It’s like a Hollywood script

Finally, Slimm and I are back together. This will be our first time back on a truck together in what feels like years, but has really only been about one year.

I have to wake up 5 hours earlier than I am used to, but I think it’s worth it.

We hugged in the parking lot. It was a brief hug, but it was a hug nonetheless.

Then we got breakfast.

And our breakfast was interrupted because some guy fell out of bed. Now my gravy is going to be cold, and nobody likes cold gravy on their biscuits.

“Radio Med One.”

“MmmmGohead” I reply sleepily.

“Caller is advising agonal respirations.”

“Mmmmkay.”

I turn to Slimm. “I hope the caller is just stupid.”

“Me too, bro. Me too.”

“Radio Med One”

WHAT?! “Gohead”

“Caller advises full arrest. They are starting CPR.”

Shit.

This sucks. The sun isn’t up yet, and neither am I.

Sure enough, it’s a full arrest. The fire guy recognizes me.

“What’s up, C?” he asks as he’s doing compressions. “You pick up an extra shift?”

“Naw, man, I’m back on the truck with Slimm again. Whatcha got?”

“Glad to hear you guys are back. Wife woke up and found him here about ten minutes ago. AED says ‘no shock,’ Bubba got the LMA in, and Chester is about to start the IO.”

I feel around this guy. I don’t see any obvious trauma, but his skin sure is cyanotic. And cold. I mean, remarkably cold. Most people I have felt this cold before have either had lividity or rigor, but he has neither. He is in asystole, and his pupils are dilated and fixed.

Basically, he’s dead. But not dead enough to stop working.

“C, you want us to stop, or keep going?”

“Nah, keep going, let’s move him out into the kitchen, and we’ll work him there. We have more room there.”

Somebody gets the IO, and I see Slimm putting together the bicarb and epi. He looks over at me. “We going to do the two rounds then call it?” he asks.

“Nah, buddy. We’re gonna get him back.”

I wink. Just joking, of course.

But we did.

Five minutes later he had a pulse, was breathing on his own about ten times a minute, and had a blood pressure of 130/90.

“We have to stop doing this.”

“What? Getting people back?”

“Not that. But doing it so easily.

“They should make a movie about us.”

Jobs are tough to find

We are taking some guy to the hospital because “my legs hurt.”

He’s a vagrant, and has been “doing a lot of walking.”

Essentially, he’s homeless and jobless, and wanders from town to town, and we got so lucky that he wound up in ours.

“What kind of work do you do for a living?”

“Whatever work I can find.”

“Is it hard for you to find jobs?”

“I find something every once in a while. There aren’t many jobs out there though.”

“It must be hard to get a job with all those tattoos.”

“Yeah. People judge me. It sucks, man.”

“I can see why they would judge you. That big swastika on your neck is kinda hard to miss.”

Anemia

An unknown problem at a house. Which begs the question: how does the caller not know why they are calling?

Anyways.

We pull up right in front of the engine, and we all make our way towards the door. We can hear the gurgling from outside.

Inside, we find a lady who is obviously in the throes of death, laying in a hospital bed. She has that open-mouth look that healthy people don’t have.

Someone who looks like she might be a nurse of some sort is anxiously standing in the shadows, clutching what looks like a home-health folder.

“What’s going on?”

“She has anemia” says a guy who looks like he could be her husband.

Meanwhile, this lady has one foot through the pearly gates.

The fire dudes are doing their thing, getting vitals, and trying to put in an OPA, which is complicated by her wide-open mouth.

“Okay. She has anemia. What is going on today? How long has she been this sick?”
“She has anemia. That’s what’s going on.”

Obviously, I’m getting nowhere. “Okay then, why is she in the hospital bed?”

“Because she has anemia.”

Newguy has now decided to sink a tube. This lady has almost no blood pressure, and her heart rate is in the forties.

“Does she have any other problems besides anemia?”

“I don’t know.”

I gave up.

Stoned

A “person who needs to be checked out” at an apartment near the University. We are going by ourselves for once.

Today is Newguy’s day in the back, which means I get to carry this stupid jump bag up three flights of stairs. Great.

“What’s going on today?” he asks the college-aged male who answers the door.

We are doing Boston accents on this call, so I can’t help cracking a smile.

“Man, something is wrong with me, man” comes the reply.

“Okay. What’s wrong?”

“Man, I just don’t feel good.”

“Okay. What’s wrong?”

“Man, I’m telling you, I just don’t feel good.”

“You’re going to have to be a little more specific.”

“I dunno, man. Like, I just don’t feel good.”

“Okay.”

He gets quiet for a minute and looks down at the floor. “I think I smoked too much weed, man.”

“You smoked too much weed?”

“Yeah.”

“And now you’re really high?”

“Yeah.”

“Was the weed laced with anything? Did you do any other drugs? Anything like that?”

“Nah, man. Just the weed.”

“Are you sure the weed wasn’t laced with anything?”

“Yeah.”

“How are you sure?”

“’Cuz I know my weed.”

“But do you know the guy you bought it from well enough to know it wasn’t laced with anything?”

“I didn’t buy it.”

“Okay. How’d you get it? Did someone give it to you?”

“I grew it in my closet.”

“Interesting.”

“Man, I am so high. Something is wrong with me. Man, I don’t think I can read any more, MAN!

“Let me get this straight. You grow your own marijuana in your closet, and now you smoked so much that you can’t read, and you want to go to the hospital?”

“Do I need to go to the hospital?”

“I don’t know. I don’t think they can help you with reading comprehension.”

“I’ve never been this high before.”

 

We took him to the hospital.

Keep it simple

Look, y’all. I’m interested in your reports and everything, but let’s try to keep it simple, okay?

I don’t care that the patient had her gallbladder removed in 2004. It has nothing to do with the tibia sticking out of her skin.*

I sure as hell don’t care that the patient got bitten by a spider eighteen weeks ago.*

I don’t care that the patient stopped taking Lisinopril three years ago when his doctor switched him to Cozaar. And I don’t care why the doctor made the switch, because it probably had something to do with the cough the Lisinopril gave him.*

I don’t care that the patient speaks Spanish, because we are communicating just fine with her in English. Also, working in the Southeast United States, I’m pretty good at spotting Hispanic people.*

Just tell me what hospital they want to go to.

And don’t bother with the vitals. Because we both know you need them only to write them on your report, and I am going to take my own.

 

*all things I have actually been told by first responders

Pick one

“Unit whatever to radio.”

“Whatever, go ahead.”

“Yeah, we need a second unit out here for an additional patient at this MVC.”

“Do you need that other unit emergency or non-emergency?”

“That depends. Where are they coming from?”

Wrong answer.

Distance has virtually no bearing on how an ambulance should respond. I don’t care about response times, and I don’t care about the company meeting their response time goals. Your patient can either a) wait just a little while to go to the hospital, because they aren’t dying right now, or, b) needs to go to the hospital five minutes ago, and you can’t take them.

Pick one. 90 percent of our emergent responses are bullshit anyways.

Listen and learn

Newguy is out today. He and his wife are finding out the gender of their new baby, so he is going to the appointment. Well, Mrs. Newguy says they aren’t going to find out, but Newguy says he is going to cheat and sneak a peek at the ultrasound. He even has a plan and everything for how he is going to do it.

Nobody tell Mrs. Newguy, okay?

I’m working with a kid today. I did the math, and he was in diapers when I started in EMS. And he already has a bad attitude.

There is a difference between burned out and a bad attitude.

We get a call for a lady who is sick. It turns out the lady is visiting her daughter from Oregon, and has been confused, febrile, and weak for the past few days, and it is getting worse.

Daughter hands me an insurance card and says she needs to go to the hospital about 45 minutes away. While she is saying this, Babyface pipes in.

“Well, we could take her to Local Hospital, and they can just transfer her if needed, but they will probably just let her go if she just has a fever.”

Daughter looks excited, then goes on to explain that the sick lady is allergic to Tylenol and Penicillin, and has a diagnosis of primary biliary cirrhosis. No other medical problems though, which is good for a grandmother in her late seventies.

Finally we see the patient. She’s confused, sure enough. She’s pale, and the jaundice is pretty apparent in her sclera. (What is the plural of sclera? Is there one?) So, she’s sick, and probably needs to spend a day or two in the hospital for some IV antibiotics.

“Okay, we’ll take her to Westside Hospital. We are going to go bring our stretcher in here, and we’ll be out of the way.”

Babyface is absolutely apoplectic. “Why can’t we just take her to Local Hospital? It’s across the street. Westside is forty-five minutes away.”

I get stern with him. “I know where we are, and I know where the hospitals are, and we are going to take her to Westside Hospital.”

Later, at Westside, he decides to assert his position once again.

“Man, we should have just taken her to Local. This doesn’t make any sense.”

“What is primary biliary cirrohsis?”

“She’s probably an alcoholic, and she drank too much, and now her liver is shutting down.”

“Wrong. What is the first thing that comes to your mind when you hear that a person is confused, weak, and febrile?”

“Sepsis?”

“Fair enough. Does the diagnosis of primary biliary cirrhosis change that? You still thinking sepsis? What about her jaundice?”

“I don’t care about her cirrhosis, she just has a fever.”

“No, her ammonia levels are high, and she needs lactulose. She is very confused, and only responds to verbal stimuli, which suggests hepatic encephalopathy, and she needs an ICU. Taking her to Local Hospital would have been a bad decision, and a waste of time.”

He was still mad at me for the rest of the shift.

I don’t chase patients

A call for a person “out of their mind.” PD is already there.

“He’s crazy.”

“No joke. The dispatcher told us that. Why does he need to go to the hospital?”

“His mom wants him evaluated.”

“Why?”

“He’s crazy.”

I’m getting nowhere with this guy, so Newguy and I walk into the house and find the alleged patient and his mommy. The patient is in his mid-thirties, so I don’t know why he calls her “mommy” but who am I to judge?

“Ma’am, why does your son need to go to the hospital?”

“Because he’s crazy.”

I don’t even bother asking again. I just turn to the dude on the couch.

“You ready to go?”

“I guess.”

Cut to 10 minutes later, going down the road. The dude on the couch, who is now the dude on the stretcher, hasn’t said a word. He won’t answer my questions, or talk to me at all, so I’m just sitting in my chair catching up on paperwork.

The ambulance comes to a stop at a red light. Newguy is listening to a Handel on the Law podcast, and I’m kinda trying to pay attention to that.

‘Click click click.’

Before I look up, dude on the stretcher is now dude jumping out the back door. He takes off like an NFL running back with an open field in front of him.

I mean, he is gone.

“Med four radio.”

“Med four.”

“Show us ten-eight. Our patient left the ambulance and ran. Maybe PD might want to look for him.”

“Which direction did he go, med four?”

“I think north.”

“You think?”

“Yeah, I don’t chase people.”

The dynamic duo is back

Slimm and I are going to be partners again.

We had to pull a lot of strings, call in some favors, make some offers, and do some shift trading, but we made it happen. A well-executed plan is quite something to be a part of.

I’ve enjoyed working with Newguy for the past few months, but I need to be back with my partner.

I wasn’t going to last much longer without Slimm.

We are already planning on hugging it out before our first shift back together.

I’m very happy.

Sometimes we pick up chicks

Somebody got tased by the long arm of the local law. Which means, of course, that an ambulance has to ‘check him out.’

Which means, of course, that we turn on the lights and sirens because someone requested our service.

Policy, you know.

Also, because an ambulance is going, the fire truck is going as well. In case, you know, the person is actually on fire. We generally can’t trust police officers to determine whether or not a person is on fire, so we might as well cover all our bases.

The dispatcher hasn’t finished reading the call to us before I stop paying attention and go back to my book. I’m reading The Pillars of the Earth again. I’m at the part where Aliena is about to marry Alfred.

“What are we going to?” asks the student third rider from the back seat.

“The cops tased some guy. Probably bullshit.”

Like all the other calls.

Sure enough, there’s a guy sitting in the back of a cruiser with taser barbs sticking out of his back. He is obviously not an upstanding member of society, and probably didn’t finish high school, judging by his lack of a vocabulary. He’s being such an asshole that I wish we could tase him again just to shut him up.

He’s even being a dick to me as I take the barbs out of his back.

Newguy goes to apply some band-aids to the puncture wounds on the patient’s back.

“Man, I don’t want no damn band-aid!”

“Tough. I don’t want you bleeding on Officer Nicely’s car.”

“Man, this is some bullshit! All this over a dirty ass hoe!”

We glance over to the alleged dirty woman when this rude man with holes in his back informs us of the reason for the argument, which resulted in the assault charges he now faces.

“Man, that bitch gave me HERPES!”

Newguy doesn’t miss a beat.

“So you’re saying she’s single now?”