A long story, Part III: The Poignant Question

…continued again from the other day, and the other day’s other day…

 

So while we are all sitting in front of my friend’s garage, watching the big red truck and the small red truck pull up to the house, Bubba looks confused. I don’t have much to say, because things are going to get busy in a few seconds, and I’m trying to stay out of the way.

They unload their equipment and make their way up the driveway, introduce themselves, and begin to work on Bubba.

I’m standing somewhat back, ready to answer any questions they may have, but the situation is very well in hand. I’m not a paramedic right now, I’m just a guy standing with a patient.

I can see Bubba looking at their patches, and we all notice the ambulance’s arrival at the end of the drive.

“Y’all from the fire department?” he asks. It sounds more like “fur duhpurtment,” but we all are fluent in Southern drawl.

“Yessir, we are.”

“Well, what are y’all doing here?”

“Sir, you called nine-one-one. We come to all emergency calls.”

“Well that’s just stupid, ain’t it?”

“Why would you say that, mister Bubba?”

“I called for an ambulance, man, not a fire truck. Why did anyone send a fire truck when there wasn’t a fire?”

 

Later, I told him that I’ve been asking that same question for somewhere near fifteen years, and when he found the answer, to let me know.

A long story Part II: The Mix-up

…continued from the other day…

 

So I gave Bubba some aspirin, Vicki chilled the hell out, and we moved Bubba outside near the garage. Mainly to keep everyone away, but also to make it easier on the first responders.

Stairs and all, you know.

So the responders arrive, first the big red truck, followed by the small red truck, and then, a few minutes later, the ambulance. It was at this point that Bubba asked a very poignant, pertinent question, which I will save for tomorrow’s post.

These guys are doing the whole ALS thing to him. The guys in the small red truck leave seem anxious to leave, but the guys from the big red truck have their cardiac monitor, so they can’t go just yet.

Bubba’s getting a 12-lead.

One of the guys from the small red truck is looking at it, and he turns to one of the guys from the ambulance and says “looks like a real slow sinus brady with a real long first-degree block.”

“Hmmmm” says the ambulance man.

Mind you, I took Bubba’s pulse several minutes ago, and it was in the 80s. Bubba doesn’t look like a guy would have a “real slow sinus brady.”

“Can I see that real quick?” I ask.

One of the guys from the big red truck looks at me quizzically, as if to say “what the hell does this strange fellow want to see the EKG for?” but the ambulance guy hands it over to me, as they start to move Bubba onto the stretcher.

It’s pretty clear that it isn’t a sinus brady at all. And there isn’t a first-degree block anywhere.

I hand it back to the ambulance man. “That rate is somewhere near 80, and there isn’t a first-degree block.”

Before the ambulance man and the man from the small red truck can lecture me on how they know how to read an EKG, and I’m just some doofus with a party hat, I point out the answer printed right there on their paper.

“Your printer speed is set to fifty.”

He looks like I just explained string theory.

“Normal is twenty-five.”

“…Oh…”

 

A long story, Part I: The Freak-out

So, I’m visiting a friend’s house for a child’s birthday. I know what you’re thinking: I don’t have any friends. And you are right. Sort of. I have, like, three. And I was at the home of one of them.

His father-in-law was also there. A large, hulking man, built like a defensive lineman. Sort of like a big square with legs.

He comes up to me, and kind of hushed, says “my chest feels a little tight, C. What do you think I should do?”

I ask him about his medical history and all that good jazz. He’s 62, mildly overweight, hypertensive, with high cholesterol. He had a normal stress test a few months ago, and his EKG was “normal” according to the doctors. He’s never had a heart cath, or a heart attack, or anything major happen to him. He takes his medications regularly like he is supposed to, and everything is managed appropriately.

Our conversation is noticed, and his wife comes over and wants to know what’s going on. “My chest feels a little funny, I was just talking to C about what I should do” he tells her.

The next few minutes saw his wife almost have a syncopal episode, fan herself with a paper plate, say “lawdy jeezus” at least three times, and she summoned no fewer than two of her middle-aged concerned friends over. The next conversation went something like this:

“What should we do?”

“Probably put him in a car and take him to the hospital.”

“We should take him to an urgent care center!”

“Urgent care would be a waste of your time. Go to an Emergency Room.”

“Should we call 911?”

“No, just leave now and go to the hospital right up the-”

“I’m calling 911!”
“There isn’t really any need for that, he could be at the hospital before-”

“VICKI! CALL NINE-ONE-ONE! BUBBA’S HAVIN A HARTATTACK!”

“I really think that he would get there quicker if you just drove to the hospital yoursel-”

“BUT HE NEEDS PARAMEDICS! VICKI! WHERE’S THE AMBULANCE!”

“You do realize that I am a paramedic, right?”

“Yeah, but you aren’t working right now!”

 

I sighed, went off to find some aspirin, and sat down to wait.

 

To be continued…

So long, Slimm

After three years, and thousands of calls, the end of C and Slimm is here.

Management has seen fit to end the best work relationship either one of us has ever had and give us two new partners.

We did the math a few days ago, and figured we have run 3,285 calls together. Give or take a few. That figures 6 calls per day on a 12 hour shift. We’ve run some awesome calls: together we have almost 25 saves (seriously, he is that good), delivered 5 babies, one being a set of twins, and we even made the news a few times. He looks handsome on film. I just look stupid. We’ve run the bad calls too: nasty car wrecks with fatalities, more than a handful of deceased shooting victims, both homicides and suicides, a person hit by a train, and the man who asked us not to let him die. We failed him.

It’s been more good than bad, and even through the bad times we had each other.

We’ve laughed. A lot. We’ve cried. Not really. We’ve spent dozens of hours throwing a football, and even more arguing about what to get for lunch.

We had lengthy conversations during the Presidential election, and I couldn’t win the arguments. Slimm was hung up on the Mormon thing.

So now I get a new guy. He’s from Minnesota or something like that. Some state that isn’t Mississippi, but starts with an ‘M.’ I haven’t given him a nickname yet. I guess he’s going to have to earn it.

I often call Slimm my ‘brother from another mother of a different color,’ and I mean it. Slimm has become a trusted confidante, and an even better friend. I’m sure going to miss working with him.

My partner is back!

Holy cow, Slimm is back. I swear, I could have hugged him. In a buddy-type of way. I wouldn’t want to make him uncomfortable or anything.

It was a surprise, too. See, at Local Ambulance, we have a clipboard next to where all the keys are kept with the unit assignments on it. The usual procedure is you walk up to the clipboard, find your unit number, follow the line over to find which vehicle you are in, and keep going to see who your partner is.

I had quit doing that because I was becoming increasingly sad that my partner wasn’t coming to work with me. So I would find the supply worker, and ask him or her for the keys, then just wait on the partner-of-the-day to show up. Some days were good, some days were interminable.

So imagine my surprise when early one morning, Slimm sticks his head in the back of the ambulance while I am checking off the intubation kit.

“What’s up buddy?” he said.

I shrieked. Almost like a schoolgirl.

It’s not me, it’s you.

So the Mrs. has a best friend. Don’t they all? They’ve known each other for almost their whole lives, and talk every day about literally every thing.

Bestfriend is a nice girl. But I don’t like her. It’s nothing personal, I just don’t like her. This can probably be attributed to my not liking people in general.

This came up in conversation Friday, when the Mrs. suggested we go to Bestfriend’s house for a Super Bowl party. “Nah, I don’t want to” was my reply.

I will spare you the rest of the conversation details, but leave you with the knowledge that I was the subject of a small amount of angst, and a larger amount of anger.

And I watched the Super Bowl by myself.

But that’s okay with me!

It’s nothing personal with Bestfriend, it really isn’t. Like I mentioned, she is a nice girl. She’s pretty, with a non-shrill voice that doesn’t make me want to shove icepicks in my ear canals. She has a pretty smile, and is intelligent enough, while maintaining a slight air of ditzy-ness, to keep her personality cute.

What is it about this human condition that makes us have to like other people, and have to like being around them? Why do we try to fix people who are introverted, like there is something wrong with them?

When I was growing up, I had an uncle Jack, my mother’s brother. He wax about 15 years older than my mother, who was born in the early 50s. Uncle Jack was an introvert.

We would see Jack at family events, like Christmas and Thanksgiving every few years, and I swear he would never say more than a paragraph in a day. He just didn’t talk or socialize. One Christmas he actually took his presents to his room, and opened them by himself.

Nobody tried to fix him. It was just his personality, and nobody tried to fix it, because there was nothing wrong with him.

So back to the original question at hand: why does something have to be wrong with me if I would rather spend my time with a house cat as opposed to another person? At least a cat won’t interrupt the game during a crucial third and long.

Is there really something wrong with me because I would rather stay at home and read a book instead of going over to the house of a person that I don’t like to spend time with even more people that I don’t like?

Leave me alone; I’m doing alright over here.

Cliché

“Medic Eighteen, a motor vehicle crash with injuries reported. Possible entrapment.”

“Ten-four. We’re enroute.”

The MDT gives us a location well known for collisions, a windy road which goes around a good-sized lake. This stretch of road is hilly as well, with lanes that were designed for cars traveling much lower than the posted speed limit of 50 miles per hour. It’s fairly rural, with only a few houses, which are all a great distance apart.

It’s about a 15 minute drive from our station.

“Medic Eighteen, State Patrol is on scene, advising one vehicle is a Sheriff Deputy, and a pickup truck.”

I don’t like the sound of this. Neither does my partner.

“Ten-four, we are about seven minutes out.”

We debate calling for a helicopter, since the closest trauma center is easily a 45 minute drive. We decide to wait until we get there. The helicopter base is only a 5 minute flight away from the scene. It’s an area the flight crews know well.

“Eighteen, Trooper advises complaints only on the driver of the truck. Negative injuries on the Deputy.”

“Received. Two out.”

Good thing we decided to wait on the bird.

We arrive on scene just as the volunteer firefighters arrive from the other side of the accident. Lots of pretty colored lights bounce off the damp pavement and leafless trees.

We see serious damage to both cars. It appears that the pickup truck crossed the center line in the middle of the curve, and struck the rear driver’s side door of the Sheriff cruiser. The Deputy must have swerved slightly to avoid the collision, and luckily so. He certainly avoided serious injury.

Colored plastic and engine fluids are scattered and smeared all over the pavement.

The driver of the truck is walking around, talking with the State Trooper on scene.

I approach the Deputy, still standing beside his cruiser, and notice the airbag on his side deployed.

“Y’okay, buddy?”

“Yeah, I’m just a little shook up, but I’m alright. Go ahead and get your form out, I’m not going to the hospital.”

It’s always good when they know the routine.

I peer into the cruiser, to assess the steering wheel and windshield. And I see it. In the passenger seat.

3 large boxes from the local doughnut shop. The box on top is open, 2 doughnuts conspicuously missing. Then I see the smashed, half eaten, grape jelly doughnut on the dash, just underneath the light bar.

“Hungry this morning?” I ask with a smile.

“I swear, I was buying them for the guys this morning. We are going to the range to qualify with our pistols, I swear!”

“Sure thing” I say as I reach in to grab a glazed bit of deliciousness. I’m hungry myself, and haven’t had breakfast yet either.

“Man, I’m never going to hear the end of this, am I?”

Nope. Not at all.

Do we have to be friends?

I mean, seriously. Why do we have to be friends? I much prefer the title “acquaintances.”

I’ve never been one for needing/wanting/making friends. The people I consider friends are few and far between. I’m thinking there are 6 people I consider friends.

Not to say that I’m not friendly with others. I get along well with my coworkers and people I see at work, with a few exceptions. Like, 2 exceptions. Dumbass and Rambo. Whatever. That’s going to be another post.

Take Slimm for example. I like him. He has all the necessary traits needed to be a good person. He’s nice. He has a good work ethic. He’s a good father and husband. He’s a good EMT and a good partner. But we aren’t friends. We discussed this topic a few days ago.

His contention was that we were friends by default. From simply spending 12 hours at a time together in an ambulance, we have gotten to know each other well. As is to be expected in a partnership. He thinks “that makes us friends by default.” I disagreed, and informed him that we weren’t friends.

Slimm knows the names of my wife and children, and has seen pictures and videos. (Hey, toddlers are cute, okay?) But he has never met them. He’s never seen the inside, much less the outside of my house. Hell, he doesn’t even have a general idea, aside from a city’s name, where I live. And that’s perfectly okay with me.

This in no way means we aren’t friendly. I just don’t see the necessity of titling a relationship as “friends.” I much prefer to be “coworkers.” I would rather be thought of as a good clinician and strong paramedic, than a friend.

It seems that I take the opposite approach to the majority of those in EMS these days. The majority of my coworkers seem have this unspoken need to be friends with each other. Well, not all of them. It seems to be a generational thing. The younger crowd, of which there are increasing numbers, seem to have this inherent need for approval and self-validation. While I am one of the younger generation chronologically, I am a member of the older generation when considering experience. I have seen lots of people come and go from this field, and have met all types of people. Most come and go quickly. This is not a field for the faint of heart or weak-stomached. Lots of people that have come and gone simply can’t handle the stress that comes with this career.

And that’s okay.

I think of the Italian that I spent several years with. We worked in a low-income area with a large indigent population. We ran lots of serious calls, at least one per shift. And when I think of paramedic ability, he consistently ranks at the top of any list I can come up with. But he is an absolute jerk, and I despise him personally.

That doesn’t matter, at least in my opinion, because I respect him as a paramedic. I have since moved on to another service, and the Italian and I rarely cross paths, and if we do, it is while passing in and out of emergency rooms.

There were numerous opportunities for me to switch shifts, and change partners. But I stayed with him because I wanted to be part of a crew that did a good job, and was respected. The Italian taught me much of what I know, most importantly, the necessity of remaining calm under pressure.

While I can’t stand him personally, I can think of few people with whom I would trust the lives of my family.

If I have to be remembered as anything, I would want people to say “I would have trusted CCC with the lives of my children and loved ones.” That’s a far bigger compliment than “he was a good friend” could ever be.

Flash, who reads this blog, and is a frequent commenter, is one of those I consider a friend. While we met on an ambulance, and that’s the majority of what we have in common, it seems to be deeper than that. Flash has a child my age, and is only a few years younger than my parents. He has been a paramedic as long as I have been alive, if not slightly more, yet he understands friends is not what this career is about. He’s a devout Christian, (which I plan on addressing soon enough) and a history buff. Simply put, his life is not EMS. I hear he is an excellent organist, which is where he got his nickname. But I’ve never heard him play. I really should, though.

While his chronological age is closer to that of my parents, I have never thought of him in terms of his age. He’s always been plain Flash to me. I value Flash as a friend, and regularly seek his opinion on various topics. We share a mutual respect and admiration for each other.

Like I said, it’s far more valuable to me to be respected then friends.

Perhaps there is a need for validation because of the notion of self-esteem. Personally, I don’t think of self-esteem as something that comes from my list of friends, but from the satisfaction I gain from doing things right.

I can think back to early grade school, when I was first introduced to the concept of self-esteem. “It’s important to feel good about yourself, and being liked by others is a big part of self-esteem” the teacher would say.

That’s crap, and in my humble opinion, a large part of what is wrong with society.

When someone’s need for validation through friends outweighs their desire to do good and right by people, what we have is a disconnect. We have popular paramedics and EMTs, instead of good paramedics and EMTs.

Love me, hate me, like me, dislike me. I don’t give a damn. Just give me the chance to prove my competence. Once you give me that chance, I promise I won’t disappoint.

Respect me as a paramedic, not because we are friendly with each other.

Flash speaks

My friend and frequent commenter Flash has, after some slight prodding on my part, agreed to grace my blog with some of his thoughts. His comments are often worthy of their own blog, but Flash is content, for now, to remain a commenter as opposed to blogger.

His thoughts are fresh, intelligent, and cogent. He is wise beyond his years, and we could all learn from him.

Without further ado, I will turn this post over to Flash:

———-

Too Old To Work offered some kind comments in regard to my response to one of CCC’s entries and suggested that I ought to have my own blog. The Captain followed up by suggesting that I might write a guest column here. I’m not sure that I have enough to say sua sponte to support my own blog so up to now I have been content to respond here and at other locations to things others have said.

Several decades ago, I was at a seminar and a gentleman there made a very interesting and intriguing statement. He said, “I’m not here to tell you what to do and how to do it. The road that you’re walking has never been walked before and I can’t tell you what you will face or how to meet the challenges that you will face because they will be new. The only constructive thing that I can do is to tell you what not to do. I can say to you, ‘Don’t go down that road, it’s a dead end. I’ve been down that road already.’”

Now, these many years later, I feel much the same as he did. I’m on final approach and about to land this thing that is called a career in EMS after a flight of almost 3½ decades .

As I come to the end, I listen to you folks still in high flight, and I find that you are thinking about, talking about and taking EMS provision to much higher levels than were even possible when I began and through much of my career.

For instance, in your practice, 12-lead EKG interpretation at a high level is routine and you feel that those who can’t or won’t do it are deficient practitioners. When I started, we used a Lifepak 2 and we didn’t even have all the parts. The possibility wasn’t there.

But your strength is in more than technological because I believe that patient care is aided by technology but driven by the belief and the desire to be a more educated and skilled provider. I have, because of my early influences, long been one of the few voices crying in the wilderness (around here at least) for our emergency medical practice in the field to move away from that of merely being technicians to that of being clinicians. And that is something that most of you who are reading this now take for granted as the direction EMS should go.

Not all agree with you, so your mission, should you choose to accept it, is to continue pressing forward for that kind of care against all opposition and it will be considerable, as it always has been.

Meanwhile, I’ll occasionally tend to comment on some of the issues that face us and some of the directions EMS is going. I hope that some of my comments may be help you think through things as you move forward. Something I have always tried to remember is that people who care about something will from time to time disagree about how to achieve it. So if you meet an intelligent person who is invested in your cause, he is not your enemy, even if he disagrees with you. As Benjamin Franklin said, “Gentlemen, we must all hang together or we most assuredly will all hang separately.”

———-

If I were able to form my own ambulance service, picking the Paramedics and EMTs that I wanted, a “Dream Team of EMS” if you will, Flash would be a first-round pick. 

I may not know Flash outside of the virtual world, but I feel a kinship there.  I can imagine running the worst call ever with him as my partner, without a word being spoken. 

Thanks for agreeing to post for me, Flash.

I don’t like people

I don’t like people. True story.

Sure, I like taking care of people, but, as a whole, I don’t like people. Mostly the issue lies with dealing with the utter bullshit people pull. Sure, there are exceptions to the rule, but they are just that: exceptions. Generally, I like my colleagues and coworkers, and enjoy working with them. But out of uniform, I don’t like them. I like meeting new colleagues, and enjoy hearing their ideas. But, if it’s not EMS related, I tend not to care.

Don’t get me wrong, I don’t wish ill on anyone, or want anyone to get injured. But those genuinely ill or injured people are getting fewer and further between. Maybe it’s the years upon years of pretending to take “complaints” of neck pain from a parking-lot fender bender seriously, or maybe is burnout, I don’t know.

I would much rather spend a day at home, alone, than with others. I certainly wouldn’t consider myself a loner, or recluse though. I have friends, mind you, but they are a very small group. 2 of my roughly 10 friends aren’t involved in public safety. And I don’t see them often enough. But at the same time, I see them plenty enough.

It got to the point that a loved one suggest I see a psychiatrist, so I did. Nice enough lady with the fancy diplomas on her wall. She said I exhibited signs of an “avoidant personality disorder.”

“What’s wrong with not liking people?”

“It’s not normal. It’s not supposed to be like that. You should like, and want to be around, people.”

“Why?”

Then she spewed some crap about “normal” relationships, and prescribed me some magic pills that were supposed to make me happy. Even though I’m not unhappy. I told her I wouldn’t fill the prescription, and that she was wasting paper and ink, but she wrote it anyway.

Maybe it’s burnout, maybe I’m tired of putting up with the stupid crap that people do. Maybe it’s normal, and nobody else out there wants to admit it.  Maybe, just maybe, I should fill that script for the magic pills, and see if they make me a better person.