, We don't know where our victim jumped in relation to the bridge, and the waters' currents are strong, making most of our work guesswork at best.
The U.S. Coast Guard releases the Firematic units after two hours of searching, deeming the operation a "recovery" rather then a "rescue." The U.S.C.G. requests help in a few hours to search for the body.
The rescue boats return to the marina and the firefighters unload their gear. I sit in the back of the ambulance and contemplate what my first Dead On Arrival feels like.
Later on that night I go for a run. I stand at the edge of the water and listen to the dark waves lap against the sides of the wooden dock I am now standing on. I star out into the vast, dark, empty water, and am struck by how tainted everything in my sight seems. I stare down into the dark, cold water, and try to imagine what it must have felt like to be on top of that bridge, staring your own death in the face, and then taking your own life.
The lighthouse blinks in the distance. I sit on the dock and watch the cars pass over the bridge.
I close my eyes.
I pray.
It is 19:00 hours. I am driving to the weekly Rescue Drill when the pager sounds. Signal 24; Mutual Aid, Water Rescue. I hit the gas without switching on my blue light; I am only a few blocks away, and it's too early for my light to be effective, anyway.
The engines are already waiting outside the firehouse bay. Firefighters scramble to make the trucks. I wait near the ambulance for a Rescue Crew to assemble.
A group of firefighters, and one older EMT jumps onto the rig. I get on with them and we're off.
We get to the marina. The Chief is already on scene, and setting up a command post for centrallized radio communications. Firefighters and a few select rescue members hop onto the rescue boats. The Dive Team arrives, and gear is loaded onto the boats. After limited delays, the two boats are off.
I stay behind, with the ambulance and the Rescue Crew stationed with the ambulance. I stand next to the Chief and listen to the radios. Chief begins speaking with the local police department, and establishes connection with the U.S. Coast Guard. Together, they establish a search pattern in the water, centralized around a large bridge connecting the mainland to the beach. My first thought is carwreck. Ejection; Fast & Simple.
But, as I look towards the bridge I see that traffic is moving. MY theory is shot to pieces. What the hell happened? I wonder to myself.
Chief gets a message from the Police Department. "We just got a call from the mother..." The radio spits and crackles. The Truth emerges.
Our victim, a 19 year old female, was dropped off at the base of the bridge by friends of hers, and then left there per her request. She walked up to the center of the bridge, called her mother who lives about an hour and a half away, told her mother she was jumping, and then jumped.
I turn to look at the water.
Suicide.
It's windy outside. I become acutely aware of the sensation the cold, salty air leaves as it beats at my exposed skin. I watch the water.
45 minutes pass and no sign of our victim. We wait... An hour passes. Two, We don't know where our victim jumped in relation to the bridge, and the waters' currents are strong, making most of our work guesswork at best.
The U.S. Coast Guard releases the Firematic units after two hours of searching, deeming the operation a "recovery" rather then a "rescue." The U.S.C.G. requests help in a few hours to search for the body.
The rescue boats return to the marina and the firefighters unload their gear. I sit in the back of the ambulance and contemplate what my first Dead On Arrival feels like.
Later on that night I go for a run. I stand at the edge of the water and listen to the dark waves lap against the sides of the wooden dock I am now standing on. I star out into the vast, dark, empty water, and am struck by how tainted everything in my sight seems. I stare down into the dark, cold water, and try to imagine what it must have felt like to be on top of that bridge, staring your own death in the face, and then taking your own life.
The lighthouse blinks in the distance. I sit on the dock and watch the cars pass over the bridge.
I close my eyes.
I pray.
Friday, March 28, 2008
Biblical Proportions
Please click HERE before reading!
It is the second day of work in Kaberamaido, Uganda. I am working with Dr. Bill and the other EMTs. We are stationed just outside the orphanage compound, and are serving the local village women.
I am kneeling next to an older patient, along with my translator, and asking her the standard questions. Name, Age, Chief Complaint, etc. I am also gathering a brief medical history having to do with TB, Malaria, and HIV/AIDs.
The patient in question appears to be a healthy one. It has been a refreshing surprise to Triage this woman, as there doesn't seem to be anything acutely wrong with her. She doesn't have any clinical signs of TB or pneumonia, and she isn't having a malaria attack. The only thing she is complaining of is vision loss, and given her age, it might just be due to getting older as opposed to some other medical cause.
I begin interviewing her on her vision loss. How long as it been going on, is it getting worse over time, is it all the time or just sometimes? She answers accordingly. I am writing down her answers when she begins speaking to the translator. The translator turns to me and says "She wants to know what she can do to improve her vision so that she can read the Bible again."
The pen in my hand freezes, and I am crushed with humility. I turn to her, speechless. Here is this woman, a woman who has walked for miles to see us, and the only thing she requests is the ability to read the Bible again. "I will do everything I can." I say.
Dr. Bill comes over and examines her. He wears reading glasses, and lets her try them on. Our translator pulls out a Bible from his back-pocket, apparently something he carries with him wherever he goes. Our patient breaks into a smile and begins reading quietly to herself. Dr. Bill asks if she can see, and she says yes. He vows to give her his glasses at the end of the day, when he's done working.
I make a note on her record so that we remember to find her at the end of the day.
I go home that night and read the Bible, and understand every single word.
It is the second day of work in Kaberamaido, Uganda. I am working with Dr. Bill and the other EMTs. We are stationed just outside the orphanage compound, and are serving the local village women.
I am kneeling next to an older patient, along with my translator, and asking her the standard questions. Name, Age, Chief Complaint, etc. I am also gathering a brief medical history having to do with TB, Malaria, and HIV/AIDs.
The patient in question appears to be a healthy one. It has been a refreshing surprise to Triage this woman, as there doesn't seem to be anything acutely wrong with her. She doesn't have any clinical signs of TB or pneumonia, and she isn't having a malaria attack. The only thing she is complaining of is vision loss, and given her age, it might just be due to getting older as opposed to some other medical cause.
I begin interviewing her on her vision loss. How long as it been going on, is it getting worse over time, is it all the time or just sometimes? She answers accordingly. I am writing down her answers when she begins speaking to the translator. The translator turns to me and says "She wants to know what she can do to improve her vision so that she can read the Bible again."
The pen in my hand freezes, and I am crushed with humility. I turn to her, speechless. Here is this woman, a woman who has walked for miles to see us, and the only thing she requests is the ability to read the Bible again. "I will do everything I can." I say.
Dr. Bill comes over and examines her. He wears reading glasses, and lets her try them on. Our translator pulls out a Bible from his back-pocket, apparently something he carries with him wherever he goes. Our patient breaks into a smile and begins reading quietly to herself. Dr. Bill asks if she can see, and she says yes. He vows to give her his glasses at the end of the day, when he's done working.
I make a note on her record so that we remember to find her at the end of the day.
I go home that night and read the Bible, and understand every single word.
Thursday, March 27, 2008
First Patient
Please click HERE before reading!
It is the first morning in Kaberamaido. I have barely woken up when Jacquie walks into our room with a stethoscope around her neck. The EMS nerd in my wakes up, and I remember why we are here. I grab my stethoscope and pull on some scrubs, and I am ready.
I walk outside and greet the women who have congregated. There are the leaders of our trip and some new faces, women that live in the village and have just stopped by to say hello. The rest of the team begins to wake up and come outside, and everyone seems to be chatting about the rest of the day except for an older woman. It is beginning to get hot out, and I wonder why this woman is here, as it soon becomes clear that she is not part of our team.
Dr. Bill wakes up and comes outside. I walk inside to see what's for breakfast, and remember that I left my backpack on the porch. I go to retrieve it, and see Dr. Bill examining the mystery woman. Apparently, our first patient had arrived.
Dr. Bill and Jacquie brought her inside to examine her on the couch. The rest of us waited outside. Jacquie emerged and announced that this woman most likely had TB, and that her left lung was filled with fluid. She said that this would be a good teaching case, and all the EMTs should come inside and listen to her lungs.
And so, we did.
I walk up to the patient, who is now laying on our couch, chest exposed, surrounded by 6 or so collegiate EMTs. It strikes me as how awkward teaching hospitals must be for the patients, and I realize what a great sacrifice patients at teaching hospitals make in order to train the Doctors of tomorrow. Jacquie hands me her stethoscope and I take four-point lung sounds. The difference is clear, and amazing, if only from a clinical standpoint. It is unlike anything I've ever heard in the States, or anything I could have even thought possible.
I want to spend more time listening. I want to examine every second acoustically, to internalize it, to understand it, but the others are waiting for a turn and I feel badly for the patient, so I hand the scope back to Jacquie and go wash my hands.
It strikes me as odd, how casual this encounter has been. TB is so stigmatized in the States, especially to us healthcare providers. (With good reason, I suppose.) And here we were, first thing in the morning, with a TB patient worse then any one in the States for the last few decades, sitting on our couch. "She has a few months to live, if that." I think, while I turn the faucet and wait for the water to flow.
I wash my hands thoroughly. It's all I can do.
It is the first morning in Kaberamaido. I have barely woken up when Jacquie walks into our room with a stethoscope around her neck. The EMS nerd in my wakes up, and I remember why we are here. I grab my stethoscope and pull on some scrubs, and I am ready.
I walk outside and greet the women who have congregated. There are the leaders of our trip and some new faces, women that live in the village and have just stopped by to say hello. The rest of the team begins to wake up and come outside, and everyone seems to be chatting about the rest of the day except for an older woman. It is beginning to get hot out, and I wonder why this woman is here, as it soon becomes clear that she is not part of our team.
Dr. Bill wakes up and comes outside. I walk inside to see what's for breakfast, and remember that I left my backpack on the porch. I go to retrieve it, and see Dr. Bill examining the mystery woman. Apparently, our first patient had arrived.
Dr. Bill and Jacquie brought her inside to examine her on the couch. The rest of us waited outside. Jacquie emerged and announced that this woman most likely had TB, and that her left lung was filled with fluid. She said that this would be a good teaching case, and all the EMTs should come inside and listen to her lungs.
And so, we did.
I walk up to the patient, who is now laying on our couch, chest exposed, surrounded by 6 or so collegiate EMTs. It strikes me as how awkward teaching hospitals must be for the patients, and I realize what a great sacrifice patients at teaching hospitals make in order to train the Doctors of tomorrow. Jacquie hands me her stethoscope and I take four-point lung sounds. The difference is clear, and amazing, if only from a clinical standpoint. It is unlike anything I've ever heard in the States, or anything I could have even thought possible.
I want to spend more time listening. I want to examine every second acoustically, to internalize it, to understand it, but the others are waiting for a turn and I feel badly for the patient, so I hand the scope back to Jacquie and go wash my hands.
It strikes me as odd, how casual this encounter has been. TB is so stigmatized in the States, especially to us healthcare providers. (With good reason, I suppose.) And here we were, first thing in the morning, with a TB patient worse then any one in the States for the last few decades, sitting on our couch. "She has a few months to live, if that." I think, while I turn the faucet and wait for the water to flow.
I wash my hands thoroughly. It's all I can do.
Tuesday, March 25, 2008
Malaria Attacks
Please click HERE before reading!
It is my first official day in Kaberamaido, Uganda, and the team has headed to the orphanage to meet the children. We arrive and are welcomed by a hundred or so faces, children lined up according to sex and age, all watching us with fascination laced with uncertainty.
We are introduced to the children's caretakers, formally called "matrons," and begin introducing ourselves to the children. We stumble a little, awkwardly speaking English to children we know cannot understand us, hoping for the slightest bit of connection and receiving none.
Regardless, we persevere. We take the children outside to play with the soccer balls some members of the team brought. I sing along and play a game when Jacquie, the medical teams leader comes out and requests an EMT. Stef follows Jacquie. I wait a few minutes to give them space, and then follow.
"Liz!" Jacquie declares as I enter the room. "Glad you're here, you can help Triage." I nod and grab some gloves. My heart pounds as I feel the eyes of the patients staring at me. Adrenaline courses through my veins. I get a piece of paper and a pen, and team up with Stef. Our translator is waiting for us to tell him what to do. The room is separated into three groups, Priority, Respiratory Distress, and Abdominal Pain. We decide to tackle the group closest to us, which happens to be Abdominal Pain.
I kneel down next to a young girl, and get the basics out of the way. Name, Age, Chief Complaint; severe abdominal pain. I get a set of lung sounds. Clear bilat. I ask if she's had a fever recently, she says yes. I ask if she has a fever now, she says yes. I ask if she's been coughing, she says yes. I ask her if she has to spit anything out when she coughs, she says yes. I ask what color is it? She says clear/whiteish. I make a mental note, "no blood." That means no TB. I ask her lie down so I can examine her. I unbutton her shirt and realize there's no need to palpate. I see a mass in the upper left quadrant of her abdomen, a huge swollen mountain erupting from her small body. I place a hand gently on it and test for rigidity, which of course is present. "Lit?" I ask, which means "Hurt?" in Kumahm. She nods yes. I tell her to button her shirt and let her sit up. I don't need to examine her further.
Stef finishes writing up the report and I bring it to Doctor F., the Emergency Physician we are traveling with. He stares in disbelief at the size of this young girls spleen, and sends her to the Priority group to wait for a van to the hospital with a tentative diagnosis of Malaria.
I move on to Triage the others. The questions are all the same. The answers vary, but I stay the same. I am a machine. Every patient is an equation, a question that can be answered through logic and a systematic algorithm of questions dictated by protocols that I have studied. I can feel the art of medicine and the logic pumping through my blood, as natural as the air I breathe. I am in control. In a world where HIV/AIDs runs rampant, where children are dying from treatable diseases like Malaria and Pneumonia, where diseases like Dysentery, diseases we eradicated in the USA decades ago, still exist, I am in control. I am focused and I am in charge. I am one with the universe and all who inhabit it. I am living, breathing, Medicine.
I am living, breathing, Art.
It is my first official day in Kaberamaido, Uganda, and the team has headed to the orphanage to meet the children. We arrive and are welcomed by a hundred or so faces, children lined up according to sex and age, all watching us with fascination laced with uncertainty.
We are introduced to the children's caretakers, formally called "matrons," and begin introducing ourselves to the children. We stumble a little, awkwardly speaking English to children we know cannot understand us, hoping for the slightest bit of connection and receiving none.
Regardless, we persevere. We take the children outside to play with the soccer balls some members of the team brought. I sing along and play a game when Jacquie, the medical teams leader comes out and requests an EMT. Stef follows Jacquie. I wait a few minutes to give them space, and then follow.
"Liz!" Jacquie declares as I enter the room. "Glad you're here, you can help Triage." I nod and grab some gloves. My heart pounds as I feel the eyes of the patients staring at me. Adrenaline courses through my veins. I get a piece of paper and a pen, and team up with Stef. Our translator is waiting for us to tell him what to do. The room is separated into three groups, Priority, Respiratory Distress, and Abdominal Pain. We decide to tackle the group closest to us, which happens to be Abdominal Pain.
I kneel down next to a young girl, and get the basics out of the way. Name, Age, Chief Complaint; severe abdominal pain. I get a set of lung sounds. Clear bilat. I ask if she's had a fever recently, she says yes. I ask if she has a fever now, she says yes. I ask if she's been coughing, she says yes. I ask her if she has to spit anything out when she coughs, she says yes. I ask what color is it? She says clear/whiteish. I make a mental note, "no blood." That means no TB. I ask her lie down so I can examine her. I unbutton her shirt and realize there's no need to palpate. I see a mass in the upper left quadrant of her abdomen, a huge swollen mountain erupting from her small body. I place a hand gently on it and test for rigidity, which of course is present. "Lit?" I ask, which means "Hurt?" in Kumahm. She nods yes. I tell her to button her shirt and let her sit up. I don't need to examine her further.
Stef finishes writing up the report and I bring it to Doctor F., the Emergency Physician we are traveling with. He stares in disbelief at the size of this young girls spleen, and sends her to the Priority group to wait for a van to the hospital with a tentative diagnosis of Malaria.
I move on to Triage the others. The questions are all the same. The answers vary, but I stay the same. I am a machine. Every patient is an equation, a question that can be answered through logic and a systematic algorithm of questions dictated by protocols that I have studied. I can feel the art of medicine and the logic pumping through my blood, as natural as the air I breathe. I am in control. In a world where HIV/AIDs runs rampant, where children are dying from treatable diseases like Malaria and Pneumonia, where diseases like Dysentery, diseases we eradicated in the USA decades ago, still exist, I am in control. I am focused and I am in charge. I am one with the universe and all who inhabit it. I am living, breathing, Medicine.
I am living, breathing, Art.
Monday, January 14, 2008
Frequent Flyer
Please click HERE before reading!
My very first ambulance call, ever, was to what eventually would be tagged as a frequent flyer's house. It is early in the morning and I received my fire pager a day ago. It was over the summer, so I had my windows open and awoke to the sound of sirens. A few seconds later, my fire pager goes off. I leap out of bed and run to my car, tripping over any and every obstacle on my way downstairs.
I don't care.
I break all sorts of laws as I make my way to the firehouse for the first time. I forget to slow down and wind up overshooting. "Shit." I screech to a halt and reverse, and park outside the ambulance bay, crooked and blocking 2 spots.
The ambulance is pulled out and waiting. The driver is sitting inside. Feeling new and stupid, I knock on the passenger window and motion towards the rear. The driver nods and I get inside. He is looking at a map, but takes a moment to introduce himself to me. My heart is pounding so hard I swear it is going to fall out onto the stretcher in front of me. Little did I know it, but I would experience most of my "firsts" with this particular EMT.
We get to the house. The house is dilapidated. It reeks of urine and sweat. Our patient is lying naked on his bed. He is an elderly man, but is not disoriented. He answers all of our questions and his vitals are within normal range. He doesn't want to go to the hospital, he just wanted help getting up. There is no emergency here. Our patient hit the emergency call button he wears around his neck when he fell out of bed and thought he couldn't get up. In fact, the operator is still on the speaker phone when we get there. No wonder it came across as an unknown medical.
We call Med Control and inform them of the situation. We aren't comfortable leaving this man alone, but he's alert and oriented and can technically make his own decision. While the EMT is on the phone with Med Control, we scan the patients home in an attempt to find a phone number of a relative. On one of his walls, posted in yellowed index cards, are emergency contacts. We call his son. His son tells us that he wants us to take his dad to a hospital 45 minutes from our district. We tell him we can't do that. His son says to leave the patient where he is, and he will come get him. We say, okay.
Our patient fell off the bed because he had urinated in the middle of it, and didn't want to be wet. Our patient spends most of his time on that bed. Our patient was alone with no one to take care of him when he needed it. I wanted to change the sheets on his bed, at least, before we left.
But that's not what we do. We leave.
This particular patient calls us often, always different ailments and always the same result. He never wants to go to the hospital. I think he might just be lonely.
My very first ambulance call, ever, was to what eventually would be tagged as a frequent flyer's house. It is early in the morning and I received my fire pager a day ago. It was over the summer, so I had my windows open and awoke to the sound of sirens. A few seconds later, my fire pager goes off. I leap out of bed and run to my car, tripping over any and every obstacle on my way downstairs.
I don't care.
I break all sorts of laws as I make my way to the firehouse for the first time. I forget to slow down and wind up overshooting. "Shit." I screech to a halt and reverse, and park outside the ambulance bay, crooked and blocking 2 spots.
The ambulance is pulled out and waiting. The driver is sitting inside. Feeling new and stupid, I knock on the passenger window and motion towards the rear. The driver nods and I get inside. He is looking at a map, but takes a moment to introduce himself to me. My heart is pounding so hard I swear it is going to fall out onto the stretcher in front of me. Little did I know it, but I would experience most of my "firsts" with this particular EMT.
We get to the house. The house is dilapidated. It reeks of urine and sweat. Our patient is lying naked on his bed. He is an elderly man, but is not disoriented. He answers all of our questions and his vitals are within normal range. He doesn't want to go to the hospital, he just wanted help getting up. There is no emergency here. Our patient hit the emergency call button he wears around his neck when he fell out of bed and thought he couldn't get up. In fact, the operator is still on the speaker phone when we get there. No wonder it came across as an unknown medical.
We call Med Control and inform them of the situation. We aren't comfortable leaving this man alone, but he's alert and oriented and can technically make his own decision. While the EMT is on the phone with Med Control, we scan the patients home in an attempt to find a phone number of a relative. On one of his walls, posted in yellowed index cards, are emergency contacts. We call his son. His son tells us that he wants us to take his dad to a hospital 45 minutes from our district. We tell him we can't do that. His son says to leave the patient where he is, and he will come get him. We say, okay.
Our patient fell off the bed because he had urinated in the middle of it, and didn't want to be wet. Our patient spends most of his time on that bed. Our patient was alone with no one to take care of him when he needed it. I wanted to change the sheets on his bed, at least, before we left.
But that's not what we do. We leave.
This particular patient calls us often, always different ailments and always the same result. He never wants to go to the hospital. I think he might just be lonely.
Saturday, January 12, 2008
3 girls, 250 pounds
Please click HERE before reading!
Myself and two other EMTs were hanging out at the firehouse when our pagers go off. A mutual aid to a neighboring town for a diabetic emergency. We hop in the ambulance and go.
The EMT in charge tells me to grab the trauma bag and that we're going to try and run this call as fast as possible. We all agree this would be the best strategy.
Our driver is a firefighter. He's a retired officer and at least 30 years older then all of us. We get to the scene and there are two police officers standing outside on the front lawn. The EMT in charge grabs the PCR book. We enter the house and are greeted by the tell-tale odor of neglect. Our patient is lying in her bed, and easily weighs over 200 pounds. She is groaning and complaining of dizziness and nausea. She is approximately 60 years of age. She has a history of hypertension. She is disoriented and doesn't know where she is. She is a diabetic and has been drinking. We need to move, fast.
One of the EMTs goes out to grab the stair chair. I stay with the EMT in charge and discuss the best way of removing the patient. I am resentful of the police officers and I am resentful of our driver. They are all outside. They all know what the house looks like and smells like. They all know what our patient looks like. They all should be in here, helping.
The room is small, the stair-chair barely fits. There is a dresser and the rest is bed. I climb up onto the bed next to our patient. "Ruth," I say "if I help you will you be able to sit up?" She is disoriented and groans, but we manage to sit her up. I put one of her arms around my neck and lift her up. Somehow we manage to get her out of the house and onto the stretcher.
Ruth is disoriented. She doesn't like the bright lights in the back of the rig. We dim them as much as we can. The EMT in charge radios into the hospital. They want to send us to triage. I remind the EMT to let them know that our patient has a history of diabetes and has been drinking. They take us in the main room instead.
Myself and two other EMTs were hanging out at the firehouse when our pagers go off. A mutual aid to a neighboring town for a diabetic emergency. We hop in the ambulance and go.
The EMT in charge tells me to grab the trauma bag and that we're going to try and run this call as fast as possible. We all agree this would be the best strategy.
Our driver is a firefighter. He's a retired officer and at least 30 years older then all of us. We get to the scene and there are two police officers standing outside on the front lawn. The EMT in charge grabs the PCR book. We enter the house and are greeted by the tell-tale odor of neglect. Our patient is lying in her bed, and easily weighs over 200 pounds. She is groaning and complaining of dizziness and nausea. She is approximately 60 years of age. She has a history of hypertension. She is disoriented and doesn't know where she is. She is a diabetic and has been drinking. We need to move, fast.
One of the EMTs goes out to grab the stair chair. I stay with the EMT in charge and discuss the best way of removing the patient. I am resentful of the police officers and I am resentful of our driver. They are all outside. They all know what the house looks like and smells like. They all know what our patient looks like. They all should be in here, helping.
The room is small, the stair-chair barely fits. There is a dresser and the rest is bed. I climb up onto the bed next to our patient. "Ruth," I say "if I help you will you be able to sit up?" She is disoriented and groans, but we manage to sit her up. I put one of her arms around my neck and lift her up. Somehow we manage to get her out of the house and onto the stretcher.
Ruth is disoriented. She doesn't like the bright lights in the back of the rig. We dim them as much as we can. The EMT in charge radios into the hospital. They want to send us to triage. I remind the EMT to let them know that our patient has a history of diabetes and has been drinking. They take us in the main room instead.
Friday, January 11, 2008
Triage
Please click HERE before reading!
It's a rescue drill night and I am at the firehouse. I had gotten out of EMT class early, and decided to go hang out at the firehouse until rescue drills started. I sit down in front of the TV and just as I go to turn it on the call comes in. Abdominal pain.
I walk over to the ambulance bay and I hear my Captain swear under his breath. Apparently it was a busy day for our district. We drive faster then normal because the call location was farther then normal. With the lights and sirens on, I watch as cars on the highway dive out of our way.
The beach has been closed for hours. Our patient is found kneeling over a toilet in the first-aid room. She has been drinking. She is experiencing extreme abdominal pain. It's a routine call but she's in an incredible amount of pain, and we can't do anything about it. The EMT in charge asks her to rate her pain on a scale of 1-10, 10 being the worst pain she's ever felt. Our patient rates it as a 12. We ask her to describe the pain. Our patient says that she's never given birth, but that she imagines giving birth would be easier then this. We load her onto the stretcher and give her oxygen. We try to offer her reassurance. It's all we can do as basics.
The ride to the hospital is excruciating. Every bump causes severe pain. We tell the driver to take it easy. We go slower.
The EMT in charge radios into the hospital. The hospital, apparently, has had a busy day too. I hear the nurse on the other end tell the EMT in charge to go to triage. I feel immediate compassion for our patient. I look at her and wonder what she was doing at the beach so late, why she was there alone, and if there was anyone I could call for her?
We get to the ER and transfer our patient to a wheelchair. I get her a bucket in case she needs to be sick again. The EMT in charge delivers her oral report to the triage nurse. I always feel badly when I leave my patients alone in the hospital, but even more so when I leave them in triage knowing that they will probably have to wait hours before a nurse even takes their vitals again.
I place a hand on her shoulder and tell her to feel better. It's all I can do.
It's a rescue drill night and I am at the firehouse. I had gotten out of EMT class early, and decided to go hang out at the firehouse until rescue drills started. I sit down in front of the TV and just as I go to turn it on the call comes in. Abdominal pain.
I walk over to the ambulance bay and I hear my Captain swear under his breath. Apparently it was a busy day for our district. We drive faster then normal because the call location was farther then normal. With the lights and sirens on, I watch as cars on the highway dive out of our way.
The beach has been closed for hours. Our patient is found kneeling over a toilet in the first-aid room. She has been drinking. She is experiencing extreme abdominal pain. It's a routine call but she's in an incredible amount of pain, and we can't do anything about it. The EMT in charge asks her to rate her pain on a scale of 1-10, 10 being the worst pain she's ever felt. Our patient rates it as a 12. We ask her to describe the pain. Our patient says that she's never given birth, but that she imagines giving birth would be easier then this. We load her onto the stretcher and give her oxygen. We try to offer her reassurance. It's all we can do as basics.
The ride to the hospital is excruciating. Every bump causes severe pain. We tell the driver to take it easy. We go slower.
The EMT in charge radios into the hospital. The hospital, apparently, has had a busy day too. I hear the nurse on the other end tell the EMT in charge to go to triage. I feel immediate compassion for our patient. I look at her and wonder what she was doing at the beach so late, why she was there alone, and if there was anyone I could call for her?
We get to the ER and transfer our patient to a wheelchair. I get her a bucket in case she needs to be sick again. The EMT in charge delivers her oral report to the triage nurse. I always feel badly when I leave my patients alone in the hospital, but even more so when I leave them in triage knowing that they will probably have to wait hours before a nurse even takes their vitals again.
I place a hand on her shoulder and tell her to feel better. It's all I can do.
Saturday, January 5, 2008
Rookie's First Code
Please click HERE before reading!
I am leaving the firehouse after we got canceled en route to a motor-vehicle accident. It is 05:00 hours, and I am driving home lazily. It is late. I am tired. I have been a member of the Fire Department for only a few weeks, and I know I have a lot to learn. Even so, I am thinking about how much I enjoy being part of the Rescue Squad, and how I don't mind waking up to get to calls when my pager crackles to life. "Echo Cardiac Arrest."
Fuck.
I screech to a stop and make a u-turn as fast as I can. My car protests as I hit the gas and accelerate without warning, but I make it to the firehouse in time. The EMT and the Driver from the last call also return to the firehouse in a frenzied, frantic blur. The EMT looks worried. "Is anyone else on their way?" he asks the Driver up front. "I don't think so." The Driver replies. The First Responder cars dart past. The Chiefs are already en route. "I guess that's it." The EMT says, with a mixture of apprehension and disappointment. "Let's go."
The sirens scream as we make our way to the scene. I grab gloves. The EMT tells me that we will need a backboard, and that I should bring it in with me. I grab the PCR book and a backboard from the ambulance and run into the house. The patient is in full arrest when we get there. She has no pulse and she is not breathing. She is an elderly woman who has a history of cardiac-related problems. She originally called the ambulance because she was having trouble breathing, but things took a turn for the worse.
I prop the backboard up on a nearby wall. The EMT in charge tells me to take our patient's son out of the room and get information from him. This is my first time interviewing a patient's family member, and I am nervous. I try to be professional, though. "Excuse me, Sir, what is the patient's name?" "Mary." He says, distracted. I scribble the name in the appropriate box. "Ok, and how old is she?" "uh..." He looks into the adjacent room, where his mother lies on the floor. "76." He turns away and begins to cry. I feel relentless and cold. "You don't happen to know her social security number, do you?" He looks at me, confused. "No" he replies, distantly. He doesn't want to talk to me. He doesn't want to talk to anyone, really. And I want to offer compassion, but I am new and scared and unsure of how these things are supposed to play out, so I continue asking questions. "What is the telephone number here?" "123-4567." He says, now completely hollow.
When I finish obtaining the necessary information I place a hand on his shoulder and smile, weakly. It's all I can do. It's all I know how to do. He turns around and enters the other room. I remain where I am, shaking from anxiety and adrenaline. I replace the pen into the clipboard and wait. The crew brings the stretcher outside the front door. I hear the EMT in the other room say "Come on, let's go." They had shocked her with the AED and had successfully recovered a pulse. None of us were ALS, so we don't start an IV or intubate. 5 different men work to place our patient onto the backboard and then onto the stretcher. I wait outside with the stretcher.
The patient is placed onto the stretcher. I quickly realize that no one is going to tell me what to do. I see that the EMT bagging the patient is struggling, so I reach up to make a better seal for him. I struggle to hold the mask on the patients face because of the height of the stretcher, but I manage to keep it still. I get into the ambulance and help load the stretcher on. I hear police sirens and the EMT in charge saying that we are getting a police escort to the hospital. I am positioned directly over the patients head, now. I am kneeling and I am looking directly into her eyes. They are glazed over and glassy. Her mouth is open and she is agonally breathing. I wonder what it's like to be her. I wonder about her family and her son. I wonder about who she was, what her legacy was, what she was passionate about. I hold the seal on the mask. I grip the mask so tightly my hands begin to hurt and I wonder if I am hurting her, too. I realize how ridiculous that question sounds. I still feel like I am hurting her. I still feel like her fragile skin will rip because of the extreme force I am exerting on her jawline to hold the mask in place. I feel as if someone is doing the same thing to my jaw.
She watches me.
We get to the hospital. We lost the pulse on the way to the hospital. We get the stretcher out of the ambulance. The EMT who is bagging the patient also happens to be a retired officer, and he orders the EMT who unloaded the stretcher to lower it to my height so I can maintain a proper seal. I am eternally grateful to him.
We get into the ER and are directed into a trauma room, where a code team is already assembled and waiting. We transfer the patient to the hospital gurney. I hold the seal until an Intern takes over. It is now 06:oo hours.
The code team is pitiful. They are new and young and inexperienced. They take turns reading the EKG and doing CPR rotations. They shock the patient. They push drugs. They are trying, I suppose.
We wait for the head EMT to fill out the PCR and then we leave. Our work is done. Our patient would eventually be revived, and live for quite a long time, with permanent brain damage. Sometimes I can't help but wonder if we had ALS on scene, or if she had a more experienced code team, what the chances of her recovering entirely would be.
It was a Monday. Cardiac arrests happen on Monday.
I am leaving the firehouse after we got canceled en route to a motor-vehicle accident. It is 05:00 hours, and I am driving home lazily. It is late. I am tired. I have been a member of the Fire Department for only a few weeks, and I know I have a lot to learn. Even so, I am thinking about how much I enjoy being part of the Rescue Squad, and how I don't mind waking up to get to calls when my pager crackles to life. "Echo Cardiac Arrest."
Fuck.
I screech to a stop and make a u-turn as fast as I can. My car protests as I hit the gas and accelerate without warning, but I make it to the firehouse in time. The EMT and the Driver from the last call also return to the firehouse in a frenzied, frantic blur. The EMT looks worried. "Is anyone else on their way?" he asks the Driver up front. "I don't think so." The Driver replies. The First Responder cars dart past. The Chiefs are already en route. "I guess that's it." The EMT says, with a mixture of apprehension and disappointment. "Let's go."
The sirens scream as we make our way to the scene. I grab gloves. The EMT tells me that we will need a backboard, and that I should bring it in with me. I grab the PCR book and a backboard from the ambulance and run into the house. The patient is in full arrest when we get there. She has no pulse and she is not breathing. She is an elderly woman who has a history of cardiac-related problems. She originally called the ambulance because she was having trouble breathing, but things took a turn for the worse.
I prop the backboard up on a nearby wall. The EMT in charge tells me to take our patient's son out of the room and get information from him. This is my first time interviewing a patient's family member, and I am nervous. I try to be professional, though. "Excuse me, Sir, what is the patient's name?" "Mary." He says, distracted. I scribble the name in the appropriate box. "Ok, and how old is she?" "uh..." He looks into the adjacent room, where his mother lies on the floor. "76." He turns away and begins to cry. I feel relentless and cold. "You don't happen to know her social security number, do you?" He looks at me, confused. "No" he replies, distantly. He doesn't want to talk to me. He doesn't want to talk to anyone, really. And I want to offer compassion, but I am new and scared and unsure of how these things are supposed to play out, so I continue asking questions. "What is the telephone number here?" "123-4567." He says, now completely hollow.
When I finish obtaining the necessary information I place a hand on his shoulder and smile, weakly. It's all I can do. It's all I know how to do. He turns around and enters the other room. I remain where I am, shaking from anxiety and adrenaline. I replace the pen into the clipboard and wait. The crew brings the stretcher outside the front door. I hear the EMT in the other room say "Come on, let's go." They had shocked her with the AED and had successfully recovered a pulse. None of us were ALS, so we don't start an IV or intubate. 5 different men work to place our patient onto the backboard and then onto the stretcher. I wait outside with the stretcher.
The patient is placed onto the stretcher. I quickly realize that no one is going to tell me what to do. I see that the EMT bagging the patient is struggling, so I reach up to make a better seal for him. I struggle to hold the mask on the patients face because of the height of the stretcher, but I manage to keep it still. I get into the ambulance and help load the stretcher on. I hear police sirens and the EMT in charge saying that we are getting a police escort to the hospital. I am positioned directly over the patients head, now. I am kneeling and I am looking directly into her eyes. They are glazed over and glassy. Her mouth is open and she is agonally breathing. I wonder what it's like to be her. I wonder about her family and her son. I wonder about who she was, what her legacy was, what she was passionate about. I hold the seal on the mask. I grip the mask so tightly my hands begin to hurt and I wonder if I am hurting her, too. I realize how ridiculous that question sounds. I still feel like I am hurting her. I still feel like her fragile skin will rip because of the extreme force I am exerting on her jawline to hold the mask in place. I feel as if someone is doing the same thing to my jaw.
She watches me.
We get to the hospital. We lost the pulse on the way to the hospital. We get the stretcher out of the ambulance. The EMT who is bagging the patient also happens to be a retired officer, and he orders the EMT who unloaded the stretcher to lower it to my height so I can maintain a proper seal. I am eternally grateful to him.
We get into the ER and are directed into a trauma room, where a code team is already assembled and waiting. We transfer the patient to the hospital gurney. I hold the seal until an Intern takes over. It is now 06:oo hours.
The code team is pitiful. They are new and young and inexperienced. They take turns reading the EKG and doing CPR rotations. They shock the patient. They push drugs. They are trying, I suppose.
We wait for the head EMT to fill out the PCR and then we leave. Our work is done. Our patient would eventually be revived, and live for quite a long time, with permanent brain damage. Sometimes I can't help but wonder if we had ALS on scene, or if she had a more experienced code team, what the chances of her recovering entirely would be.
It was a Monday. Cardiac arrests happen on Monday.
Tuesday, January 1, 2008
Half-Hearted Medicine
Please click HERE before reading!
The call came in as a mutual aid to a neighboring community. It was an overdose of unknown origin.
We pull up to the scene and see a police cruiser. An EMT from the local town is already on-scene, treating the patient. I run and grab a backboard from the rig. Our patient is unconscious and in respiratory distress. He is only breathing 6 times/minute, far below the normal range for an average adult male. He is naked and in his bathroom. His pregnant girlfriend and young relative both look on worriedly.
We drag our patients body out of the bathroom and, in a small attempt at modesty, cover him up with a sheet off the stretcher. The EMTs get vitals and evaluate his body for any traumatic injuries. I am quietly worried about brain damage and the like. Our patient is showing classic signs of opiate use and abuse. Decreased level of consciousness, depressed respiration and pinpoint pupils were all present. He has clearly overdosed and is in need of immediate medical attention.
As we load him onto the stretcher, our patient's young relative looks up at me and smiles. I try to be reassuring, but am distracted by the job I am doing. I want to say something to him, but suddenly find myself outside and loading the stretcher into the ambulance.
I am worried. I weigh the pros and cons quickly of overstepping the lines seniority has drawn and decide to say fuck it, this is a matter of life or death. Or, at the very least, permanent brain damage. I ask the EMT from my department as subtly as possible if I should set up oxygen. He says that it's a good idea. He instructs me to place a non-rebreather mask on the patient, a mask that is only effective if the patient is breathing within a normal range, which our patient isn't. In fact, he is literally half of what it should be. I know this. I assume the EMTs in the ambulance with me know this too, or know something else I haven't learned in my EMT class yet. Even still, I ask as politely as I can, "are you sure?" He says "yes" and goes back to filling out the PCR. I set up the oxygen and watch our patient with the fierceness of a mother bear. I wait for him to crash.
We get to the hospital. I am so furious that I walk outside after delivering our patient to the ER and don't see the nurses revive our patient with Narcan, the miracle drug. I don't see our patient regain full consciousness. I don't see our patient become belligerent and combative. I don't see our patient rip the IV line out from his forearm and demand to know where he is. I don't see our patient try to leave without the slightest acknowledgment to the rescue workers or ER nurses.
I feel angry. Angry at the incompetent EMTs, angry at the junkie patient I spent the last 15 minutes worrying about advocating for. I ask the EMT in charge as respectfully as I can manage why we didn't bag the guy. The EMT says that the patient was "in a deep sleep." I don't know what to say to someone that confuses "deep sleep" with "opiate induced coma" so I shut my mouth and get to work replacing the oxygen tank. The EMT makes a remark about "fucking junkies," and I suddenly understand.
If this patient where an elderly patient who was in respiratory distress, the situation would have been approached differently. But because this was a drug overdose, key medical elements were overlooked because of providers' assumptions.
Half-hearted medicine can and will kill people. It's what I learned tonight.
The call came in as a mutual aid to a neighboring community. It was an overdose of unknown origin.
We pull up to the scene and see a police cruiser. An EMT from the local town is already on-scene, treating the patient. I run and grab a backboard from the rig. Our patient is unconscious and in respiratory distress. He is only breathing 6 times/minute, far below the normal range for an average adult male. He is naked and in his bathroom. His pregnant girlfriend and young relative both look on worriedly.
We drag our patients body out of the bathroom and, in a small attempt at modesty, cover him up with a sheet off the stretcher. The EMTs get vitals and evaluate his body for any traumatic injuries. I am quietly worried about brain damage and the like. Our patient is showing classic signs of opiate use and abuse. Decreased level of consciousness, depressed respiration and pinpoint pupils were all present. He has clearly overdosed and is in need of immediate medical attention.
As we load him onto the stretcher, our patient's young relative looks up at me and smiles. I try to be reassuring, but am distracted by the job I am doing. I want to say something to him, but suddenly find myself outside and loading the stretcher into the ambulance.
I am worried. I weigh the pros and cons quickly of overstepping the lines seniority has drawn and decide to say fuck it, this is a matter of life or death. Or, at the very least, permanent brain damage. I ask the EMT from my department as subtly as possible if I should set up oxygen. He says that it's a good idea. He instructs me to place a non-rebreather mask on the patient, a mask that is only effective if the patient is breathing within a normal range, which our patient isn't. In fact, he is literally half of what it should be. I know this. I assume the EMTs in the ambulance with me know this too, or know something else I haven't learned in my EMT class yet. Even still, I ask as politely as I can, "are you sure?" He says "yes" and goes back to filling out the PCR. I set up the oxygen and watch our patient with the fierceness of a mother bear. I wait for him to crash.
We get to the hospital. I am so furious that I walk outside after delivering our patient to the ER and don't see the nurses revive our patient with Narcan, the miracle drug. I don't see our patient regain full consciousness. I don't see our patient become belligerent and combative. I don't see our patient rip the IV line out from his forearm and demand to know where he is. I don't see our patient try to leave without the slightest acknowledgment to the rescue workers or ER nurses.
I feel angry. Angry at the incompetent EMTs, angry at the junkie patient I spent the last 15 minutes worrying about advocating for. I ask the EMT in charge as respectfully as I can manage why we didn't bag the guy. The EMT says that the patient was "in a deep sleep." I don't know what to say to someone that confuses "deep sleep" with "opiate induced coma" so I shut my mouth and get to work replacing the oxygen tank. The EMT makes a remark about "fucking junkies," and I suddenly understand.
If this patient where an elderly patient who was in respiratory distress, the situation would have been approached differently. But because this was a drug overdose, key medical elements were overlooked because of providers' assumptions.
Half-hearted medicine can and will kill people. It's what I learned tonight.
He hit me... Please don't tell!
Please click HERE before reading!
It is 02:45 hours and the pager sounds. "23 year old female, injuries from a fall." I jump out of bed and into my car. I wonder what a 23 year old would be doing at this hour that could possibly cause injuries from a fall as I am driving to the firehouse.
My Captain tells me to get collars and a backboard. He grabs the trauma bag, and we enter the scene. There is a woman lying on the ground, next to a bed. She is extremely thin, abnormally so, and clutching her middle. Her boyfriend is there and looks worried. We transfer her to the backboard. Her boyfriend tells her it will be okay, that he will be at the hospital soon, and tries to kiss her on the forehead. She turns her head away from him before he gets the chance.
We load her into the ambulance. My Captain asks her what happened, and the story comes out. She is on parole, she tells us, and her boyfriend threw her around. She says she's been drinking tonight even though she's not supposed to, and begs us not to tell the police. My Captain tells her that it's not our place to turn her in, we're just concerned about her health. She looks relieved. My Captain instructs me to examine her to make sure there are no obvious fractures while he gets her vitals. I check her pelvic bones to see if they are broken, which they aren't. She talks and talks. She asks my Captain what to do? He tells her to just tell the nurse's that she fell. She says okay. She looks like she is formulating an alibi as we speak. She smiles and is trying to cover her desperation. She is sad, though. I can tell. She jokes and laughs, but she is in pain. She is lost and confused and scared and completely, totally alone.
I am frustrated with our patient and with my Captain. What makes women stay with these men, what makes them defend these men, is beyond my comprehension. And I want to shake our patient, I want to look her in the eyes and have her get it. I want her to understand what life is supposed to be like. But of course, further injuring the patient is against all kinds of laws, so I sit still and simmer in frustration, anger, confusion, and of course, love.
My Captain asks if I want to give the radio report. I am scared, as this would be my first time. He says go for it. I say I'm not so sure. Our patient laughs and says "aww, go ahead honey." I give up, and grab the radio. "See? That wasn't so bad!" My Captain says. I grin despite of myself.
We get to the hospital and are told to report to triage. I want to tell her I understand. I want to direct her to help. I want to let her know that this isn't how love is supposed to be, but I am a rookie and do not want to overstep my Captain, so I keep my mouth shut. We transfer our patient to a wheelchair. My Captain hands the PCR to the triage Nurse. I place my hand on our patient's shoulder, look her in the eyes, and tell her to take care of herself. She places her hand on top of mine and thanks me with the deepest, saddest "thank-yous" I've ever heard. I wish I could have stayed with her.
As we leave, I overhear the skeptical triage nurse interrogating our patient about her apparant "fall" out of bed. "Good." I think to myself. "At least someone sees through her, other than me." I leave the ER feeling better. We return and eat breakfast at the firehouse.
It is 02:45 hours and the pager sounds. "23 year old female, injuries from a fall." I jump out of bed and into my car. I wonder what a 23 year old would be doing at this hour that could possibly cause injuries from a fall as I am driving to the firehouse.
My Captain tells me to get collars and a backboard. He grabs the trauma bag, and we enter the scene. There is a woman lying on the ground, next to a bed. She is extremely thin, abnormally so, and clutching her middle. Her boyfriend is there and looks worried. We transfer her to the backboard. Her boyfriend tells her it will be okay, that he will be at the hospital soon, and tries to kiss her on the forehead. She turns her head away from him before he gets the chance.
We load her into the ambulance. My Captain asks her what happened, and the story comes out. She is on parole, she tells us, and her boyfriend threw her around. She says she's been drinking tonight even though she's not supposed to, and begs us not to tell the police. My Captain tells her that it's not our place to turn her in, we're just concerned about her health. She looks relieved. My Captain instructs me to examine her to make sure there are no obvious fractures while he gets her vitals. I check her pelvic bones to see if they are broken, which they aren't. She talks and talks. She asks my Captain what to do? He tells her to just tell the nurse's that she fell. She says okay. She looks like she is formulating an alibi as we speak. She smiles and is trying to cover her desperation. She is sad, though. I can tell. She jokes and laughs, but she is in pain. She is lost and confused and scared and completely, totally alone.
I am frustrated with our patient and with my Captain. What makes women stay with these men, what makes them defend these men, is beyond my comprehension. And I want to shake our patient, I want to look her in the eyes and have her get it. I want her to understand what life is supposed to be like. But of course, further injuring the patient is against all kinds of laws, so I sit still and simmer in frustration, anger, confusion, and of course, love.
My Captain asks if I want to give the radio report. I am scared, as this would be my first time. He says go for it. I say I'm not so sure. Our patient laughs and says "aww, go ahead honey." I give up, and grab the radio. "See? That wasn't so bad!" My Captain says. I grin despite of myself.
We get to the hospital and are told to report to triage. I want to tell her I understand. I want to direct her to help. I want to let her know that this isn't how love is supposed to be, but I am a rookie and do not want to overstep my Captain, so I keep my mouth shut. We transfer our patient to a wheelchair. My Captain hands the PCR to the triage Nurse. I place my hand on our patient's shoulder, look her in the eyes, and tell her to take care of herself. She places her hand on top of mine and thanks me with the deepest, saddest "thank-yous" I've ever heard. I wish I could have stayed with her.
As we leave, I overhear the skeptical triage nurse interrogating our patient about her apparant "fall" out of bed. "Good." I think to myself. "At least someone sees through her, other than me." I leave the ER feeling better. We return and eat breakfast at the firehouse.
No One's Named Trinidad
Please click HERE before reading!
19:00 hours. I am sitting in the ready-room of a local fire department when tones go off. The radio crackles overhead and an irritated police officer comes on the air - "We have a drunk being belligerent and disruptive... Just roll a bus, get him out of here."
The paid firefighters roll their eyes and, grumbling, saunter towards the ambulance waiting in the bay. I follow. As an observer, I am not responsible for patient care - indeed, I am not acting in the capacity of a medical provider at all. I am here to build relations with the local Fire Department, in hopes of eventually working together between my organization and theirs.
Regardless - We arrive on scene and I hop out of the rig. There is a small, scared, hispanic man sitting on the corner of two streets. There are two noticeably larger men, police, standing above him casually. The two firefighter/EMTs that I am with also get out of the ambulance, admittedly less happy to be here then I am, and start talking with the police.
"He doesn't speak English," one tells the EMT in charge, "We don't know what to do with him..." A beat, followed by a grin. "He's your problem now."
The EMT groans and grab our patients' arm - "Come on, buddy, you're coming with us."
We get onto the ambulance. The EMT directs our patient to sit on the side bench. He looks at me, and tells me to sit on the other side of the ambulance, almost as if protecting me from him. The EMT starts getting vitals.
I take a minute to visually examine our patient. He is sitting with his hands on his head, almost as if he thinks he's under arrest. He looks concerned, and scared. He looks at me, and blinks.
We start heading towards the hospital. The EMT turns to our patient and asks for his name - Our patient stares blankly back. Annoyed, the EMT rolls his eyes and goes back to filling out what he can.
I feel for this man. I have very limited knowledge of spanish, and an even poorer way of executing the language, but I try. "¿Cómo te llamas?"
Our patient turns to me, and suddenly, he is lit up. Like a lightswitch, and to my horrow, he begins speaking very quickly, and insistently, all in spanish, all directed at me.
Helplessly, I try to explain - "No hablo español... No comprende!"
Sadly, our patient turns away. We get to the ER and lead him in. The EMT delivers the little information we can give to the triage nurse, and they begin joking together. One of the orderlies pass by and callously tells us that all we need to do is tell our patient "no hablo." The EMT begins going through our patients wallet - and, annoyed, asks the nurse if there's anyone who speaks spanish. "The only ID I can find in this wallet says his name is Trinidad. No one's named Trinidad."
A hispanic looking nurse is leaving the ER. The EMT pulls her over and asks her to translate - She looks irritated, but not surprised. She returns a few minutes later and tells the EMT our patients name is Trinidad. The EMT rolls his eyes and writes her off as an idiot. He puts "Trinidad" for patients name on the run form.
We leave the hospital. The EMT sits up front with the driver, and they joke about how no one's named Trinidad, how it's a country, not the person's name...
I sit in the back thinking about our patient - How he didn't need to be in the hospital, certainly not the ER... How he will now need to pay for the ambulance ride, the ER stay, and the awful medical service he will receive. Sadly, I watch the road from the back window of the rig, and wait for the next call to be received.
19:00 hours. I am sitting in the ready-room of a local fire department when tones go off. The radio crackles overhead and an irritated police officer comes on the air - "We have a drunk being belligerent and disruptive... Just roll a bus, get him out of here."
The paid firefighters roll their eyes and, grumbling, saunter towards the ambulance waiting in the bay. I follow. As an observer, I am not responsible for patient care - indeed, I am not acting in the capacity of a medical provider at all. I am here to build relations with the local Fire Department, in hopes of eventually working together between my organization and theirs.
Regardless - We arrive on scene and I hop out of the rig. There is a small, scared, hispanic man sitting on the corner of two streets. There are two noticeably larger men, police, standing above him casually. The two firefighter/EMTs that I am with also get out of the ambulance, admittedly less happy to be here then I am, and start talking with the police.
"He doesn't speak English," one tells the EMT in charge, "We don't know what to do with him..." A beat, followed by a grin. "He's your problem now."
The EMT groans and grab our patients' arm - "Come on, buddy, you're coming with us."
We get onto the ambulance. The EMT directs our patient to sit on the side bench. He looks at me, and tells me to sit on the other side of the ambulance, almost as if protecting me from him. The EMT starts getting vitals.
I take a minute to visually examine our patient. He is sitting with his hands on his head, almost as if he thinks he's under arrest. He looks concerned, and scared. He looks at me, and blinks.
We start heading towards the hospital. The EMT turns to our patient and asks for his name - Our patient stares blankly back. Annoyed, the EMT rolls his eyes and goes back to filling out what he can.
I feel for this man. I have very limited knowledge of spanish, and an even poorer way of executing the language, but I try. "¿Cómo te llamas?"
Our patient turns to me, and suddenly, he is lit up. Like a lightswitch, and to my horrow, he begins speaking very quickly, and insistently, all in spanish, all directed at me.
Helplessly, I try to explain - "No hablo español... No comprende!"
Sadly, our patient turns away. We get to the ER and lead him in. The EMT delivers the little information we can give to the triage nurse, and they begin joking together. One of the orderlies pass by and callously tells us that all we need to do is tell our patient "no hablo." The EMT begins going through our patients wallet - and, annoyed, asks the nurse if there's anyone who speaks spanish. "The only ID I can find in this wallet says his name is Trinidad. No one's named Trinidad."
A hispanic looking nurse is leaving the ER. The EMT pulls her over and asks her to translate - She looks irritated, but not surprised. She returns a few minutes later and tells the EMT our patients name is Trinidad. The EMT rolls his eyes and writes her off as an idiot. He puts "Trinidad" for patients name on the run form.
We leave the hospital. The EMT sits up front with the driver, and they joke about how no one's named Trinidad, how it's a country, not the person's name...
I sit in the back thinking about our patient - How he didn't need to be in the hospital, certainly not the ER... How he will now need to pay for the ambulance ride, the ER stay, and the awful medical service he will receive. Sadly, I watch the road from the back window of the rig, and wait for the next call to be received.
DISCLAIMER
Details within the stories posted in this blog may have been altered to protect Patient Confidentiality. All entries are in accordance with HIPPAA regulation. The views in this blog reflect mine and mine alone. This blog is not meant to offer medical advice but rather should be used for entertainment purposes only!
Happy New Year!
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The call came in at 23:50 hours, ten minutes before the New Year. I was baking cookies with my siblings. We had just taken them out of the oven and were waiting for them to cool a little before we ate them.
I was in the middle of washing the trays off when tones dropped. I get halfway down the block before the dispatch information finishes coming over the air. "73-year old Male, Syncope." It was a relatively high-priority call, so I hit the gas and switch on my blue light.
I get to the firehouse in an illegal, record-breaking, 2 and a half minutes. I pull up to the firehouse the same time our driver shows up. I jump onto the ambulance and take off my sweatshirt, so I can be more easily identified as an EMT. A second EMT gets into the back with me, and we're off.
We get to the scene. I grab the oxygen bag and my partner grabs the PCR book. My Captain and a few Chiefs are on-scene already with a patient that is absolutely fine. He is alert and oriented and speaking in full sentences. He is in good health for his age. He does not want to go to the hospital, he says. He doesn't need to, he says. My Captain says he's got to go. His last blood pressure reading was 190/90, dangerously high even for someone who has a history of hypertension. I ask how he's feeling now, if there's any pain, any difficulty breathing. He says there's none. His oxygen sat reading is low, though, so I grab the O2 tank just in case.
I set up the oxygen tank as a precautionary measure and am placing the mask on his face when his family, who have been in the other room until now, come in and yell HAPPY NEW YEARS! Amused and slightly bewildered, myself and the other rescue workers celebrate the new year with these strangers for all of 3 seconds, and then we're back to work.
The crew sets up the stretcher outside and I ask him what he was doing before he fainted. He chuckles and says "I was watching Carrie Underwood! I guess she's better looking then I thought." I let out a giggle and help him stand up. I tell a family member to throw all of the medications our patient takes into a ziploc bag so he can take them to the hospital with him. He grabs a jacket and we position him onto the stretcher.
The ride to the hospital is relatively uneventful. I radio ahead to the ER and we drop our patient off. We leave the hospital and are back in service at 00:23 hours.
2008, it seems, is off to a running start. It should be an interesting year.
The call came in at 23:50 hours, ten minutes before the New Year. I was baking cookies with my siblings. We had just taken them out of the oven and were waiting for them to cool a little before we ate them.
I was in the middle of washing the trays off when tones dropped. I get halfway down the block before the dispatch information finishes coming over the air. "73-year old Male, Syncope." It was a relatively high-priority call, so I hit the gas and switch on my blue light.
I get to the firehouse in an illegal, record-breaking, 2 and a half minutes. I pull up to the firehouse the same time our driver shows up. I jump onto the ambulance and take off my sweatshirt, so I can be more easily identified as an EMT. A second EMT gets into the back with me, and we're off.
We get to the scene. I grab the oxygen bag and my partner grabs the PCR book. My Captain and a few Chiefs are on-scene already with a patient that is absolutely fine. He is alert and oriented and speaking in full sentences. He is in good health for his age. He does not want to go to the hospital, he says. He doesn't need to, he says. My Captain says he's got to go. His last blood pressure reading was 190/90, dangerously high even for someone who has a history of hypertension. I ask how he's feeling now, if there's any pain, any difficulty breathing. He says there's none. His oxygen sat reading is low, though, so I grab the O2 tank just in case.
I set up the oxygen tank as a precautionary measure and am placing the mask on his face when his family, who have been in the other room until now, come in and yell HAPPY NEW YEARS! Amused and slightly bewildered, myself and the other rescue workers celebrate the new year with these strangers for all of 3 seconds, and then we're back to work.
The crew sets up the stretcher outside and I ask him what he was doing before he fainted. He chuckles and says "I was watching Carrie Underwood! I guess she's better looking then I thought." I let out a giggle and help him stand up. I tell a family member to throw all of the medications our patient takes into a ziploc bag so he can take them to the hospital with him. He grabs a jacket and we position him onto the stretcher.
The ride to the hospital is relatively uneventful. I radio ahead to the ER and we drop our patient off. We leave the hospital and are back in service at 00:23 hours.
2008, it seems, is off to a running start. It should be an interesting year.
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