“Floyd, dude”

I’m transporting a nice guy in his thirties for a broken ankle. He’s a stoner, and currently high as a kite, which has nothing to do with the unfortunate injury he sustained. Regardless, it doesn’t stop the other first responders from judging him from his marijuana use.

I just wish he would share, and I didn’t have to occasionally pee in a cup.

He’s loaded in the ambulance, and we are on the way to a fancy building where they have the capabilities to repair his protruding tibia. He’s gotten a little bit of morphine, which seems to help his pain. He now describes his injury as “gnarly.”

Sounds of music waft into the patient compartment as Slimm turns up the radio a bit.

“Dude, is that Floyd?!”

“Yes, sir.”

“Is it Dark Side? What’s your partner’s name?”

“Yeah, we were listening to it earlier. His name is Slimm.”

“Hey, Slimm!” he yells. “Turn it up!”

My intrepid partner obliges, and we all jam out to Pink Floyd for the next several minutes. The delightful gentleman even gave an excellent air drum rendition during Money.

False competence

Double-ALS-night-shift-overtime. Half good, half bad. I don’t know why I agreed to work a night shift.

It’s going easy enough until around 3 in the morning. Diabetic call at the local premortuary sepsis factory decubitus plant nursing home. Easy enough, right? Throw some dextrose up in there and be done with it, right?

Wrong.

The staff says he must go to the hospital to be evaluated because the doctor says so. To complicate matters, we can’t get a line on this guy, who I swear, must have served in the first World War, and he has a long history of dementia, so who is to say what his normal mental status is, anyway?

Fine. No biggie. Stab him with a bit of Glucagon, move him to the stretcher, and drive him to the hospital. No big deal, right?

Wrong.

It’s my turn to drive. It’s going just fine. I’m listening to George Noory talk about aliens over the Pacific Northwest. It’s an easy drive over two lane roads dappled with houses. When all of a sudden…

“Hey, C, light it up, okay?”

“Dowhatnow?”

“Turn on the lights and sirens.”

“Huh?”

“Let’s go emergency!”

“Why?”

“His mental status isn’t improving.”

Taking a glance at my watch and doing some quick calculations, I realize ten minutes isn’t necessarily enough for Glucagon to work, and this guy has dementia anyway.

“Umm, you want me to get back there and ride this call?” I ask.

“No, I’ve got it. We should just get there faster.”

“I have faith in you. And the next three traffic lights won’t hold us up too much.”

—–

I’ll stop the story here, because the conversation became fraught with animosity. Suffice it to say, I don’t believe in traveling emergency to the hospital, except in extreme circumstances. I won’t judge someone who chooses to use the lights and sirens during some calls, but during a hypoglycemic episode, when there hasn’t been enough time to allow the drug to work, and the vitals are better than mine? No way does that warrant lights and sirens.

Especially not at three in the morning.

Let’s not trick ourselves into thinking we are heroes by running people off the road to get to the hospital.

Maybe services could review the calls in which the medic decided to utilize lights and sirens during transport. I bet there is some interesting information out there.

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.

A blogger outed

Somebody who knows me found my blog.

Uh-oh.

I have enjoyed a certain amount of anonymity from behind the veil of the internet, and have been quite fortunate. A few of my readers know my name, and an even smaller number, perhaps 3 or 4, have met me in my life riding on ambulances.

Sometimes I ponder on the benefits of my perceived anonymity.

Would I get in trouble if my bosses knew I blogged?

Would I get fired if they knew?

Have I crossed a line blogging?

Am I doing a good thing for EMS by blogging?

Do my coworkers read my blog?

Do they know who I am?

While that last question has largely been a resounding “no” over the past year, now there is one who knows. Slimm knows I blog, but he doesn’t know where my blog is, what my self-assumed identity is, and he doesn’t care. He will occasionally suggest an idea for a post, typically by saying “you should blog about that one, dude.” But he doesn’t read my blog.

My coworker has assured me that my anonymity will remain, and that he has no ulterior motives. He says he has been reading my blog for several months, and the “stories just clicked one day.”

I trust him to maintain my anonymity, but I wonder.

Is anonymity a good thing in blogging?

Should I head off any perceived trouble by approaching my bosses?

Should I out myself here?

Does it matter who I am, where I am, or where I work?

Can a blogger not just be a nameless, faceless guy with a patch?

—–

I would welcome input from you, my readers.

Its a girl!

No, there wasn’t a human baby delivered recently. I’m referring to the cow that today’s partner had on that call.

It wasn’t a big deal. Some dude passed out while he was driving, likely attributed to his blood sugar being 27. Then he hit a tree.

Trees usually win. But this was a sapling.

Much less damage than expected from the dispatch. But what else is new?

But seriously, how can we possibly do our job if we are pinging off the walls faster than a table tennis ball coming off the paddle of a Korean Olympic gold medalist?

Getting flustered and losing control is probably one of the worst things we can do as providers. Our patients and citizens expect a certain level of calmness when we enter a scene. After all, they are having an emergency (perceived or actual) and they expect us to know exactly what to do to mitigate the situation.

When we can’t control ourselves, how are we supposed to control the emergency?

Whenever I am lucky enough to stand in front of a group of eager, bright-eyed EMT students on their first day in class, I start my first lecture with the same sentence each time: “Be the duck.”

Imagine if you will, a beautiful duck swimming across a pond on a spring day. The duck is graceful and calm, and appears relaxed, but is moving towards some part of the pond with a sense of alacrity. But underneath the water, that duck’s feet are paddling as fast as they can go.

Be the duck.

Not awesome

“GSW/HEAD POSS DOA/NOT BREATHING” read the notes on the screen of the MDT.

I can literally see the adrenelin coursing through my partner’s veins, and I can literally hear his heart rate increase to a sinus tachycardia with frequent PACs. He has obviously never run a shooting before, and I think I can smell the wet ink on his EMT card.

“YES!!!!” he yells in a voice that is all too loud for the front seat of a small ambulance, as he slams the gear shift into drive.

Somehow we manage to make it to the front of the neighborhood in one piece, minus a little bit of rubber from the rear tires. Now we are staging.

Still staging.

10 minutes after we begin staging, the county dispatcher contacts the engine crew. “Engine 22, PD hasn’t advised the scene is clear, but they advise obvious DOA, and have requested a crime scene investigator. Will advise when scene is safe to enter.”

“Medic 7, County” I call. “Medic Seven.” “County, cancel 22, I believe we can handle.”

Engine 22 pulls away from the scene, into the rising sun.

After being cleared for entry by the county dispatcher, we make our way into the house.

“Upstairs, third door on the left, make sure not to mess anything up, CCC.” says the PD Lieutenant who has known me for years.

“I never do, Lou.”

If it weren’t for gravity, I swear this kid next to me would be bouncing off the walls and the ceiling.

A cursory glance at the patient from the doorway confirms what everyone else already knows, the voice of EMS simply being a required formality in this jurisdiction.

Partner’s eyes are big enough to eat dinner from. I have a feeling mine reveal different emotions. We make our way back to the front of the well kept, middle-class home, my partner heading towards the ambulance, not to be seen for a few minutes. I gravitate towards the gathered police and family members down stairs.

I learn the man upstairs is a husband of 30 years, and a father of 4. He was to become a grandfather in several months. He worked as an architect for a firm building high rise buildings in the big city, and has battled depression for most of his adult life.

His wife is remarkably stoic, but appears empty inside. As if the weight of the situation has not fully set in. His high-school aged son, now the man of the house, is remarkably composed, as I hear him talking on his phone in the kitchen, canceling some events that were previously planned for this evening. “I can’t make it, bro. I’ll call you later, okay?”

I learn a lot about my patient in just a few short moments. I look into the eyes of his wife, and express my condolences. I ask if she is sure that she is okay, and make sure there is nothing else I can do for her before I leave. She assures me there isn’t, and thanks me with genuine emotion.

Lou obtains the necessary information from me as I leave the house, assuring me that this is a pretty clear suicide, and no foul play is suspected.

I climb back into the ambulance, and can no sooner reach for the radio to return to service, when partner, still in sinus tachycardia, looks at me with a big grin.

“Dude, that was awesome!”

Now a part of me is mad, and I can’t help it.

“No, it wasn’t ‘awesome.’ It is terrible. There are three children inside that home who just lost their father. There is a wife in that home who came home from running errands to find her husband of 30 years dead in their bed. And not just dead, but a traumatic dead. There is a pregnant lady somewhere near by who lost her dad, and who’s baby will never have him as a grandfather. There is a company that no longer has a coworker, and friends who will never get to see him again. There won’t be an open casket, and that image you saw in that bedroom is the last vision his children, and his wife, will ever have of him. It’s not fucking awesome, and it’s not cool. Grow up.”

Later, I wanted to apologize to him. But I didn’t. The kid is going to have to learn some how.

Our patients are more than just patients. They are someone’s family.

I miss my partner

Slimm has been gone for something like 6 weeks. Something about having a baby, a family emergency, a surgical procedure, blah, blah, blah.

I really want him to come back.

It’s tough working with different people every day.

Slimm and I have gotten into a groove the past two years. I estimate we have worked well over 350 days together, twelve hours at a time.

We can run calls without saying a word to each other. We each know what needs to be done, and we just do it. Plus, he drives like butter. Seriously. He has the ability to make the imperceptible stops and starts, which helps when I’m in the back.

What do you want me to do?” asks each and every partner-of-the-day I work with. I understand they just want to be helpful, and don’t know how I like to run calls. I don’t mind working with newbies, or other seasoned vets at all, it’s just taxing.

I really miss my partner. 

Trouble makers take care of themselves

When I was younger and newer in this business, and admittedly much less mature than I am now, I received some of the best advice ever from a partner.

This particular partner is a vertically challenged, white-haired man with twenty years of experience to go along with his mild lisp. Not that those are important characteristics, but hey, it’s how I remember him. He is also still a very good friend who constantly tries to get me to work for “Capital Thitty Fire Department.” He’s a gung-ho fireman, after all, as well as an awesome clinician.

I was absolutely incensed one day, and spitting mad at one of our dispatchers. This dispatcher (at a service we worked for at the time, where neither one of us are employed any more) made it a point to boss people around, making herself “in charge” of everyone, and everything. She was basically an uppity bitch.

Like I said, I was spitting mad, and yelling some mild obscenities.

“Ya gotta calm down, CCC” he said. “Thothe people will take care of themthelves. Don’t worry about her.”

I was much too young, and again, immature to comprehend the depth of his advice.

But he was right.

Most people who cause trouble have a habit of taking care of themselves.

Those of us who don’t cause trouble are the only ones who are going to make any difference in EMS.

Trouble-makers are just along for a short ride, before they get shown the door.

 

Zero to Hero

Got a random partner today. Slimm was out for some reason. He told me, but I forgot about two minutes later.

New kid just got hired at Local Ambulance Service. I vaguely remember his face during orientation. I’m usually pretty tired, and get bored reading PowerPoint slides during those things.

He’s nice enough, so I introduce him to a few people at hospitals.

I thought it was going well. We ran some stupid calls for stupid complaints I don’t care to try and remember. Nothing memorable, at least. Then, for what appears to be no reason, he gets upset with me as I am climbing back into the ambulance.

“Man, it’s not nice to tell people I’m new.”

“Ummm, you are. You were hired three weeks ago, and just finished your intern rides two days ago. That’s pretty new, if you ask me.”

“I’m new to Local Ambulance Service, not new to EMS.”

“Go on.”

“I worked at Renal Medical Response for 6 months before I got hired here.”

“Interesting. How long have you been an EMT?”

“Since August. But I started paramedic school in October.”

“5 months? Dude, you’re new to EMS.”

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.