On the Clock

New Post

2008-11-28T19:15:00.001-05:00

Hey guys and gals!

I've got a post up at my new site. I figured I'd update here for a few times with a reminder that I've moved in case anyone missed it!

Take care out there,
Sam

New Site

2008-11-23T23:06:00.003-05:00

It seems to be the thing to do in medblogs nowadays! First, Cheating Death became Medic Three. Then Epi moved her blog to an amazing new site.

Now, you can add me to the list. I'm not getting rid of this site, taking it down, or anything like that. I moved all my links, entries, etc. to a new site, though. I now have the domain http://samtheemt.com.

It's all ready to go. I hope you guys like it; let me know what you think! I'll be updating regularly there now.

Take care out there,
Sam

Mama Who Bore Me

2008-11-21T02:51:00.002-05:00

Her hand is cold as it makes contact with my face. She's looking right at me with these cloudy green eyes, lost in her overdosed haze. I'm supporting most of her weight as she tries to pee before we go. I'm literally her rock right now.

"Sarah," she says longingly as she strokes my face, "Sarah I'm so sorry."

She smells like my mom. Her hair is long enough that it reminds me of playing with my mom's hair as I sat behind her on the couch. A burning wetness stings behind my eyes, and I force it back.

In a moment of lucidity, she snaps.

"Oh GOD just go, just let me die, Sam. Jesus just go, I just want to die, I took all these pills and I just want to die."

I help her up from the toilet, pulling her pants up while juggling her weight with the basket I hold for her as she tries to vomit. I flush the toilet with my foot, and bear hug her all the way out to the stretcher.

"My husband doesn't love me. I asked him for a divorce. He knows I want to die, he told me to just fucking take the pills and get it over with and just do it. He has a death wish for me."
"Mary, we're going to take you to the hospital now."

I don't even have a set of vitals on her. Eric and Jake wheel the stretcher out to the ambulance as Mary clutches my hand like it's her lifeline. Without letting go, I climb into the back with Jake as Eric heads for the driver's seat. She keeps looking at me without seeing me.

She sees her daughter, Sarah.

"Sarah, I just love you so much, you and your brother, you know? I'm so, so sorry. You're so beautiful. You've gotten so much older since I saw you last. And your hair, it's so long."

She stops, her head hitting the stretcher with a thick smacking noise that sickens me.

"Oh god the drugs, Sam, the drugs are kicking in."
"Mary, I need you to stay with me. My partner is going to start and IV on you to give you some fluids and medicine, okay? I'm just putting these stickers on your chest so we can get a picture of your heart and make sure it's okay."
"Okay, okay, I'm trying."
"No one sleeps in the ambulance, isn't that right, Sam," I hear Jake say as he spikes the bag of saline.
"It's the second rule of the ambulance," I say, referencing Frank Pierce's number one rule without letting on.
"I'm here, I'm with you."

I tie the tourniquet around her arm and feel for a vein. It's beautiful, and I know Jake can get it with no problem. I move over so he can stick her, and try to keep her talking.

"Mary? Mary? Mary, stay awake."

She doesn't move. I rub her sternum deeply and she groans, opening her eyes.

"I'm here, I'm awake. Oh, Sarah, you're so pretty."
"No sleeping, Mary, I need you to stay with me right here, right now."

Her head smacks against the stretcher again, and her arm drops.

"Mary," I yell at her as I rub her sternum again, "Mary open your eyes."

She doesn't move. I rub it again, with more force, and she doesn't even flinch.

"FUCK," I yell at Jake as I hurdle over the patient and stretcher in one fell swoop.
"What?"
"She's not breathing."

I pull out the bag-valve mask and rip the plastic off. It floats in the current the heater produces, waving eerily. I hook up the oxygen and drop the stretcher back. I position her, lift her chin, and make a tight seal with the mask.

I watch her oxygen saturation levels rise as I breathe for her, my hands responsible for her life. Jake finishes the IV and pulls out a nasopharyngeal airway to keep her airway patent as I bag her. I see things flying around the back as he applies lubricant to the airway, pulls out suctioning equipment

Every five seconds, I pump a life restoring breath into her body. Jake gets orders for Narcan and pushes it, but there's no result.

She wakes up long enough to pull out the airway as she vomits, and promptly returns to her previous state. I try to hook up the suction and still keep her alive as Jake yells vitals up to Eric to call into the hospital.

My hand is cramping from my grip on her face--on her life. I push the annoyance out of my mind. Bag, I tell myself once every five seconds, but it's not enough. I need the metronomic tattoo I usually get from the bridge we drive. But tonight we go to a different hospital, away from bridges and rivers.

I hum. It's quiet enough that Jake can't hear, but I know that some part of Mary does. It provides me a steady, calm rhythm to which I can bag, and connects Mary to her daughter, at least in my mind.

Mama who bore me
Mama who gave me
No way to handle things
Who made me so bad

Mama, the weeping
Mama, the angels
No sleep in Heaven, or Bethlehem

Some pray that one day
Christ will come a'-callin'
They light a candle
And hope that it glows
And some just lie there
Crying for him to come and find them
But when he comes they don't know how to go

As we arrive at the hospital, I continue the song in my head, too embarrassed to be heard. It's partly out of respect--respect for Mary and Sarah and the sanctity of the bond. I bag her as we change beds, as they expose her indecently on the table.

I allow myself to be pulled out of the room by the current of those around us. Propping myself up against the wall in the EMS room, I close my eyes tightly and shake my head.

"You alright," Eric asks as he comes in.
"Yep," I lie.

Of Cats and STEMIs

2008-11-18T04:40:00.004-05:00

The cat is the first thing I notice when we come in the door. Scrawny and motionless, it peers up at me. It's perched contently on the back of a recliner, and as I move closer it tilts its head slightly.

I swear it's animatronic. It looks like some weird statuette of a cat covered in fur that someone would find at a bazaar. In fact, most of the things in this room look like something I'd find at a flea market or carnival.

I introduce myself with the same tired words.

"Hi, my name is Sam, I'm an EMT with the rescue squad. Can you tell me what's going on tonight?"

The cat opens its mouth as if to respond, but I hear a woman speak instead.

"It's my mom. She's having this weird pressure in her chest. Aren't you, Mom?"

I look over to the recliner with the cat and see a woman sitting comfortably. She doesn't seem in any distress, other than a hand placed carelessly on her breast. She doesn't speak.

"She just got like this about thirty minutes ago, and I figured I ought to call." A baby lies fast asleep on the couch next to the daughter.
"Alright, what's your mom's name?"
"Alice."
"Thanks."
"You know, I was thinking about this because the other weekend I had kidney stones, and they hurt a lot, but mom had kidney stones and didn't really complain, and--"

I let the paramedic hear the rest of the story as I start addressing our patient. She speaks to me a little bit, lets me take her vitals, and tells me that she wants to go to the hospital. That's fine by me.

Out of the corner of my eye, I see Drew looking at the cat suspiciously. He moves his finger towards it, and it extends its head to smell. His eyes grow wide, and I stifle a giggle.

I ask Alice some more about her symptoms once we get into the ambulance. She says it only hurts a little bit, but she just feels uneasy. Her blood pressure is sky high, and she does complain of a headache. She says she just doesn't feel quite right.

I look over at the monitor after I finish setting up the 12-lead for the paramedic. It's suddenly quite clear why she's not feeling right. As the strip prints, I set up an IV. Alice's heart muscle is dying, and she needs to be at the hospital now.

Without alarming her, my partner informs Drew that he needs to get us to the emergency room post haste. The red lights flash in the deep blue night, but the siren remains silent in this rural town.

I'm fixing to insert the drip set into a liter bag of saline, when I find myself planted firmly in the IV box.

"Hey Drew," I call up to the front sweetly.
"Yes ma'am?"
"Could you tone it down just a notch? You found me a new home in this pretty orange box."
"10-4, my bad!"

The IV is beautiful, and I do my best to maintain my balance while I hand over the tubing. I've never run a truly emergent call with this paramedic, so I'm trying to get used to his style while effectively help Alice. It proves difficult at best.

My partner gives her four baby aspirin, a sublingual nitro, and a little bit of morphine IV. This is the first obvious ST Elevated Myocardial Infarction (STEMI) I've run, so I try to keep my excitement to a minimum.

Alice says she's feeling much better as he calls the hospital to speak with the doctor. It's weird the way she acts, though. Her movements are small, and she remains relatively motionless on my stretcher. She only speaks when spoken to, and her voice is soft.

A statuette of a woman, Alice is something you'd find in a bazaar. Alice is her cat.

I shake the weird images from my head as we wheel her into the hospital. It's five in the morning, and my mind is playing tricks on me.

"Do you think I can go to work today," she asks the doctor genuinely.
"That'd be a resounding no," I hear someone reply as I make my way back to the EMS room.

"Sorry about the IV box," Drew says as he pats my shoulder.
"Not a problem," I say as I dust my self off dramatically.
"But dude...what was with that cat!?"

The Screaming Bridge

2008-11-16T02:55:00.003-05:00

I had a really long conversation with a friend tonight. He made me cry over the image of a solitary green mitten in the snowy sunset. It's okay if you don't understand; mittens shouldn't make people cry, I know this. He inspired me to write the images I see, rather than trying to force them into a story. It was basically exactly what I needed to hear.

Because I've stopped writing. I'm sorry; I'm a delinquent blogger. But for some time, I've just felt uninspired, and really pressured by myself to write about every call and every word.

That's not a fair expectation for me to have of myself. I should seriously stop that.

So I promise you this: when I feel inspired to write, I will write. And when nothing is coming to me, I won't try to muddle through flat words to bring you inspired thoughts.

And eventually, I'll tell you about the screaming bridge.

Take care out there,
Sam

Award!

2008-11-14T00:25:00.005-05:00

I know I promised a post on that strip. I'll get on it ASAP, but I've just been super drained lately. This is a rough time of the semester, and with trying to volunteer 18 hours a week and work 20...well, you can understand I'm sure.

In any event, I was nominated for this Bookworm Award that's been running the gamut of my favorite medbloggers for a bit now. Thanks so much to Bernice and ParamedicSuperMonkey, two wonderful bloggers. Go give them a read if you haven't already :)

Rules are as follows. Pass it on to five other bloggers, and tell them to open the nearest book to page 56. Write out the fifth sentence on that page, and also the next two to five sentences. The CLOSEST BOOK, NOT YOUR FAVORITE, OR MOST INTELLECTUAL!

Okay...I have two books right on top of one another. The first is Rescue 471 by Peter Canning.
"We get called for an unresponsive diabetic on Brookfield Street."

Second is The Things They Carried by Tim O'Brien. I had a conversation with a friend today (via GChat's awesome new video interface!) about this book, so I dug it out of my bookshelf to reread it :)
"I remember staring at the old man, then at my hands, then at Canada."

Epi, duh. She's phenomenal, and if you haven't read her blog by now, you're seriously missing out.

EE at Backboards and Bandaids. It's so nice to read the musings of another college EMT.

Medic Three aka Cheating Death. He's got some seriously wonderful stuff. Go check it out!

ManchMedic. One of my new favorite blogs. I can't believe I didn't read his before.

Lastly, Witness. This is mainly just so he'll post SOMETHING, but he's a fabulous writer and I love it when he actually does update.

Tonight in the ER, I had a woman who was seriously afraid of needles. She was there with her boyfriend for abdominal pain. The conversation went something like this.

Me:"Hi, my name is--"
Her: "OH MY GOD OH MY GOD ARE YOU GOING TO STICK ME WITH NEEDLES OH GOD!"
Me: "Ma'am, I have to start an IV. The doctor is going to want to give you some fluids and medication to help you with that pain."
Her: *incoherent screaming*
Boyfriend: "Baby, which is going to be worse...this little needle stick or the pain in your stomach?"
Her: "THE NEEDLE!"
Boyfriend: "Then why did we come...?"

She feigned fainting. When her boyfriend let go of her hand, it sort of hesitated in mid-air and then collapsed dramatically on the bed. He rolled his eyes at me, I smiled back at him, and finished what I was doing.

The nurse comes in, looks at me, looks at her, and looks at the boyfriend.

"Hey," she says as she shakes her. She continues feigning this unconsciousness. "Hey, listen. Anytime you want to stop pretending like you're unconscious, that'd be great. I don't have the time to sit around and play with you."

Miraculously, she comes around, mentions something about feeling woozy, and how she hates needles.

It was a great day had by all.

p.s.--My best friend has a legitimate phobia of needles, so I understand people who don't do well with needles. I do my best to be accommodating and take them seriously. But when I have three-year-old patients who deal with it better than they do, and they start acting like they're unconscious...I lose all respect.

Take care out there,
Sam

Things and Stuff

2008-11-08T16:08:00.002-05:00

So, I didn't get one of the finalist spots for the blogging scholarship. Oh well! There's always next year, and for now, there are some great blogs nominated. You can see the full list and links to each finalist here. Check them out; maybe you'll find a new, awesome one! Regardless, I'm so excited to see so many young people being active and engaged with their surroundings. I'm sick of the apathy my generation seems to have, and it's nice to see a lot of my peers rejecting that.

Also...our favorite frequent flier that I wrote about here is sort of getting what's coming to her. Apparently they're finishing up the paperwork, and she'll have a warrant for abuse of 911. Let's see if she'll end up moving again.

I've got a post coming on this strip soon:

Oh, Drew.

2008-11-06T06:58:00.004-05:00

I love my partners so, so much. Let me give you a little hint as to why.

During Obama's infomercial
Drew: "Hey Sam, look! Wavy waves of grain! Er...waving waves of...wait, what?"
Me: "Amber waves of grain?"
Drew: "Yeah!"

At dinner
Waitress: "What can I get you?"
Drew: "Hmmm...how many bruschettas come in a bruschetta?"
Waitress: "Uh...what?"
Drew: "Nevermind."

After our call tonight
Eric: "You didn't write your report en route?"
Drew: "Naw, I never do."
Eric: "Why?"
Drew: "With my handwriting? It would be completely ineligible."
Me: "HAHAHAHAHA!"
Drew: "Er...that other one."

A Few Things

2008-11-05T01:37:00.005-05:00

I've been gone from the internet for a little bit. I took a trip home to introduce Ben to the family; they loved him! Dad even called from Antarctica to take place in the boyfriend-meeting activities. In any event, I left my laptop back at the apartment, and I've been working/schooling since then. I'm back, though!

So, for Halloween, I went as Number 13 from "House." I hope you know who that is, because no one else seemed to. Luckily, my roommate went as Dr. Allison Cameron, so we made a pretty dynamic duo. Here's the best picture of it from that night, in my opinion.What were you all for Halloween!?

Next, over the weekend, David McMahon from AuthorBlog was kind enough to choose me as his focus for The Sunday Roast. It was incredibly kind of him to interview me, and the comments I got as a result were quite sweet. Thank you to everyone who read and commented! And also, thank you to everyone who visited for the first time.

So, I applied for a Blogging Scholarship. I didn't even know there was such a thing as a scholarship for college students who blog, but wow! If I'm fortunate enough to be selected as a finalist (which will be announced here on the morning of the 6th), there will be a public vote. I'll keep you up to date, because I'd really appreciate your vote. Lord knows I could use the money for grad school, haha!

Lastly, EpiJunky gave me the Superior Scribbler award. I am incredibly flattered, and if I could give it right back to her, you know I would. So, here are the rules.

* Each Superior Scribbler must in turn pass The Award on to 5 most-deserving Bloggy Friends.
* Each Superior Scribbler must link to the author & the name of the blog from whom he/she has received The Award.
* Each Superior Scribbler must display The Award on his/her blog, and link to This Post, which explains The Award.
* Each Blogger who wins The Superior Scribbler Award must visit this post and add his/her name to the Mr. Linky List. That way, we'll be able to keep up-to-date on everyone who receives This Prestigious Honor!
* Each Superior Scribbler must post these rules on his/her blog.

So, here comes the love.

First, I'd like to recognize Jeff at Building Common Ground. A new found friend, he writes an excellent blog about "building common ground between people on the autism spectrum and those who love, work with and play with them." I'm fortunate to count him as a friend, and really respect what he has to say.

Secondly, to my dear-old-dad at Medical Ice. Yeah, I'm his daughter, so I'm a little bit biased. But he writes a wonderful blog about an experience very few people will get to experience. And I seriously love the pictures he posts!

Michael Morse at Rescuing Providence is one of my new favorite bloggers. He writes some seriously powerful stuff, and I hope to one day be as successful as he. If you haven't checked his blog out, do it immediately.

Just Keep Breathing has quickly become one of my roommate's and my favorite blogs. Compelling stories, wonderful posters, and humorous anecdotes. I just love it when a new entry pops up on my google reader!

Finally, EMS Haiku. The posters he makes are seriously funny, and I look forward to seeing a new one every time I check. It's obvious this man is a talented, intelligent, and humorous blogger. Go give him a read.

So there are something like 25 other blogs I'd like to mention, but I'll stop at five like the rules state. Just know that you're all fantastic.

I have a few stories rolling around in my head right now, and as soon as I get them sorted out, I'll be sure to write them down immediately! Thank you all again for the sweet comments.

Take care out there,
Sam

Edited to add: I voted absentee a few weeks ago. Mom went to vote today, saw my name under hers, and saw that my vote had been counted! Yay for doing my civic duty from afar! I do hope you all got out and voted; it's so vitally important. I am happy to say I was watching when history was made, and that I was able to see both candidates give eloquent speeches. I refuse to make this a partisan thing, so suffice it to say that I'm just always so proud when I see Americans turning out to take part in the democratic process.

Coming Home

2008-10-30T08:47:00.003-04:00

It seems that we can't make a successful trip to the hospital and back to quarters without something happening. We're sort of like a black cloud for the police department, because we always end up sending them to check things out.

One night after a particularly lengthy trip out to Clearview Regional, we finally make it back across the water. As we hit the last bump of the bridge, I feel the medic slow a little bit.

"Did you see that," Drew asks me as he looks in his side mirrors frantically.
"Uh...see what?"
"Some guy was beating the shit out of a girl!"
"While they were driving?"
"No, no...the car was pulled over and he was hitting this girl or something!"
"Really?"
"Yeah. Medic 1 to central; be advised..." As he calls it in, I inspect my mirror closely but see nothing.
"10-4, Medic 1, we'll send an officer out there."

We've had a few other times where we see a car behaving strangely and call it in. Tonight, however, was exceptionally odd.

"We've got a drunk one," Eric and I say in unison.
"Really? It's a Wednesday night..." Drew peeks his head up from the back and observes.
"Definitely not right," I chime in as the car nearly hits the median.
"You calling it in?"
"Yeah, I'll get it," Eric says as he picks up the radio.
"Kay!"
"Medic 1 to central; be advised we're westbound on Main, headed into town behind a vehicle that's having a bit of trouble staying in its own lane. Virginia plates. Dark 4-door sedan. We'll stay behind them."
"10-4, Medic 1, we'll have an officer en route."

We follow the car for a while and observe. Driving slowly and often crossing lanes, this seems to be a driver who's under the influence. We listen to the police dispatch as they approach. Moving over, three police cars fly past us. I watch for a moment and see the blue lights come on.

"Unit 218 to central; traffic stop." Drew, Eric and I high five as we head back to quarters.
"Nice," we say as we walk back to the day room.

We find out later in the night that while the driver wasn't drunk, he was driving on a suspended license.

Us-1, Drivers-0.

On the way back from the hospital again that night, Drew and I are chatting sleepily. The car in front of us flashes its lights a few times, and I look up. An old car is smoking from the hood, hazard lights flashing ominously in the haze.

"Medic 1 to central; be advised that there's a possible car fire in the westbound lane of Main and 1st. North Carolina plates."
"10-4, Medic 1; we'll send fire out there."

Drew and I laugh a little, knowing the firefighters are going to be so happy about being awoken at 0400.

We listen to the dispatch all the way home and once we crawl back into bed.

"Central, appears the driver hit a deer and fluids are draining out of her car. Will advise."

Us-2, Drivers-0, Unfortunate Deer of Clearview...well, 0

Turning the radio down, I hear Drew sigh.
"We always bring out the crazies, don't we?"
"Yeah, but we're young; we can still handle it."
"Mmm, here's to that," he murmurs into his pillow as we try to get a few final (futile) minutes of sleep.

Close to Home, pt.2

2008-10-29T21:19:00.002-04:00

I can see the concern on our nurse's face when he hears my report. I sound less like a family member, and more like an EMT.

"Seventy nine year old female presented with sudden slurred speech. Cincinnati Stroke Scale wasn't exactly passed, but wasn't exactly failed either. No other complaints, other than excessive thirst. No history of diabetes. Some left sided facial droop. She's just acting...strangely."
"Good catch," he says as he puts his hand on my shoulder.
"Thanks."
"Whatever happens, you did a good job."

I just nod as I go into my grandma's room. I watch the tech start a great IV, and sit down in the corner. The doctor comes in, starts talking, and before I know it, she's in the CT scan. I am exceedingly tired, and I try not to take a little nap.

"When can we go," I hear my grandma say as she's wheeled back in the room.
"I don't know, Grandma. We have to get you checked out and make sure you're okay."
"Then we can go to New York?"

I look to my mom and she just sighs.

"I don't know, Grandma," I say again.
"What do you mean?"
"Well we'll just have to see what happens, okay?"
"Okay."

Time passes and my vision starts to blur. I work so hard to keep my eyes open, but every now and again I let them shut. I drift off for a few minutes, but when I open my eyes, I see the doctor.

"Everything looks fine, Mrs. Montgomery. I think you had a TIA, but I feel comfortable discharging you with a prescription for Plavix. Now if you need anything don't hesitate to come back here, okay?"
"Okay," she says, "now how about New York?"
"G...grandma," I pause, "I don't think we're going to New York."
"What? Why? Of course we are."
"I just don't feel comfortable driving all the way up there with you having just had a TIA."
"But we have to go! Let's just go now and we an get there early in the morning, okay?"
"No, we're going to get something to eat and then go back home."
"Fine," she sighs, "whatever you think is best."

I feel so bad, but I know it's what's best for her. I help her to the bathroom one more time, and on the way she stumbles over nothing, catching my arm. Once in the bathroom, she falls and I catch her before she can hit the ground.

"Hey, Doc, I don't know about taking her home. She just fell in the bathroom and tripped in the hall...I just don't know."
"I say just take her home, and then have her see her doc there. Maybe he can direct admit her to the hospital there."
"Yeah...uhhh...okay."

We find a place to eat in this military school town, and I eat quickly. I just want to get home so we can get her taken care of, but time seems to be moving so slowly. I get up to take her to the bathroom again, and two military guys eye me hungrily. I sigh heavily and help her into the bathroom.

"I don't feel so good," she says.
"How so?"
"Just don't feel so good."
"Okay, let's get you out of here, alright?"
"Okay."

We go back to the table to get the check, and she reiterates this sentiment to my mom. Mom looks at me, I look at the car, and she nods.

"Pop-pop," I say sort of quietly, "we're going to go back to the hospital."
"Why?"
"She's not getting any better, and now she's saying that she feels bad. Mom and I just don't feel comfortable taking her home."
"Well okay then."

So we start the trip back.

An MRI and carotid doppler later, they decide to admit her--finally. Mom and I manage to snag the last available hotel room in the city and collapse onto the beds tiredly.

The phone rings.

"Hey honey," I hear my mom say, and I laugh as I realize Dad's calling from Antarctica.

I roll over sleepily, and mom starts the story.

"So you'll never believe what happened today."

Close to Home, pt.1

2008-10-22T13:42:00.002-04:00

"What should I make for dinner," she asks me.
"Grandma, it doesn't matter. Ben's a twenty-something member of the male population. He'll eat whatever you put in front of him."
"But, does he eat chicken?"
"Yes."
"What about beef?"
"Yes!"
"What's his favorite thing to eat?"
"Whatever's in front of him, Grandma."

She sighs and adjusts her jewelry. She's sitting behind me in the car. Mom's driving and laughing at the conversation taking place, and my grandfather is inspecting the GPS. I roll my eyes as I adjust my pillow. This is going to be a long roadtrip.

"I just want the dinner to be perfect when you bring your boyfriend home to meet us."
"Grandma, it will be, I promise."
"What about desserts?"
"You know you're the queen of desserts. He'll love whatever you make."
"Well maybe I could make..."

I turn around to look at her from the passenger's seat.

"What?"
"Are...the cookies...are the cookies too big?"

She's started slurring her words, and something inside me snaps. TIA. CVA. My mind is blank, except for the word "STROKE" flashing in big, red letters.

My mom locks eyes with me from her seat, and I reach over to the GPS. I click "Hospitals," and click the first one on the list. We're somewhere in the mountains of Virginia, and I silently thank God for the GPS.

"Do you think we should stop and call 911," Mom asks me quietly. I check my cell phone and see that I have no service.
"N...no, just drive to the hospital...quickly."

I turn back around to look at grandma. I see a little bit of facial droop, but it's nothing significant.
"Grandma?"
"Yeshh?"
"Could you do me a big favor and squeeze my hands really tight for me? Just squeeze them as hard as you can."
"Okay," she says as she obliges. Her grip is strong and equal.
"Now I want you to smile really big for me," I say as I demonstrate, "show me those pretty teeth!"
"Like thissh," she asks as she smiles.
"Perfect," I reply. I don't bother asking her to say a sentence for me; I already know she's slurring.
"Now put your arms out in front of you like a zombie. Okay, now close your eyes."
"Thisshis silly," she slurs as her left arm drifts away from the left. I try to chaulk it up to being in the car, but I keep it at the back of my mind.

I panic. The Cincinnatti Stroke Scale is great and everything, but what do I do for the next 10 miles until we get to the hospital? I have no equipment. I have no partners. I imagine the worst case scenario in my mind and prepare for that.

I check my cell phone again, and I have one little bar of service hanging on for dear life. I dial the number quickly and wait for it to ring.
"Ben? It's Sam. 70-something year old female, rapid onset slurred speech, no history of diabetes. Go." I'm not really breathing or thinking at this point, so I realize I've probably completely confused him.
"Uh...CVA, TIA, I'd check her blood sugar. When's the last time she had something to eat?"
"This morning."
"Yeah I'd think CVA or TIA."
"Okay, thank you."
"Are you driving to a hospital?"
"Yeah."
"When did it happen?"
"Like ten minutes ago."
"Everything's going to be okay."

I hang up the phone and sit in silence for a second.

"I'm soo thirshty," she says, and for some reason this triggers something in me.
"Hey Grandma, remember when I was little, and you used to tell me about Magic Mountain?"
"Ohh yessh," she says.
"Tell me about it again. I've forgotten."

She starts explaining it to me. Everything she says makes sense, it's just a little off. She smiles and giggles every now and then, but it's not the usual way she acts. I get chills every time I process what's happening, so I stop processing and just keep her talking.

Mom's driving with a purpose, and I try to use some hidden powers of telepathy to move the cars in front of us.

Move, move, move, move is the silent mantra I'm repeating in my head in time with the tattooed staccato the road beats out. I urge the car to become an ambulance, fitted with lights and siren. I close my eyes and assure myself that when I open them, the familiar controls will be inbetween my mother and me--not the two cup holders.

When my eyes open, I'm let down. Grasping for straws. My composure is slipping, my emotions creeping their way into my mission.

With teary eyes, I turn back to her. She's snoozing against my grandfather contentedly.

"Grandma, I need you to stay awake, okay? I know you're tired, but just keep talking to me."
"Wellll fine."
"Let me tell you about Ben."
"Oh tell me about him."
"He's a firefighter," I say as my voice waivers.
"Ooo very shtrong."
"Yes, and he's a medic. He's very caring and sweet, and really knows how to take care of his patients. He's smart, and funny, and you know what?"
"Whaat?"
"His hand is like...the size of five of yours." She giggles and I continue telling her about him, focusing on the dinner we'll all be having together soon. The dinner we'll be having when everything is okay, and no one is panicking.

As we pull into the emergency room parking lot, I turn back around.
"We're going to the hospital, Grandma, I'm afraid you could be having a transient ischemic episode."
"But whyy the hoshpital?"
"Because it's for my peace of mind. I'm sure you're okay, but if we keep driving to New York like this, I'm going to be freaking out the whole time. Is that okay?"
"You know I'd do anything for you."

Anonymous

2008-10-21T14:24:00.004-04:00

On my last post, I got a comment from an anonymous person.

Get another job, you're obviously over this one.
Patients don't have medical knowledge and can think they're very sick.
Nice ATTITUDE...

Now, I wasn't mad or mildly perturbed; I didn't even laugh it off. I was actually really hurt. I'm a very sensitive person, obviously, but let me explain.

I know that the things people say from an "anonymous" handle really shouldn't bother me. Obviously this person didn't have the chutzpah to say it to me face-to-face, in a private email, or even using his/her real name. That's fine. I don't allow anonymous commenting so that I can be attacked; I allow it so my friends, family, and other readers without accounts can comment. But whatever; it's a risk I take.

But to say that I'm "obviously over" this job? Wow. That couldn't be less true. I absolutely adore my job--both volunteer and paid. If I didn't love it, why would I give 18 hours of my heart, soul, and time to the rescue squad without pay? If I didn't love it, why would I forgo parties, plays, speakers, and other fun things on campus and with my friends so that I could try to help others? If I didn't love it, why would I want to do it for the rest of my life?

I curse because it is cathartic. I have seen too many things in my short time in EMS; I have to have a catharsis. And, anyone who knows me can tell you, I do not wake up easily. It is a miracle that I'm able to function on these calls. I can sleep for thirteen hours straight (easily) if I'm uninterrupted. When I wake up, I'm not happy about it. But like I said in the post, it's not about running the call, it's about waking up. I have to get myself ready to run the call, or else it's not going to go well.

My "b.s. flag" went up on that call because by now, I can tell when certain things aren't an emergency. I didn't mean to say that this woman wasn't in real pain. I'm sure she was; I'm a chronic migraine sufferer, and there have been headaches in my past where I literally thought I was dying. But what I do know is that this was not an emergency. The first call--the man with the chest pain--warranted an IV, an EKG, and lights and sirens all the way to the hospital. He needed immediate, emergent attention. The second woman did not need immediate attention, and could have driven herself to the hospital (or been driven by her boyfriend). At the very least, she could have called a taxi.

I treated her like I treat any patient. I asked the appropriate questions, did all the things I needed to do, and explained to her what would happen upon our arrival to the emergency room. Just because I think her complaint is not an emergency doesn't mean I'm going to risk her care and my license by not doing a full work-up.

And, in the words of EE, she who put it best,

Anonymous:

The patient wants some dope. It is painfully obvious. The patient is also impeding the care of a very sick man...

Feel free to give me advice, or suggest other ways I can go about it. Feel free to say whatever you want, really; it's a free country after all. But if you say that my attitude is wrong, or that I'm jaded to the profession...well, you just couldn't be more wrong.

Ask my partners, my coworkers in the emergency room, my boyfriend, or my family. Ask my mom about how I beam when I tell her about a call I ran where I had the chance to save someone's life. Ask my fellow lab-tech about the victory dance I do every time I get an important IV (it's a sight to see, really). Ask Drew about the way I held a patient's hand all the way to the hospital, or assured the woman with "radioactive urine" that she wasn't going to hurt me and that I took her complaint seriously. Ask Ben about how frustrated I am when my best efforts fail in the ER or the ambulance and I feel like a failure myself.

Hear what they have to say, and then tell me I need to find a new job.

To the rest of you who commented; thank you. Thank you for sticking up for me, for relating to me, and for supporting me. You guys rock.

Take care out there,
Sam

Cursed

2008-10-20T10:50:00.000-04:00

There's this thing I do when a call comes out in the middle of the night, waking me up. Well, let's be honest, it's usually Drew that wakes me up, after I sleep right through that annoying ringing in the hallway. I wake up, stick my feet in my boots, grab my glasses, and curse. I curse like a sailor all the way out to the medic. I usually stop long enough to mark up the radio, but that's about it.

It's one long string of profanity, punctuated by the occasional article or noun. It has more to do with being woken up than actually running the call, I think, but regardless, it happens every time.

So tonight is no different.
"Sam, let's go."
"Uggggh, but it's chest pain, that's ALS and buhhhh..."
"Yeah but the paramedic is sending us to check it out. We've got Eric; he's a medic."
"Fine...let's go."

And then starts the cursing. A heavy length of profanity leaves my mouth, and then I pause, breathing for a second before starting in again. Drew just laughs from the back, and Eric barely acknowledges anything as he drives. Nearly running us off the road, I curse louder, this time including his name.

"Is that really necessary," I sigh, "you have the medic pegged at 80, so you're probably going at least 90!"

Well, I say that, only with more color to it.

I see our destination approaching on the right, and take a deep breath. I close my eyes, rub my temples, and I'm ready.

"Hello," I say with a smile that doesn't betray me, "my name is Sam; I'm with the rescue squad."

But my smile fades quickly as I take in the situation. He's in his late fifties, and clutching his chest. He breathes heavily, about twice as fast as the normal man, and I see sweat dripping from his forehead. The cursing starts in again in my thoughts, but this time it's due to the man's condition.

Eric and Drew's concern shows in their face as well, and after getting a set of vital signs, I stay with our patient as they get the stretcher. I glance out the door and see Eric on the phone to the paramedic.

The radio interrupts my thoughts, cutting in with a prealert.

"Station 1," I hear, and my heart drops immediately, "headache." Three of us are tied up on this call, and the paramedic is the only one at the station, who we desperately need. Getting this sorted out is going to be more than difficult. I curse some more in my head.

We load our patient quickly and I set up an IV as Drew drives back to the station to swap out crews. I try to spike the bag while maintaining my balance, but I know that's hopeless. I'm thrown back into the IV box while yelping a bit. I finally manage to get it set up about the time we're pulling back into the station. Drew and I hop out as the paramedic gets in, and we run to a different ambulance.

"Medic 2 is en route," I pant into the radio as we pull back out of the driveway. I flip through the map book and find the address. It's way out there, and I let myself relax for a moment.

Dispatch comments on our rip-and-run saw that a 20 year old female heard something pop in her head. My b.s. flag shoots up immediately, and I relax a bit more, even though the cursing continues inside my mind.

We arrive on scene and I see a woman, two men, and a dog in the living room. The dog seems to have the main goal in life of tripping me. He almost succeeds twice.

"Ma'am, can you tell me what's going on today?"
"I've had a migraine all day long, and then I coughed and heard something pop in my head."
"Did it hurt any worse after that?"
"Well, no."
"Okay. How bad is your pain on a scale from one to ten?"
"Like a seven."
"Do you want to go to the hospital?"
"Yep."
"Do either of you want to follow behind us or ride up front," Drew asks the two men sitting sleepily on the couch.
"Oh hell naw," is the response her boyfriend offers up. Great.

She wants to go to Clearview regional, where I work, so I pull my ID out of my pocket and clip it to my shirt. I ask her some more questions, get her vital signs, and get her situated in the ambulance.

We take off, and she says nothing. She answers my questions, but sits in relative silence. She asks me once if I can give her anything for pain, but I tell her that at my level of certification, I can't. Something about her just isn't quite right, though. She never looks me in the eye when she answers a question, just when she asks for pain medicine. She picks at her nails and yawns.

Switching the radio over, I call in report.

"Good morning, Clearview, this is EMT Montgomery. I'm en route to your facility with a twenty year old female whose chief complaint is of a migraine. Patient is alert and oriented to person, time, and place, and appears in minor distress. Vitals are within normal limits, and patient has no other complaints, except for nausea. Interestingly enough, Clearview, patient states that she coughed a few hours ago and felt something pop in her head. There was no increase of her pain. Not requesting any orders as I'm sure you may have guessed; do you have any questions?"

There's a brief pause on the other line, and when they key up the microphone, I hear some laughing.

"Uh, negative Medic 2...wait...did you say she heard something pop?"
"That's affirmative, Clearview."

Another pause, some more laughter.

"10-4, Medic 2, see you when you get here!"

We pull into their bay and park next to Eric's ambulance. Unloading the patient, he and I exchange sighs. We move her to the hospital bed, I give my report to the nurse, and hand her my already-finished narrative.

"Hey, Montgomery," I hear from the EMS room, "you call in that report?"
"Oh, hey!" I see one of my favorite paramedics as I walk in.
"So that was you?"
"Yeah," I smile sheepishly.
"Loved it. Enough facts with enough sarcasm; I give it two thumbs up," he laughs.
"Aw, shucks, you're too sweet."
"Hey, I'm just telling it like it is."

I hear the prealert again, and I'm cursing more, praying it's not us. We climb into the medic, and I'm relieved to hear another station toned out. Finally, the cursing stops.

Face Down

2008-10-16T18:17:00.000-04:00

I always expect "ground level falls" to be nothing more than the life alert commercials we all know and love. The first call of this nature I went on, the woman on the floor actually called out to us as we knocked on the door, "help, I've fallen and I can't get up." I guess I've just gotten used to helping a little old lady up, getting a signature, and going about my day.

But when I walk in the room, I can tell this one's going to be a headache. She's lying face down with her head in the bedroom and her body in the bathroom. Christ, I think to myself as I see her pantyhose still bunched around her ankles. The bathroom is, of course, tiny. It's a wonder she managed to fit in there with a shower, sink, and toilet.

Her husband, obviously deep in the throes of dementia, sits on a portable bed pan/toilet contraption next to the door, with the cordless phone in his lap.

"Hi, my name is Sam, I'm with the rescue squad. Can you tell me what happened?"
"I fell," she replies with a mouth full of floor.
"Right," I sigh, "but what happened?"
"I stood up from the toilet, bent over, tripped over something, fell over the toilet, and here I am."

At this point, I have c-spine control. She denies hitting her head, but at this point, I'm not taking any risks.

Now we have a problem, I'm starting to realize. She's face down in a tiny room, and we have to backboard her. There's no possible way to log roll her or even fit the backboard in the same room independent of her.

"So...we'll get the board under her, bring her out, log roll her off of it, and then log roll her back onto it?" Drew scratches his head a bit as he makes his way into the bathroom without stepping on our patient.
"Yeah," I pause, "I uh...guess so."

My favorite police officer has shown up, and is offering to help. This is why he's my favorite. We start the tedious process of sliding the board under her, from head to toe, while maintaining c-spine control, and while trying to keep from hurting her.

Finally, we manage to finagle the board all the way under her, and start lifting the board out of the bathroom, over the portable bed pan thing, and onto a flat surface. This is not an easy task due to her weight and the obstacles, but it happens.

Tired and sweaty, I look at Drew and the officer from my position at her head. We're each wiping sweat off in some form or fashion--it's gross.

"Okay, let's roll her," Drew says. On my count, we roll her off the backboard, do a quick assessment of any injuries, and then roll her back onto the backboard. It's a bit cockamamie, but if it works, I'm happy.

Carefully, we carry the backboard out of the room and onto the waiting stretcher. Every move we make warrants another agonized yelp from our patient, but I can't tell why. She's got nothing more than a little swelling where her glasses hit her face, but nothing is apparently wrong.

"Ma'am, what hurts," I ask her.
"Nothing, really, but I get scared when you move me," she says.
"Oh okay," I reply, "we're going to buckle you into this stretcher, roll it out to the ambulance, and put it in the back. You'll feel some bumps, but don't worry, I haven't lost a patient off of one of these yet," I say with a wink.
"Okay," she says with a little smile.

"Which hospital," I hear Drew asking family.
"I want to go to St. Mary's," she says quietly.
"Ma'am, we can either go to Clearwater Regional or Sacred Heart."
"But...that's not where my doctors are!"
"I understand that, but if we took you to St. Mary's, we'd end up driving you for an hour, which means another hour back for us after getting you situated there. That's a good two and a half more hours from now that we'd be out of service, and we need to be able to go back to our station quickly in order to help other people."
"Oh. I really want to go to St. Mary's," she sighs.

I leave her side to go check with the family. I explain to them the choices they have. They decide to send her to Lakeview, a small ER only facility associated with St. Mary's. I doubt they'll take her since she's a trauma, but I'm eager to go. The winds are howling and the rain is coming down.

"Lakeview ER, this is Clearview Medic 1 contacting you on the HEAR, do you copy?" I hear static coming back at me, and I wait for a few seconds before repeating my traffic. I call again, and still I get no response. Frustrated, I check the medic's cell phone. Every ER's number is listed, save Lakeview. I call again on the HEAR, and get nothing. I call two more times, and no one answers. We're roughly five minutes away, and I have never shown up to an ER without calling report.

I call Eric, back at the station, and have him look up the landline number. I have no service on my phone, so I creep up to the driver's seat and take Drew's. I finish my report as we are pulling into the parking lot.

"Standby," the nurse says on the other end, "we may want to divert you to St. Mary's."
"That's a negative," I respond, "we are in your parking lot now."
She sighs before coming back with a simple, "10-4."

We can't figure out the doors. We've never been here before, and I'm not sure if it's a keycard, or a number I have to punch in. Frustrated and banging on the door, I try to control myself.

Finally, the one and only tech comes to let us in. He reminds me of someone who's taken speed; he simply cannot stop talking, moving, or twitching. He leads us to the bed and helps us move her over. There's one other patient here in this 10-bed facility, and I can spot possibly two nurses. I snag one to give report and find myself the EMS room.

The tech follows me in there and stands awkwardly beside me, as I begin to write my narrative.
"Um, so you look really familiar," he begins.
"Oh? Um...I...I don't know."
"Or maybe you just remind me of someone I know who's as pretty as you." I'm in no mood. I sigh as I push the hair out of my face.
"Maybe you've seen me around Waverly," I nod.
"Oh really? Do you work out there too?"
"No, but my boyfriend is a career firefighter medic out in Waverly."
"Oh," he says, "that's cool. I'm going to go get a drink."

As he slinks out, I mark myself a point on my imaginary scoreboard. Sam-928,327, Cliché members of the opposite sex-0.

I finish up my narrative, find Drew, and basically drag him out the door.
"Let's go, let's go, let's goooo!"
"Eager much?"
"I'm tired, sweaty, cranky, and just got hit on by Speedy McRaceRace back there. Let's get out of here!"
"Okay, okay," he says as he forces his door open against the wind.

A few minutes pass on our way home. We listen to the radio and sing "Nights in White Satin," really loudly and out of tune.

"'Cause I love youuuuu, ohhhhhhh how I love youuuuu!!!!" Drew's voice wavers, and mine follows suit. I can't stop laughing. This is why I love being Drew's partner.

After a boring song comes on, Drew sighs.
"If you had to explain that call in one word, what would it be?"
I think for a second, and reply with, "obnoxious."
"Oh."
"Why, what were you thinking?"
"Clusterfuck."

Um...

2008-10-07T10:40:00.003-04:00

Overheard while starting an IV last night:

Nurse: So what brought you to the ER today?
20 y/o female: I just can't catch my breath.
Nurse: Do you have a history of asthma or any breathing problems?
20 y/o female: No, not that I know of.
Nurse: Have you ever had anything like this before?
20 y/o female: Yeah.
Nurse: Why was that?
20 y/o female: Well you see, I smoke pot about every other day...

A real post coming hopefully tonight :) Thanks for putting up with my absence!

Take care out there,
Sam

Cute

2008-10-06T18:44:00.001-04:00

67 y/o drunk man: "Why are you poking me?"
Me: "We've got to give you an IV so we can give you some medications and fluid."
67 y/o drunk man: "Oh. You're cuuute."
Me: "Yes sir, I'm always cute when they're drunk."
67 y/o drunk man: *buuurp*

Tiny Rant

2008-10-01T22:23:00.003-04:00

Disclaimer: Anniforscia, dear, don't read this post. Please. No one should read this post with an intense fear of needles or IVs. Thanks.

Dear Paramedic Student who shall go unnamed,

There are several things I keep in my IV bucket. Let me tell you about them. I keep a latex and non-latex tourniquet. I keep a whole bunch of Vacutainer tubes to put the blood in. I keep gauze, alcohol swabs, saline locks, syringes, tape, and Tegaderm site dressings. I even keep a whole ton of saline flushes. There's a lot in there, I know.

But here's the important part. I carry two types of needles. One type of needle is for IVs. It's called an angiocath. It comes in gauges 14-24 for the IVs I use. It has a plastic catheter over the needle, and that part stays in the patient. Easy, right?

I also carry hypodermic needles that go on the END OF SYRINGES so that after I get the blood in the syringe, I can distribute it evenly into the vaccutainers. I only carry one size--18 gauge.

I keep them in SEPARATE parts of the IV bucket. You KNOW this. But yet, every single time I've started an IV, you hand me a regular needle when I need an IV needle. I've told you time and time again which is which, and even wasted supplies by opening countless needles to show you the difference. Let me see if I can clarify more.

This is an ANGIOCATH.

This is a HYPODERMIC SYRINGE NEEDLE.

Get it? No?

Angiocath...

Hypodermic needle for a syringe...

They do very different things. Please learn which is which before continuing in your paramedical education.

Sincerely,
Sam

p.s.--This rant brought to you by Sam's raging impatience with students who don't learn. I'm not being unfair, I've told him roughly fifteen times. I don't mind correcting him, but I do fear for his patients, when he sticks them, and then realizes that he's using a hypodermic needle, not an IV needle.

Busy, busy!

2008-09-29T11:33:00.002-04:00

It's been so crazy around here. Always working, schooling, volunteering, or...well, there's no good one-word gerund for it, but...hanging out with people. I have stories to write, and no time to write them! Hopefully tomorrow I'll have enough time to sit down and type out some thoughts. We'll see though; thanks for sticking with me.

Go check out Normal Sinus if you have the chance. We're finally up and rolling again; we had a little bit of a lapse in posting because of the fact that the world much prefers to keep us all busy than entertained :( But luckily, Epi has been kind enough to take on posting!

Oh, and when your significant other makes eyes at you from across the ER while holding fat flaps for a doc doing a central line, you know they're good for you. Either that or you're both totally dorky. Okay, maybe both.

Take care out there,
Sam

Socks

2008-09-24T18:33:00.002-04:00

I remember the first time I saw a dead body that I knew to be truly dead. I had seen my grandmother right after she died when I was five, but for some reason, I was pretty sure that she wasn't really dead; she was just tricking us all.

But when I was 14 years old, I had the opportunity to go to the National Youth Leadership Forum on Medicine in Houston, Texas. I was all about medicine. Either I was going to be a pediatric radiation oncologist, or a forensic scientist. I quickly realized that being a pediatric radiation oncologist wouldn't help me bring back the two I couldn't save, so I moved onto the goal of forensic science.

"Pick a field visit," our group leader said showing us the list of places we could go. M.D. Anderson and The Texas Heart Institute were just two of the places--big names. Everyone wanted to go to those and didn't care so much about the little hospitals or doctors' offices. One name leaped off the page to me. "Harris County Medical Examiner's Office," I read softly.

"You wanna go there," the leader asked with a raised eyebrow.
"Oh yeah, definitely, I want to be a forensic scientist."
"Alright. Anyone want to go with Sam to the coroner's office?" She looked around, and everyone stared at their feet.
"Guess it's just me," I sighed.

A few others from different groups decided to go, so there was a group of about seven of us. I was excited and nervous, not knowing what we'd see. We spent some time handling plasticized organs and learning about different diseases that they often saw in their office. We took our lunch break, and knew what was going to happen next.

We suited up in gowns and masks, tying our hair back under flimsy blue caps. Shuffling about, I always get pushed to the back. I'm the smallest, youngest member of the group, and it's very apparent.

We step into the first room, and they're just finishing an autopsy.
"Sorry kids, we're all done." There's a bit of a groan let out from some of the guys.
"Not to worry," our escort says, "we've got one just starting in room two."

We move over to the next room, and there's a black man in his forties lying on the cold steel. He looks like he's asleep--comfortable. I look him over from head to toe. His hair is a mess, a strange smirk dances across his unshaven face. He's not the right color, but I can't figure out what exactly is off about it. His fingernails are dirty and a yellowed towel lies over his groin. My gaze continues, and I see his ankles. Those sock marks that are always on my legs at the end of the day are still on his ankles. It looks like he just took them off a few minutes ago to take a nap.

"Whoa," I sigh.
"'Scuse me," the coroner says as he pushes through the crowd.

I watch intently as they make every incision, explain every organ and ask us some questions. Everything is fascinating to me, but I keep coming back to the sock marks. I wondered how he got them, and what color the socks were. I wondered where the socks were now, and who took them off of him.

"Any questions," the coroner asks looking up from the bone saw.
"I have one," I say as I raise my hand.
"Shoot."
"Do you ever wonder who they were? You know, like before they ended up on your table."
"I used to," he said, "but then it ate me up inside. I've stopped wondering. Sometimes I make up stories about them for myself, though. Happy stories, you know? It's easier when you don't know the truth."
"Yeah."

I still wonder where those socks are now.

Ben

2008-09-21T21:19:00.005-04:00

I promise I won't embarrass you, Ben, honestly. Oh, by the way, I've named you "Ben." I know you're reading this, which is...why I'm writing this. So everyone else who's reading it...just go along with my giddy stupidity for a while?

There are very few words, or strings of words, that can compel me to make some sort of involuntary noise. "There's been an accident," is an example. I will almost always gasp, cover my mouth, or say something intelligible.

"We need to talk," is another string of words that makes me sigh or groan. I dread unexpected, awful things like these.

So when you looked at me in the dark, and knitted your brow, pursing your lips, I expected the worst.

"Hey Sam?" Your tone was puzzled, anxious, and it scared me.
"This isn't going to work", or maybe the overused "We need to talk," is what I expected. I don't know why. Maybe I'm just gun shy, after hearing bad things come after that anxious tone.

That's why I bit my lip tentatively before answering you with a simple, "hmmph?"

But then you surprised me. After taking me out to the beach, walking for hours with me in the cold wind, and treating me to dinner, I thought you couldn't get much better. No one does those things anymore, do they? Opening car doors, walking between me and the curb; you do it all. I was surprised, flattered, and impressed.

"Too good to be true," comes to mind. I'm glad it's wrong, though. Ben, it's so wrong.

So when you took my hand and I could feel your radial pulse beating wildly in my arm, I was scared. Why would you hold my hand when you were about to tell me that you were seeing someone else and it was getting serious, or that you just didn't feel for me what you thought you did? I was prepared for it, though. It wouldn't be the first time I had heard it.

But what you said shocked me. I couldn't really speak. All I could do was make that involuntary noise, a little squeak in the back of my throat. I managed to force out the words "of course," before squeaking again.

It was dorky, adorable, heart-warming, and perfect, the way you asked me if I'd be your girlfriend. I wouldn't have it any other way; you know that.

Thank you, Ben, for showing me that they aren't all the same, or maybe that you're just different. Perhaps both. Regardless, I couldn't be happier to be your girlfriend. ...Officially.

And, uh, sorry if I'm embarrassing. It's what I do.

Sometimes I Guess They Do Live

2008-09-20T14:06:00.003-04:00

"Swear to God, she's in this tiny little back room, situated on this hospital bed," he continues.
"Isn't that always the case," I ponder, drinking some more pepsi.
"So we go back there, and she's like 'Oh, I don't feel so good,' and we're talking and whatever, and then swear to god, she just...like...dies."
"Well shit," Eric pipes up.
"Yeah. So I'm like dragging her out by her arms and trying to put the backboard behind her somewhere, and she's just doing crazy things on the monitor, y'know?"
"Ooo, what kinds of crazy things!?"
"Things I've never seen before in the field."
"Nice," I exclaim, "go on."
"So I'm doing CPR and while I compress, I'm perfusing her obviously, and she sort of grabs the stretcher and moves and stuff. It's weird. I've never had that happen."
"Happened to me once, but nothing significant," I say.
"Well she was straight up moving and her eyes were fluttering. So anyway, we get her in the back of the medic, and I've already called for Tom to meet us on scene. Well he shows up, and she's AWAKE," he almost yells.
"Wait, what?"
"Yes! Woman is straight up alive. I ask her what hurt, and she says 'nothing, if you'd stop pushing on my chest.'"
"Holy jesus!"
"I know, right? So Tom like...doesn't believe me that she was just in arrest. I ask him to ride it in with me because I'm afraid something's going to happen again, y'know?"
"Right, so did he?"
"Yeah! And sho'nuff, ol' girl goes back into arrest, and Tom is like 'shit!' Yeah, I told you man, she was in arrest. So when I compress, same thing happens. It's surreal. And we get her there, and she's alive again, and in the hospital's hands."
"That's some crazy, crazy stuff there."
"You wanna know what's craziest?"
"Um, sure."
"A few weeks later, I find out that not only did she survive to walk out of the hospital, but I'm EMS provider of the year."
"Whoa, nice job!"
"I'm like...it's not me, it's her and her weird heart stuff."

Eric and I giggle and snap off a little salute.
"To Paramedic Hall," he starts, "the greatest provider in all the lannnnd!"
I try not to choke on my drink as we get some random debris chucked at us.

"You're just mad it's not you!"
"Oh no, no, sir, we could never take that honor away from you, the greatest provider in all the lannnd," I say, echoing Eric.
"Well anyway, like I said, it's not me, it was her. Sometimes I guess they do live."

And Another Thing

2008-09-18T00:50:00.002-04:00

I wrote in my post, "Dead," about the way I dealt with a recent code. You all know me; you know how I deal with traumatic events in my life. I am stoic and collected during the crisis, and then break down later. When I'm done with my breakdown, I get my proverbial shit together, and move on with the things I need to do.

I don't really think about the burned children anymore. Sometimes I wake up in the middle of the night, hearing that mother screaming her child's name when she finds out she's died. I look at the house where I run my first code every time I go to the station. I always remember the things I see, I just deal with them as they come and move on.

I got an influx of emails and comments and response posts from what I said in "Dead." I really do appreciate the kind words and the advice. I know that there are some of you out there who have been doing this longer than I've been alive. Thank you for sharing your thoughts with me; I have so much to learn from people like you.

But when I was a young girl, I had many people who were close to me die in a relatively short amount of time. I learned that everybody dealt with tragedy different ways. Some laughed, recalling good times they had with the person. Some cried uncontrollably. Some wrote poems. Some didn't do or say anything. And what I find interesting is that not one email or comment seemed to agree on the "right" way to deal. It was actually this interesting pattern I noticed that has sparked me to do my ENGL 410 (Literature of the American South) research paper on the way in which Southern grieving differs from the rest of the nation. I hope to interview a few of you for this paper.

Again, thank you. Please don't think I'm not listening, but you have to know that I'm always going to deal with things my way. The next time I write about a code or a rough call, I'll probably talk about breaking down afterwards in some form or fashion. I'm a tender-hearted girl, and I can't see this kind of devastation without reeling from it later. I've never been one to bottle away my emotions; when I do, my parents and friends probably want to kill me. I'm a seething bottle of bitch. It's not nice.

So I'll always deal with things as they come, and I'll always be hurt by the events that should hurt. Hell, I'll always be hurt by the things that wouldn't affect most people (I cry at...well, everything).

But please, keep sharing the wisdom, experiences, and thoughts with me. I (always) love knowing what you think.

Take care out there,
Sam

Birthday

2008-09-17T23:35:00.002-04:00

"I don't think I'm ready for you to go," she says as she stands next to me in the dimly lit kitchen.
"Aw, you'll be okay," I say as I look at my feet.
"But what if you go to college, and some skanky girl tries to spread rumors about me or start a fight?"

I laugh and blink back some tears. I didn't like the idea of her being alone with no one to look after her. I knew she could take care of herself, but I had been there these past few years to make sure no one messed with her.

"You'll do great."
"Aren't you scared, Sam?"

And here I face my dilemma. Do I admit vulnerability for the sake of honesty, or do I bluff to stay strong in her eyes?

"Honestly...I'm terrified."
"I would be too."

She looks up at me with big, sad eyes. My heart breaks.

"Do you think you can come back for my birthday party?"
"I...I don't think I'll have a way to get back."
"Oh. It won't be the same without you."
"I know, I'm sorry."

And then I break down, my tears splashing down my shirt, exploding silently. She takes me in her arms, wrapping herself around me like some sort of comfort blanket.

"Oh, don't cry, Sam, don't cry," she says as her own tears splash into my hair.
"I don't want to go," I sniffle into her shoulder.
"You're going to do so great, you won't miss this at all."
"But I'll be so new and scared and what if no one likes me?"
"Who won't like you!? They're stupid."
"Come visit me?"
"Of course."

And standing there, holding me in my kitchen, she comforts me the way I used to comfort her, and makes me feel like everything is going to be okay, the way I've always tried to do for her.

Happy Birthday, Paula. Sorry I've missed it for the third year in a row. I love you.

Dead

2008-09-16T01:20:00.002-04:00

And so he died under my hands, right there on the table.

"Stop, just stop," the doctor said to me softly, pulling the leads off his chest.
"But, I..."
"Just stop, Sam, it's okay."

Twenty-one years old, with his whole life ahead of him, and he's dead. There's no word for how dead he is. Alive, shot, dead.

His memorial tattoo for some relative or friend looks up at me. Twinkling eyes, even in that tattoo, taunt me. "RIP," it says, but now it's for him.

Shot in the femur. Dead.

My compressions do nothing but circulate stale blood through tired veins. The bladder has given up too, and the muscles relax for the first time in twenty-one years.

Dead.

"Time of death, 2213." He was dead before that, but now he's dead in the eyes of the government.

"Good job, everyone." Yeah, right. If it were a good job, he wouldn't be so...dead.

His arm hangs, useless, to his side. Hitting me in the leg during CPR is its final act. I pick it up gently in my hands and put it on top of his stomach.

Dead.

"Somebody get this kid a blanket, extubate him, and call the family into the meditation room."

"This kid." A year and a half older than me, than this kid. I'm just one kid who tried to save another kid's life.

Dead.

I skid on some blood on my way out. Fuck it, I don't care and neither does he.

And then a funny thing happens. I go to the locker room, and call my mom. I've done this after every code I've run. I tell her what happened, feel a little sad, and usually cry.

But tonight, I shed two tiny little tears, hang up the phone, and go back to work. I don't spend the night thinking about him. I don't actively confront my own mortality. I just move on.

It's not that it doesn't hurt--it does. It's just that I don't have time for it to break me down.

And for some reason, this satisfies me. I'm getting stronger, getting better at this. I still feel it; I'm not jaded. I'm just less affected.

But he's no less...

Dead.