Cold Weather Musings

My God is it cold outside today!

My truck is saying 9 degrees and thats not figuring in the 30mph winds that have take the power out all over town. Wind chill -20 or so.

We ran on a few slip and falls yesterday and a couple domestics. Nothing says "Seasons Greetings" like kicking the shit out of your spouse.

My other crew did 2 DOAs in the first 10 hours of the shift and then some various BS runs the rest of it. I hate it when people die near the holidays. You know their family will never look at the seasons the same anymore. They will always equate Christmas with death. Fitting? Maybe, I don't know.

My babies wont be home until Christmas morning. I miss them like hell already, but it's good that they get to spend some time with their mother. I'm a firm believer that little boys should be raised by their fathers (if the father is able) but I'm also a firm believer that no one coddles and preens over a child like their mother. My sons have me all the time to keep their butt in line, and they know I love them but around the holiday season I guess it's ok for them to be pampered by mommy a bit.

The girl and I are getting along very well. This in it's self is news because never before in my 35 years on this planet have I had such an easy going relationship. We both respect each others space and personal differences. We even go so far as to accept each other for who we are. I KNOW, WEIRD HUH??!!??! Now if I could just get her to tell me what she wants for Christmas I'd be all set!

Got a call from one of my guys thats also on a volunteer department, he had a pretty bad run involving a whole family. One of the children died. A parent lifeflighted to a trauma center. He was pretty shook up about it. he would never admit it but I could hear it n his voice.

He asked about the usefulness of CISD meetings. I encouraged him to go, and told him if it wasn't enough to come and see me and we'd talk some more. I've been there, and it sucks. I hope he pulls through without being too screwed up. It's hard to get past those calls.

I'm holed up by the computer trying to keep my hands warm. I have the heat jacked up and Oscar (The bird...The Grouch) is singing his damn fool head off. I can imagine him saying "Hey dumbass, if you cold I'm down right frozen here...help a brother out"

Stay warm guys... hats and gloves on every call. You never know when you'll have to play in this shit for 30 minutes or so.

Seeking Acceptance

Lately we have been getting a lot of riders on the squads; some are students, others are members of the community who just want to see what EMS is all about.

I wonder about them sometime, what makes them tick? What do they think about our job? Do they respect us?

We have this kid Ben who has been riding with us for a couple weeks. He just finished up basic school and took his NR practicals. Having found out that he passed them he was on cloud nine. I felt happy for him, remembering how I felt years ago when I conquered that obstacle. I told him that the only thing standing in his way now was a few words on a computer screen. He then asked me if I thought he would make a good EMT. I told him the truth "Time will tell Ben, time will tell". I know it's not the answer he wanted but I thought it best not to sugar coat anything for him.

All of that got me thinking about acceptance and how people crave it. I have been overheard saying "I don't give a shit what anyone thinks as long as my patients are taken care of" I know now that is untrue. I do seek acceptance, as much as it displeases me.

At 35 years old I have done more and saw more than most men in their 70's. I have had jobs in every branch of emergency services and finally settled down to be a full time paramedic. I have owned 4 companies, sold 2 of them, lost 1 in a divorce and went belly up with the other. I worked in the family business for years and I even bar tended for awhile.

Through every job and everything I ever did I think I was seeking acceptance in some form or the other. In the beginning I was trying to redeem myself for being such an awful kid. My father would tell me he was proud of me, but I knew he couldn't care less what I did as long as I didn't embarrass him. I worked for his acceptance for 27 years, and he died without ever giving it to me. I'm not sure I will ever be able to come to terms with that.

When my children were born things seemed to switch for me. I'm not sure anymore if I ever wanted anything more than to make my boys proud of their father and what he does. I see children every day in the course of my job who have deadbeat fathers. Fathers who not only don't help support their kids, but are never around either. I never want to be that kind of father. I want my children to say "That is my Dad, he helps people, he's a paramedic"

We all have to have a driving force behind us and in the end I guess it is a matter of seeking acceptance. Whether you are a new EMT looking for acceptance from your peers or a son looking for acceptance from a father it hurts when you don't get that acceptance. It stings like a bitch and there is really nothing that fills that. If your a strong person you will work harder to get that acceptance if you are easily disheartened it will hurt you for quite awhile. Push on, push on and stay your course. In the end you have to accept yourself first.

So I vow today to be more accepting. I will accept people unconditionally and I will reassure them where I can, but make no mistake... I'll still tell them their an idiot when they deserve that too.

Did you expect any less?

An Old Friend.

If you are in this profession for any length of time you will make some strong bonds with other like minded people. You will learn from them and they will learn from you. You will influence each others lives and never know it happened. We rub off on one another. It's not until years later you realize what an impact they had on your life.

Today I got done with my truck check and wandered upstairs to start the daily paperwork and order supplies for the week when I saw a piece of paper with my name on it tucked under my keyboard. I opened it to find a message from a long lost friend. It listed his name and number and where he was living now with a small note that said "Call Me".

I just sat there for a moment rubbing my head. I thought "No shit, the old guys is still alive!"
I couldn't bring myself to call immediately. I had to basically talk myself into the process. Not because I didn't want to talk to him, not because I was afraid... Because what do you say to someone who unconsciously and unknowingly shaped the clinician you are? How do you tell someone that if not for them, you would be in a very different place right now?

So I sipped on my coffee and tried to rehearse my words before I placed the call. That took all of about 15 minutes and I muttered "Fuck It". I'll just call him.

The phone rang about 4 times and his wife answered it sleepily "Hello?" Shit, it is 8am what the hell was I thinking... Oh well I'm committed now.. "Is Leroy there?"

She heard it was me and her voice changed for a second when she got him on the phone, she remembered me too it would seem.

The first thing out of the old guys mouth was "Hey man, I heard you went to the dark side!" He was referring to me becoming an officer for the company and it brought a smile to my face.

The laughter started then as if it had only been 24 hours since we worked together. We talked about how he was doing and the changes in his life while he inquired about what I was doing now and that he was glad too see I had progressed so far with the company.

We caught up on the children and how they have grown, we discussed dating/being married to younger women and I promptly blamed him for instilling that fancy in my head. It was a light hearted and warm conversation and I enjoyed it very much.

You see, Leroy and I worked together years ago. When he came to work for the company he was at the end of his career and I was at the beginning of mine. He was widely regarded as one of the best paramedics that ever started a line and I was regarded as one of the loudest most obnoxious basic EMTs to ever drive a squad. He was a paramedic instructor and I was defiantly NOT the teachers pet.

I resented him those first few weeks. He was so laid back and mellow, nothing ever got to him and nothing was ever urgent. He would slowly and methodically assess our patients and then make a plan for their treatment. It was far too slow for me.. I wanted the LIGHTS, SIRENS, DRIVE FAST GO GO GO treatment. He was slowing me down.

I don't think I could have been more wrong about anyone. Leroy knew what he was doing, years of experience had proved to him "It's their emergency, not yours". That's just one of the things I learned from him. As I look back through my writing all of these years I realize that Leroy was one of my strongest influences. He taught me a great many things, even if I didn't want to learn them at the time. He was always a reassuring voice in the back of my head when I didn't think I could go any further. Always pushing me forward and forcing me to see the other side of the problem. He forced me to look at things from the patients eyes and not focus on what the book said.

I remember a run we went on in the county once with a 83 year old male that was dizzy and lightheaded. We arrived on scene and the man was flat out refusing to go to the hospital. Leroy hooked him up to the monitor and continued to try and persuade the man to seek medical attention. The man threw us out of the house.

When we got outside we told the fire department to go ahead and leave, we would not be requiring their assistance as the man was refusing care. The patients son was there outside and begging us to do something. Leroy looked at the son and said the following: "Alright sir, I'm going to have to go back in there and tell him like it is. It might sound a little rude but it's the only way I know how to convince him". The Son agreed and Leroy and I went back in. Leroy told the man "Listen buddy, your heart is in trouble. Your going to get up and walk that 4 feet to go poop, your going to sit down, push and die" This convinced the man and we started to load him on the cot when he went into full arrest. We did everything we could to try and bring him back but in the end they pronounced him at the hospital 25 minutes later. I was stunned. Here we did everything by the book. We ran a textbook code and the guy still died. This is where Leroy took me aside and said: "God made paramedics to give him a chance to change his mind" I looked at him in disbelief and he followed it with: "You gotta remember though, he don't always change his mind"

Those words would ring true with me for years following that code and they still are just as true today. I have counseled many new EMTs with the words Leroy said to me that day, and I'm sure I will in the future. Nothing more true has ever been said about why we lose patients in the field. "Your damn right it's not fair" Leroy would say. "If you wanted fair you should have found another job."

I'm glad I reconnected with Leroy, there are still so many things I can learn from him. Now that I see things a bit differently maybe I can take his lessons to heart and use them sooner than later.

In the course of you doing your job and meeting other EMS providers, pay attention. Everyone has something they can teach you if your willing to listen.

Thanks Leroy!

Getting Normal Again

Trying to resume normal activities after such a long deployment is rough. I got used to the FEMA rule set and the degree of complete chaos involved in responding to a disaster. I got used to the high stress level and constant movement. There are many differences between normal station life and a deployment of that sort. Here are a few things I figured out.

The People.

After working at a station for years you think you know the people you work with. Everyone has dirty laundry that gets aired from time to time and you just kind of take it in stride as part of working in a EMS setting.

You put those same people in a disaster situation where you need to rely on them 24/7 for 30 days and you know what kind of relationships you have really cultured over the years. You want to really get to know someone? Deny them a shower for a week, feed them MREs and keep them up for 22 hours of every day. At the end of your deployment you will know exactly what kind of person they are.

With that said I learned that the people from my area are exactly the same as they are on station. We have put in the time and years to work well together under any circumstances. They performed exactly as I knew they would and their short-comings were exactly where I expected them to be. I played to that a lot and kept them propped up where I needed to and leaned on them when I needed to. I was glad to have them there and I could not have done the job without them.

Now... there were several people that were accepted to go that I knew little to nothing about in the beginning. They all put on an excellent front when they had their face time with me but in the field I could see under currents forming. I could smell dissent and I knew that a few of them were not cut out for this kind of assignment. We would have to do the best we could to keep them all in line. I spoke with my right hand man (sometimes he uses his left) and the safety officer and let them know my concerns. They had also started hearing the bitching and complaining that was done out of earshot from me. We decided that it was just normal stress of being away from their families too long and it would pass.

Well... guess what? We were wrong. Seemed like in our eagerness to get as many people deployed on this mission as we could we wound up getting a few "Complainers" in the mix. Nothing fucks up a good op quite as efficiently as the "Complainer"

One morning during my MRE induced explosion in the porta-john I overheard one of the complainers stating to another complainer (they feed off each other) that if they were assigned one more 911 call they were going to leave the truck, get a plane ticket and fly home. Now, being the asshole that I am, guess who did the next 8 or 9 calls? When they approached me about it several hours later I asked them "Miss your flight?" Needless to say, they knew I had overheard the conversation that morning and they did their best to kiss my ass the rest of the day. I was considering installing turn signals on my BDUs so they would stop running into me. Everyone needs to vent ... Just try not to vent when the Chief is shitting in the porta-john 10 feet away.

Then there was the ones that on day one I thought "They ain't gonna make it" the kind that was red faced and looking lost from the moment we started our 1700 mile journey. You would see them at the gas station stops looking like someone had beat the shit out of them. I was worried that we would need to fly in replacements before we even got to Texas.

Oddly enough, they proved me wrong. As the stress got higher and higher they stepped up and took charge of their situation. It seemed like they might have had something to prove to themselves. When we got home from Gustav they were the first ones that signed up to leave on Ike in less than 24 hours. They will make excellent additions to our team, I'm glad I got the chance to know them.

I know I have been prattling on about nothing for several lines now so I guess in closing this topic let me say that people will surprise you. Give them a chance to piss you off before you lose all hope in their ability to succeed. You might just end up with a new friend.

The Job

Oh my God... the differences are astounding. You would think that the life of a paramedic is exciting but if your not in the field you really have no idea. EMS is essentially many, many hours of intense boredom briefly interrupted by moments of sheer panic. There really isn't that many exciting things that happen day to day. It all becomes pretty mundane in the long run.

On a hurricane deployment things are vastly different. Many, many hours of panic briefly interrupted by moments of sheer exhaustion when you collapse in your unit. That goes on for the first 24-48 hours then your body kind of goes numb and your consciousness slips into auto-pilot. Every single bit of training you have received starts prancing around in your head and you become a machine. Do it, do it again...do it again...stay alert...drink more coffee...be safe...check on your crews... Check...re-check.

Coming back to the station after that was kind of a let down. Nothing was happening fast enough and I found myself bored within a matter of minutes.

The Conclusion

If you get a chance to do it. Do it! We were honored to be there. It was the largest EMS response in United States history and we were all a part of it. We helped as many as we could and we mourned those that we couldn't help. We made friends in most unlikely of places and we measured each other as no one will ever be able to again.

Never Mistake Motion For Action -- Hemingway

Ike was rough.

So my truck is wrecked ... I'm in a new relationship ... My kids just started a new school ... My lawn needs mowed badly... The house bills are due ... The lawn mower is broken again ... The windows need winterized and my living space is destroyed after I get back from Gustav. So what do I do? Yep, I leave on Ike.

This deployment was a sharp contrast to all of the hurry up and wait of the Gustav deployment. We went to work almost immediately after getting to San Antonio. They shipped a few of the strike teams off to Houston to prepare for Ike's landfall and a few were sent further south as well.

25 units (10 of which were mine) were sent to be the first boots on the ground in Galveston. It was the most coveted assignment there was, we were honored to accept the responsibility.

We arrived about 90 minutes after the storm went through and it looked like we stepped out of the USA and into a third world nation. There was no power, cell coverage, water..NOTHING. We found where the city had set up a temporary shelter and got right to work with 300 or so people waiting to get on a bus to San Antonio.

We set up staging at a local high school and within 120 minutes we had assumed control of Galveston EMS operations. Those guys and gals had been working non-stop for several days now and their station was under water. They needed a break to get shit right and we were the people for the job.

FEMA had set us all up with phones that didn't work, Low-Jack that could not track us, GPS units that worked about 60% of the time and 2 way radios that would reach about 1 mile on a sunny day. So we felt well prepared to step into this hornets nest.

For the first 2 days it was non-stop with 911 calls. We ran a 15 truck rotation to try and get the guys some down time but you were lucky to get 45 minutes of sleep before you were woke up by something. Building collapse, fire, looting, MI, entrapment, diabetic emergencies... all of these things became so common that we didn't even bat an eyelash.

There were several USAR and DMAT teams attached with us as well and eventually we started working together as if we had all know eachother for years. It became normal to see buildings smashed and 50 foot boats just sitting on the top of houses. That chest of drawers on top of the 4 story apartment building was just another thing that seemed to belong.

The dead animals in the street began to bother me after a few days, it was stinking to hell. All of the fish that the storm surge brought in were rotting too, you kinda got used to that.

Profiteering assholes were everywhere. Finally one gas station opened and all of us were in some serious need of tobacco. I went in to buy a log or two of Grizzly mint... The sign on the shelf said 1.90 a can, he charged me 5.00 per can. When I pointed to the sign he replied: "That was before the hurricane sir" Well, it was tobacco not diapers so I didn't make too much of a fuss but I still walked out of there knowing I'd been screwed and there was nothing I could do about it. I paid my 50 bucks... and I had my tobacco.

I could sit and write for the next 5 hours of stories and adventures on Galveston Island and never come close to being able to tell you everything. So if there is something in particular you want to know about just leave a comment and I'll be happy to add another post.

As for now... I'm home. Hurricane Kyle doesn't look like he's going to do much so I can rest easy for a little while. It feels good to be home.

I got a new truck ... Things are going great with my girl ... The lawn is being taken care of ... The kids are doing excellent in school ... The bills are paid ... I bought a new mower ... and I plan on cleaning up my crap on Monday.

Hurricane Season

I've tried to be better about updating this blog but it always seems as if something interferes with my best intentions.

On the 28th of August our team was deployed to Texas for hurricane relief with Gustav. We got down to the greater San Antonio area and Gustav turned out to be all bust and no balls. That didn't keep FEMA from running our asses off for the better part of 10 days though. Returning patients to nursing facilities and private residences.

We got home last Sunday. All of us were exhausted and glad to be home. My children were missing daddy badly and I'm still culturing this new relationship with a great gal so I had priorities I had to deal with that didn't include a hurricane that caused just about ZERO damage on US soil.

Monday morning rolls around I kiss the girl and then my phone goes off. It's the boss telling me to mobilize the team again and this time add 2 more units so we can have 2 complete strike teams. Looks like hurricane IKE is not playing nice in the sandbox and we are heading back to Texas either that night or the following morning.

I drag my ass away from the girl and get dressed. She agrees to hang out with me for the day so we can at least have some semblance of together time before I'm gone for 10 more days. We hit Walmart so I can buy everything I had neglected to buy for the first trip.. (that was 140 bucks) and then we roll on over to the station so I can see what kind of damage I can cause there.

My guys had everything under control at the station, all there was for me to do was finalize some paperwork and arrange for a few replacement members. Almost everyone who deployed for Gustav wanted to deploy for IKE too... I think it was something about the being paid for 24 hours a day 7 days a week that enticed them... I dunno.

Baby girl borrows my truck so she can scoot out and get a shower... That's where it got interesting.

The station phone rings... they holler for me and tell me it's her. Hmmm... why wouldn't she call my cell phone. I knew something was wrong.

Sure enough she was puttering along minding her own business when WHAMO she got smoked by a laundry truck. Totaled my truck.

A buddy of mine was the responding officer and he called to tell me what had happened.

COP: Hey, where is your insurance card man
Me: Probably at home on my desk.. just use the old one it's the same info
COP: Ok
Me: How is the girl?
COP: She is fine
Me: Ok, that's cool... Can the truck be driven the 2 blocks back to the station
COP: Maybe..ya, I think she said she's taking it to the station. It's in pretty bad shape...
Me: I don't care... at 35 years old it's one hell of a lot easier for me to find a 3000 dollar truck than another 20 year old girlfriend
COP: (laughing) she is fine
Me: Thanks

She gets back to the station a little sore but not complaining of anything major. Her biggest fear is that one of my units would have responded to the call and called me before she had the chance to. I told her it was just the truck... had she wrecked the motorcycle then we might have had an issue.

Meanwhile back in the hurricane deployment stage we are still short 2 units and 3 sets of ALS gear. We don't want to send any basic crews because they are not billed the same as ALS crews. If we send all ALS crews obviously the paycheck is MUCH larger. So I'm in the mad scramble to get everything ready. We only have 24 hours from the time of being activated to get to Texas and check in and it's a LONG run for us.

That night she was heading home and stated that she was going to make a trip to the ER to just get checked out.. her neck was sore and she didn't want to be FUBAR the next morning. I took a couple sleeping pills and forced myself to go to bed early so I'd be ready when the deployment call cam in in the morning. She ended up back at my house later that evening although i couldn't tell you when.. I noticed something soft that smelled nice in the morning and that's the first time I knew she was there.

She heads off to have breakfast with her father and his friends and I head into the station with the rookie and all of our gear. No call yet and everything is set on my end so I decide to face my fears and go have breakfast with her and her Father.

It was not nearly as bad as I had imagined. The conversation was light and everyone was cutting up. They were teasing her pretty bad about wrecking the truck the day prior and my guys were just happy to have me buying them breakfast. We finished our meal barely and my phone rings... Get your team and head for Texas.

We just about kill ourselves getting to Texas in time but here I sit in a parking lot in Houston after being in San Antonio all day yesterday. I know the score now from the Gustav deployment and besides missing baby girl and the boys I'm ok with the world at large.

My guys want to go, they are pumped up on stale biscuits and coffee..they want to work and I keep telling all of them that it takes time. FEMA moves at their own pace and things don't happen on "Paramedic Time"

We are here to help.. waiting on a hurricane that is predicted to be pretty bad. As of right now though we sit and wait. I think I hear the porta-john calling my name. That MRE I ate yesterday is about to be re-visted and I don't think it's going to be plesant.

I'll write more as soon as I can.

Ambulance Ass

I have a reader who asks about physical fitness in EMS. She is inquiring about what type of work-out we do and how to be able to pass some PT tests.

I think she said she needed to be able to lift 85 pounds 48 inches. I can only assume that would roughly be the weight of the cot while loading it into an ambulance.

Ok, to start at the beginning. If you work in EMS and you don't follow some sort of diet and/or exercise routine you will gain weight. Simple as that. No one escapes it forever. We affectionately call this "Ambulance Ass".

I'm about 5'10" tall and I weigh in at a chubby 216lbs. I was at 240 when I knew I had to do something before my penis disappeared. I gave up Pepsi. Yep, 24 pounds shed in 4 months just by giving up the Pepsi. I also started drinking my coffee black. No cream, no sugar. I mean, COME ON, what do you drink coffee for? It sure ain't the taste.

The biggest problem I saw with my rapid weight gain was the fact that I was eating all the wrong foods at all the wrong times. This is still pretty hard to control given the nature of our work but if you make simple corrections like NEVER EVER eating after 7pm and watching your portion size you can at least hold back the progression while you work out a way to lose some of the extra baggage.

We have one guy at our station that has went completely nuts and lost over 60 pounds in 6 months. He has given up almost everything that tastes good. I think I lack the courage of that convection though. I mean...No Cheese? No Way! Whey protein shakes...water all day and a sensible dinner? I guess I'm just not a sensible guy.

As far as our reader's question goes. "Just Do It" if you are having trouble lifting 85lbs 48 inches...Just do it. Go to one of your volunteer departments and load the cot with a person on it over and over. Do it as many times as you can, remembering to put the stress on your legs and not your back. We have had PLENTY of smaller people build themselves up this way. It would also not hurt to go out to your local Walmart and buy some 2-6lb dumb bells. It doesn't seem like much weight but if you work out with them every day you will see an improvement in your arms and chest.

Everyone who wants to do this job can, it's just a matter of how much effort you want to put into reaching your goal. You'll get there.

As for me. Well I have lost 14 pounds and I'm losing more. I told you earlier how I cut out pop and sugar in my coffee...Well I also started dating a girl quite a bit younger than me. Keeping up with her is aerobic in it's self. I find more time to run around with my children and I try to stay active in the garage and away from the computer. If you sit and do nothing all day, don't be surprised when you develop ambulance ass.

OMG It Changed!

Yes, we are working with a new look here. The reason is 2 fold really.

#1 I really got tired of looking at the old format. It was boring and not very friendly on the readers eyes.

#2 There are a lot of cool new features that can only be used with a template upgrade, so I figured... Why not?

So far I have added a little tool that tells you important things that happened today in history and a way to search youtube and watch videos right from the sidebar. Type in paramedic in the little box. Some funny stuff there.

If you have any suggestions please drop me a line!

Z

The Pain Of Living.

In the course of doing our job we see plenty of horrible things. Some things you literally wish you could "Un-See". It's all part of that sacrifice we make to try and force a difference in the outcome of people's lives. The general public should never have to see these things.

An old paramedic once told me "Son, God made EMTs to give him a chance to change his mind but you have to remember that he does not always change his mind". It's those words that help me through the rough calls. What solace does the layperson have in those troubling moments?

I was thinking of this my last shift when we had probably the most horrible motorcycle accident I have ever witnessed.

We were posted across town on a special event when the alarm dropped. Our other unit was about 2 minutes away from the accident and they had an extra crew member so it was not likely myself and my partner would be called. Well, at least that's what I thought as I sat in my lawn chair sipping a cold cola and nibbling on fair food.

They had to have been on scene for about 30 seconds when the second alarm dropped and my partner and I packed up our chairs and raced to the scene.

On arrival I was pretty astounded by the lack of scene control. The road was sufficiently blocked off and there damn sure were plenty of cops there but no one seemed to have a handle on all the gawkers. It was very hard for me to determine who was involved in the accident and who was just standing around.

I send my partner to help the crew working on the motorcycle driver and I proceed to beat the bushes, so to speak, to find any other patients. I turn up empty, the driver of the car was uninjured and in police custody.

Making my way back to the trauma patient I see at least 2 maybe 3 people weeping so hard they can barely stand. As I survey the motorcycle driver I see he is being aggressively worked by my guys so I think I would be most useful trying to calm the bystanders. With the assistance of a couple police officers we get all of them off the road and over to the grass where I can try and answer any questions to the best of my ability.

They were screaming "He's dead, I know he's dead" I replied with the standard: "Everything that can be done is being done" they were not buying it. I knew he was a trauma arrest and his chances were very slim, but how do you tell that to people? You just kind of bite your lip and hope for the best.

Someone had used a whole roll of paper towels trying to stop the blood pouring from this guys face and head. What had been going through their mind when they were doing that? What horrible visions are they having today every time they close their eyes? They pile more and more paper towels on and the blood never stops. Finally EMS arrives and things are moving very quickly for them. It must seem like a nightmare, a painful visage that can not shake even with all of the light of a noon day.

I think I was most concerned with the driver of the car. How would he live with the knowledge of taking a life? The police would not let us near him, but I was worried that he was in shock so I went and talked to the Sargent. He made a few wild hand gestures and I was allowed access to the driver. He was literally destroyed with guilt. He wanted to know if the guy was going to make it. I'm sure you know how I replied: "Everything that can be done is being done".

It was a traumatic arrest and all of us know the odds are greater than 1 in 100,000. The guys worked and worked securing an airway, then stabilized his spine and neck. Into the truck he went and they left. My partner and I were left to collect the equipment from the scene and bag up all the biomass for disposal.

We were told later that he regained his heart beat after a couple rounds of Epi and Atropine in the truck. He was delivered to the ER with a pulse. I was very proud that, the guys were on cloud nine!

6 hours later, when his heart stopped and he was pronounced dead at the trauma center we were all in shock. It's not fair we said. He beat the odds! HE BEAT THE ODDS! How could he die after surviving such a horrible accident? How could God let this happen?

Son, God does not always change his mind.

Z

New plan!

After going back through all of my posts on the blog I realized that there are a lot of really interesting people that have left comments over they years. I feel kind of crappy only posting once a month or so. I feel like I'm letting people down.

So here is the new plan. I'm going to start posting at least once a week. Every week there will be new content. It's not like I don't have something to say, I just forget. I have made myself a little sign and stuck it above my desk that reads:

"Have you had your blogger therapy this week?"

I encourage all readers to send in comments or things they would like covered. If there is anything on your mind, drop me a line and we'll work through it together. I will supply an email address and put it in the links to the right of the content.

Take Care

Z

To AMA or Not to AMA. This is the question.

Ok, we have all got those calls at 4am that you just know are bull-shit. You arrive on scene and find lots more drama than trauma. You know they don't have any serious problem... or do you?

Today I had one that was kind of strange as far as possible AMA's go. You see, I don't talk a patient out of going to the hospital ever. I always felt it was my job to talk them into going to the hospital. After all, they did call 911; I would like to think I was there for a reason.

50is woman in a praying position on the floor with arms holding her up against the side of a night table. I stated "Mam, I'm here with EMS, can you tell me if you hurt anywhere?" She replied very slowly: "No I don't hurt but my legs and feet are asleep, I've been down here 3 hours."

After a brief assessment myself, my partner and the FNG helped her to her feet and she could not bear any weight (This lady was 400lbs +). We sat her down on the edge of the bed and began to sort through the laundry list of medications and diagnoses she had. All of which are not really important at this time.

After assessing her again sitting this time I noticed that she was answering everything correctly but it was taking her forever + 1 day to do it. She was incontinent as well... So I'm thinking seizure or stroke right? She is flat out refusing to go to the ER. She states they wont do anything for her. We run baselines and check a sugar... 320. Ouch, that sucks... now I'm thinking DKA or Hyperosmolar NKA (Medic school taught me big words).

The only person there to help her is her 75 year old mother, and there is NO WAY IN HELL she would be able to help her to the bathroom or to get a shower. I call the doctor hoping he will mandate her. No Dice. He told me that if the patient was A&O he wasn't going to mandate her to be brought in.

So here I am with this problem. I know she needs to go, my partner knows she needs to go...hell even the FNG knows she needs to go, but she refuses to go.

Finally I leveled with her. I told her that I was not comfortable with her being by herself and I knew that her mother could not get her cleaned up or even up to go to the bathroom. She nodded. Then I gave her the option of agreeing to go to the hospital with me or I was going to be forced to call the social services officer to place her in protective custody.

After a few minutes of word wrestling and a couple unflattering comments made under her breath she agreed to go.

There really is no moral to this story, but consider what could have happened to her if I would have just happily had her sign the AMA form and left. What would have my responsibility been then?

Food for thought: Have you ever signed off someone only to have it come back and bite you in the ass? Let me know.

Z

It's a TRAP!!!

What kind of friend would I be if I did not keep all of my avid readers apprised of every single thing I find to be utter bullshit or a blatant attempt to deceive me?

No friend at all that's what kind. So, even though this does not pertain to emergency medicine or emergency services in any way at all; I still feel the need to vent a little and let all of you single guys out there know about the great many traps I've either fell into, or almost fell into over the last 18 months.

It has only been the last month or so that I have started to notice feeling lonely. With that said I dabbled a bit over the last 18 months, but I really started examining the situation over the last 2 weeks or so. I think I have managed to piece it all back together again in my mind; or whats left of it since medic school. CT would show Swiss cheese, I'm sure.

#1 Never date for the sake of dating. You will only end up miserable WITH someone rather than the preferred "Miserable Alone"

#2 Never suggest to your 2 sons that you haven't dated seriously in over a year and a half.

I woke up to my phone ringing. The female on the end said she saw my oldest son at the supermarket with his mother (my ex of course) he said to her "Mam, your very pretty and not wearing a ring.. My dad hasn't dated seriously in over a year. I'm sure he is lonely" The lady who we will call "Lacie" wanted to call me (after getting my number from MY son) and say it was the sweetest way anyone has ever asked her out. I promptly told her that I had not asked her out. After a few seconds of conversation she obviously thought the guy standing behind my ex and my son was ME... it wasn't. I was laughing too hard when I hung up the phone to call the boy and be stern. I waited until he returned from his mothers house the next day and told him if he were to ever set me up again to offer a picture and then call and warn me. He promptly agreed.

#3 Stay away from online dating sites.

Ya they seem "Fun" and "Harmless" but they are not. I tried out Yahoo's service for about 6 months. They were running some special for 60 bucks or so, I figured I'd spend way more than that in a single night at the bar so why not give it a shot.

The first one I got was amazing. She sent a picture and I sent mine. We talked for hours and hours for the first few weeks on Yahoo Instant Messenger. Then one day she offers her phone number and we start talking on the phone. We had so much in common, we had the same likes and dislikes. We had the same view on politics, children, world events etc... This all carried on for about 3 months. Then we decide to meet. On the day before the meeting she calls me and tells me she has a confession. The picture wasn't her. She is 10 years older than me and 17 years older than she told me she was. She is married and has 3 children. Well I have to admit, I was a little stunned. I had never done the online things before and I thought "Gee, I get the real deal right out of the gate...this is AWESOME" Now I know better.

The next few were pretty bad. A few dates, a few disappointments. I had one that was sort of promising but then I realized that she really didn't care for children. Every time I would mention my boys and the fact that they are with me a lot she would say things like "Well you don't ALWAYS have them do you?" It only took 3 times for it to sink into my thick skull and I never returned any of her phone calls after that. My sons are the biggest part of my life. I love them more than anything, they are my best friends. We are a package deal.

#4 Avoid all MOB agent sites! (Mail Order Brides)

Ya so I was feeling a bit lonely one evening and I decided to myself "Self, if you can't meet the right kind of women here... go abroad!" So I start researching meeting women from different countries. All of the websites pitch a good game but when you start peeking under their skirt (so to speak) you get to the hairy mess of it. 99.5% of them are blatant scams. There is no easy or efficient way to sort out the reputable from the scammers anymore. Some sites have BOTH on their pages according to a few articles I read. I spent the better part of 6 hours reading horror stories of men scammed out of THOUSANDS of dollars in the search for love abroad. It was enough to deter me from ever trying to navigate those narrow streets.

#5 Kill all who offer you a blind date.

The phone rings, it's my buddy Chris. First question out of his mouth. "Dude, your still single right?" I affirm reluctently. "Dude, you have got to help a brother out here.. I have this date tonight but she is shy. She will only go out if her BF can come with us" I asked Chris if he could remember ANY of highschool and why I should be forced to play some stupid ass games with his date prospect and her "BF". I further informed him that I was 35 damn years old and he was 36! "Why are you even considering this" I asked. Well, he sent pictures and like the weak bastard I am... I went.

The lady I was set up with was attractive, 5' 5" about 135lbs and brunette. She was a considerable bit younger than me but I could adapt. I'm 35 not 65. She had a wonderful smile and I was starting to feel a little more at ease about this blind date.... Until she spoke.

"Hi man, I'm.... like..... Amber. Whats your name?" "Oh thats right Shelly told me you like.... are an ambulance driver or sumptin right?"

I felt like asking her if I could answer her first question before I addressed the "ambulance driver" question but then I quickly realized it would be to no avail. I start scanning the room for the exits then a brilliant plan comes to me. I excuse myself to the bathroom, call a buddy and cash in a favor.

I got back to the table and sat down. She was babbling on about some idiot on MTV's "The Real World" and how much she lusted over him. I was smiling and nodding. Trying to bide my time.

***Pager Alert*** (Show pager to Amber)

I'm sorry Amber, there has been an industrial accident. I need to get my team mobilized. We will have to do this again. She smiles and looks at me "Can I go?" I told her I was afraid not and got the hell out of there.

She actually called twice. I was unavailable twice as well.

So here I am. At work, praying for a call to come in so I can occupy my mind a little. I'm sitting up in the office typing this while the other guys are down stairs watching reruns of old movies. Most times being alone doesn't bother me. When my boys are home or when I'm busy I hardly ever think about it..... but sometimes, just sometimes I wish I could remember the scent of a woman's hair, or the way she smiles at you when she likes you, or the way you can just be close and not have to say a word.

Sex once in every 12 months wouldn't kill me either. Given my options and my misadventures I think I'll stick with the bar, at least then you know what your getting...or you at least know what the presentation looks like. I don't need a double cheeseburger from Micky D's every night... but just once in awhile I'd at least like to be able to lick the cheese off the wrapper.

night.

I Let Her Die.

The call comes in early in the morning around 12:30am to take a elderly female back to the nursing home after treatment at the ER for dyspena.

My partner and I arrive to find a 88 year old female with a GCS of about 4 working hard to breathe on 15 lpm by mask. Rate was about 32, SPO2 91%.

We ask the ER doc what O2 he wants her to go back on as the nursing home can only provide 6 lpm by concentrator. The doc then informs us she is hospice care and hands us a newly minted DNR.

We switch her over to a cannula at 6 lpm per the doc and begin the transport.

She makes it about 10 minutes and codes.

As we arrive at the nursing home I leave my partner in the back so I can run in and talk to the charge nurse and try to explain the situation. The charge was just as confused as I was. I guess what we were both wondering is why the ER didn't put her on the cannula and let the dying process happen there?

There are specific protocols for letting a patient die in the ER and there are also protocols for letting them die in a nursing facility under the care of hospice. There are NO DEFINED protocols for allowing them to die in the squad.

It all was very alien to me. My mind knew I had to follow the direction of medical control but my soul was screaming to do something... ANYTHING!

We knew she was going to go. I just didn't want her to go without her family around. I had offered to let them ride in the squad but they chose not to for one reason or another.

I feel sad.
Rest in Peace.

Frustrated!

I'm still settling into this whole "Paramedic" thing. Trying to find my place in the grand scheme of things. I have made a few very painful realizations over the last few weeks. I'll share a few with you.

#1 Your never as smart as you think you are.

You might have gotten perfect grades in school and you could have been a damn good basic or intermediate but thats no indication of how you will be as a paramedic. You see, you have always been able to secretly think "I'm not the medic, it's not my final decision" When you get that medic card guess what? Yep.. it is your final decision and that scares the bejubus out of you. Take a few deep breaths and let your training and field experience kick in. It's likely you know the solution, you just need to give yourself time to access it.

#2 It's 50/50 now buddy!

I used to get such a kick out of screwing with my medic partners on BLS runs. We would go to a nursing facility for a seemingly routine transport and of course I would be expected to take it since the medic was normally in the back. I would get in and ask a question like "Good afternoon Mam, do you feel like you have any difficulty breathing?" 95% of them would say something to the affirmative and WHAMO.. I would call my partner to take the patient, they are the medic! After getting my card most of the medics I work with now are quick to remind me that it's all 50/50 now unless they feel like getting even for my past shenanigans and stick me with all of them.

#3 Even if it hasn't happened in 10 years, it will now.

Since I have recieved my card I have observed some crazy runs. Stuff you only see once every 5-6 years. Yep, I got the majority of it in my first week. I think it ranked about a 8 on the pucker factor when I was in the back with my first AAA. Prepare for the worst, it's coming.


All of that and the lingering thought that I should probably start dating again at some point. I mean, I'm ok with being single and all but every once in awhile I would like to have some sort of female companionship. No, it's not about sex (although that would be cool too) it more just about the connection to a female that allures me. Plus, women are soft and smell nice. The problem is, I have no idea where to start! I have been so self absorbed for the past 3 years I have kind of lost touch with all the things I SHOULD be doing to put me on the right track to romance. Plus the fact that romance in it's self bores the shit out of me. I prefer REAL conversation with rational people, all the romantic drivel just seems to mask what people are truly thinking.

So I post a couple personals on a couple obscure sites (I shy away from the popular ones) and I get half a dozen or so replies and I notice a trend of BIG women. I have to sit and ask myself "Self, are you only capable of attracting women at 190+ lbs? or is it that those are the only women looking at the personal ads. I certainly hope the latter is true or I'll be single forever. I know I'm a bigger guy, but I'm not obese. I do tend to gravitate toward smaller women but I have nothing against ones with a little meat on their bones either.

So ya, all in all... I'm FRUSTRATED.

Rant off.

Extra Time

Ok for the last year I've had my life pretty well mapped out for me. Work, School, Study, Rinse and repeat.

My work schedule changed like crazy due to people covering my class time. I never really knew when I was expected to work unless I looked at the schedule the day before. Now that things are back to quasi normal I hardly know what to do. I woke up this morning before my kids did, that was kind of cool. I walked downstairs WITHOUT a textbook and had some coffee WITHOUT looking over notes or drug flashcards, I stumbled out to the back porch to survey the damage of the last storm WITHOUT stressing over an upcoming test.

It only took me about 45 minutes to realize that I needed to fill some time now or I was going to go stark raving bat shit crazy. You just get so used to a mid to high stress level that when it's gone you ALMOST miss it. Note the use of the word almost.

I have to teach at a Basic EMT class tomorrow. I'm pretty excited about that and Wednesday I go back to work but today... Hmmmm.

I think I'll run a new electrical line for my family room AC today so I can watch TV and stay cool at the same time without blowing a breaker.

I think I'll investigate my eve spouts and find out why I'm getting water in my basement.

I think I'll work on the go-cart and get it running.

I think I'll clean up the fire ring and get it ready for a few BBQ's

I think I'll replace the window in the mud room that the storm took out.

I think I'll service the boys' motorcycles and have them ready to ride when they get home.

or.

Maybe I'll just sit and and try to talk myself out of grinning like an idiot. It's really over and I actually pulled it off. At 35 years old I went back to school and became a paramedic.

Still amazes me.

Big Fight!

I wake up in the morning at 5am. I don't shave. I didn't shave on Saturday and I managed to pass my practicals. So shaving is out for today. My nerves are killing me. I can't eat, just the thought of it makes me want to vomit. Since I didn't shave, getting puke in my beard would be bad.

I go in and kiss my boys. They have sacrificed so much over the last year. Daddy has been gone almost everyday and many events were missed. They miss their Daddy.

I stumble down stairs and turn off the AC, too cold in the house. I grab a Rock Star Energy drink, I know it will make me crash, but the test is only 2.5 hours so I should be done before the big crash happens.

I drive to the shop. The director is kind enough to drive us the 50 miles to our test. He wants to give us every opportunity to be as rested as we can.

The 3 of us don't say a word on the hour drive, we are too consumed with our own thoughts, ambitions, and fears.

As we arrive at the testing center the paranoia kicks in and my stomach starts to tumble. I feel like I'm here to do battle. They WANT to fail me and I will need to fight like hell to even have a chance. I know it's irrational, but thats what I think. I'm a fighter by nature so bring it on, lets get to it. It's either you or me NREMT.

125 questions later I walk out the door wondering how long it will be before I can reschedule. It was a good fight but I think they got me. A cheap shot indeed, but I think they got me. No matter, we'll fight again and things will be very different.

Quiet on the ride home too, I know it will be at least 6 hours before I will know the results of the fight. I was bloody, bruised and tired but I thought I got a few good shots in too. I might not have won, but that bastard would know he was in a fight tomorrow.

Pull into the drive and stumble in the house. Too hot, the AC comes back on. I crawl upstairs exhausted and fall into a coma.

Phone rings. Results are in.

THAT BASTARD GAVE UP! He rolled over and showed me his belly! I may be broken up and bruised but he couldn't continue!

I'm a Paramedic

Medic School Is Over

Medic School is complete and now the real stress begins. National Registry.

5 Days from today I will find out if I'm a brand new paramedic or if I have fallen short of my goal and need to study up and re-test.

Lord knows I would like to accomplish this on the first time around, but I know many fine paramedics that had to take the test several times.

Then again... I know many crappy paramedics that only took it once.

I don't know how to feel really. One the one hand I'm EXTREMELY happy to be done with school. I have let a lot slide in the last year. On the other hand, I'm about crazy with nerves about this test.

Wish me luck.

Medic School and Clinicals. A Journey Into Hell.

Greetings all, sorry I haven't posted in awhile. I have been crazy busy. I promise I will be more attentive to this blog as soon as school is over. 10 weeks, 2 days and about 6 hours from now.

Let me start by saying the "school" part of paramedic education is not bad at all. If you have been in the field for any length of time you already have a pretty good idea of whats going on, you just need to learn to do it the "right" way. Or rather, the way that National Registry wants you to do it. If you apply yourself and read your subject matter the course work is really not that difficult.

With that said, clinicals are a bitch. It's not the skills that bother me or even the fact that in the hospital your working out of your element. It's the hours required or number of skills performed. I know some college educated idiot and all his buddies sat down and decided this is what is best for me, but I don't agree. I work between 50 and 90 hours a week. I use my skills on a daily basis and I work with a paramedic. I get absolutely NO CREDIT for this. In order for a clinical hour to count I have to be the 3rd person on the unit and supervised by a preceptor (never mind the fact that my partner is a preceptor). Lord willing, I'll pass my National Registry and then I'm going to start lobbying to do something about it.

Thats right, you all have never known me to be quiet about anything. I think I'll start with a letter to the State and then work my way up to the Feds. There has got to be something we can do for all the students that already have a vast amount of experience in their field. Some sort of testing procedure to PROVE the skills are mastered and can be grandfathered.

Let me give you a little example. I'm an advanced EMT, have been for a good many years, and I'm required to have X amount (whatever the program requires) of I.V. starts for my paramedic education. Oh please! I can start an I.V. in my sleep. I think it's utterly absurd that I have to be tested on something that I have mastered, and PROVED when I took my National Registry for Intermediate. We have got to stand together and call this "Bull-Shit". Don't bitch to your instructors, it's not their fault. They are only following guidelines that are set for them by the Governing State you are in. We need to start at the top and scream that this is shit. Politically of course... You wont get far calling your State EMS Department and using words like "shit". They will most likely just re-educate you to what a dial tone sounds like.

It's been nuts since last May. It started with A&P and then we got August off and medic school started in September. Here we are at the tail end of March and I can see the light at the end of the tunnel. I still have a considerable amount of clinical hours to complete, but I think I have it worked out so Satan only gets 1/2 of my soul.

I'm still a station officer and I feel bad about all the things I'm NOT doing there because I have to study or go to school. I'll get back on track as soon as school is over.

That seems to be the underlying theme with medic school. You are constantly making promises to fix things that you broke during school. I need to eventually find another girl-friend, I went through a messy break-up last July. Medic school wasn't the only reason, but it helped I'm sure. I need to be a better friend, I have lost touch with some really close friends because of school. And lastly but the most important to me. I need to be a full-time daddy again. My boys have suffered the worst of this and I'm tired of sacrificing time with them.

There will be points in your medic education where you just want to throw the book into a burn barrel and say "to hell it it". Don't do it. Close your eyes, take a few deep breaths and work on one issue at a time. If you look at the entire paramedic education picture it's easy to be overwhelmed. Focus on one aspect of it and complete that. Continue doing that until you have it sorted out enough that you can step back and look at your progress.

About a month ago I had enough. I was so close to calling it quits. That night at school the instructor called me into her office for our evaluations and said that based on my test scores she didn't think I would have any trouble with the final exam or the National Registry exam. She told me to keep it up, and then she reminded me I was horribly behind on my clinical hours. Well, I felt better and worse at the same time. Then the next day I went to surgery and managed to complete my clinical requirements there. I felt better and the worst of it was behind me. Push on.... Push on!

We'll chat soon I'm sure, but until then. Do what you do, love what you do and never let anyone call you a fucking "Ambulance Driver".