Tuesday, November 28, 2006

Should I laugh? Or, should I cry?

I met the coolest, calmest, most peaceful woman I have ever met in my entire existence on this planet Earth. I wanted to miniaturize her, stick her on my key chain, slide her in my pocket and hold on to her for dear life. My very own lucky rabbit’s foot. My own Buddha. My Holy Grail of peace.

She made me want to smile and cry, at the same time.

The front porch light flickered on and off as if a child had just found the switch. We could see it beckoning from a block a way. The entire block was dark as night, because it was. It was night. We exited the ambulance and sauntered to the front door. This was just a simple nosebleed. Nothing to get worried about. And, even if the moon was on fire and the sun extinguished, we wouldn’t rush anyway. We would saunter. We’re professionals.

Anyway, back to the story at hand. We were greeted at the front door by a golden / greying blob of fur. It’s tail thumping on the wall next to the door. It was so happy someone had come to visit it, especially at this late hour. We let ourselves in and saw the elderly lady sitting in the kitchen chair with her head crunched back, eyes staring at the ceiling and streams of blood trickling down the front lip onto a napkin. Infomercial played on the television set sitting in the corner of the kitchen, between the fridge and the stove. The graying golden led the way to her mom.

Her nose was bleeding. We couldn’t get it to stop and unfortunately due to her medical history and the drugs she was on, it was necessary to go to the ED to have it fixed. She didn’t want to go, but she was resigned to the fact. I fed the dog, gave her some fresh water, turned some lights on, and was sad - as if I were leaving my own pup at home alone - as I closed and locked the wooden front door. This dog was loved unconditionally by the patient. And in return, the dog loved her. I, some random jack*ss in a uniform was now separating them. Man, as I write this that pup may be home alone waiting for her mom. And that makes me sad.

So, anyway, she starts talking on the way to the hospital. As I listen my heart rate slows, my breathing becomes easy, and all the troubles in the world seem to slowly fade away. She is engaging. She is peaceful and wise. She smiles, laughs, jokes, and tells me the most horrific story I think I have ever heard. She lost her daughter in a violent crime and in the process was stabbed herself. Bleeding, alive, after being brutally assaulted she laid next to her dying daughter.

That was 25 years ago. She couldn’t have recovered from something like that. Could anyone? Yet, she was at peace. She didn’t hate anyone and lived everyday for what it was for, for what it could become. How did she do that? I would be an old, angry, bearded, drunk with rotting teeth and stale breath. I would grunt at every passerbyer and scowl at moon.

Then, we dropped her off in the ED. After a hug, which felt like I was being smothered in an warm, invisible, fleece blanket, we moved her from my bed to theirs. Every lemming did their lemming thing in the ED and we sat and waited, and talked. And as we waited, she looked at me and told me she had less than six months to live.

I have no idea what I said. My stomach sank, I must have gulped, and became instantly enveloped with sadness. I’m not sad now, as I write this. Because, I met that wonderful, remarkable, peaceful lady and she reminded me how valuable life is. And how important, regardless of ow dismal things may seem, it is to remain happy and at peace. Peace with everyone, and one’s self.

Monday, November 27, 2006

I watched a man die tonight.

I watched a man die tonight. Before my very own eyes.

Sure, he was sick. He had lost a lot of weight over the last few weeks and his family had noticed a sharp decline in his health recently. He hadn’t been eating, had not been truthful with family about his medical problems, and was convinced that the hospital was out to kill him. So was his younger, bigger brother, who, luckily (if you want to call it that) had some premonition to check up on his sibling tonight.

He was sick, that’s all there is to it. But not sick enough to where he thought he may die. Especially tonight. He realized something was wrong, but neither he, nor me, had any forethought that in 30 minutes he would be dead. In the back of the ambulance he was stable. Although sick, he was stable.

I could tell you what the hospital did, or didn’t do. But, that’s a waste of time.

I stood in the corner of the ED room. White tile and linoleum decorated the room with bright cumbersome lights attached to scopes on the ceiling. The metal bed with the black mattress held the 120 pound man, contained him as he struggled to breathe. His respiratory rate decreased and his effort increased. His body began using every muscle in attempts to oxygenate his body, his heart, his mind. His stomach bulged in and out. The muscles on his shoulders and between his clavicles squeezed every last fiber to help his chest rise and fall. The depth of his respirations gradually decreased, as if he were drowning. Like a fish out of water. He kicked his leg off the bed. The MD allowed this. “Whatever makes him comfortable”, he said.

The man I was just talking to, the one who had no idea that this was the night, that this was the hour. The one who walked up some stairs and onto my bed and was concerned about locking his house. The man, who was dying in front of my eyes.

“Intubate him! Intubate him!” my head screamed like a broken record.

His eyes were now bulging from the sockets. He was swinging his arms, fighting for his survival. His respiratory rate plummeting like soap suds down the drain. He stopped fighting. He couldn’t hold his head up and it fell to the side, his eyes still open. His heart still beating. He was exhausted, his body was done. It could do no more to oxygenate his body.

They finally intubated him. But the damage was done. His heart rate began to fall because of the lack of oxygen it had received over the last half hour. The heart is a muscle, too. And it, also, was tired. 40, 30 12, 0. It fluttered in shock. It had a meltdown, going into chaotic, nonviable rhythms. They crushed his chest with every compression. The broken ribs crackled as each pump attempted to circulate oxygen into the heart and throughout the body. His lifeless body stared at the bright telescoping light as these people attempted to remedy the situation. It didn’t work.

I don’t think he should have died. It was destined, especially with his medical problems. But not tonight. It saddens me that healthcare is like a roulette table in Vegas. You never know when your numbers going to come up. And even though you can stack your odds, in the end, it’s a game of luck. If you throw lucky 7’s, you get the smart MD, the right RN, and the “A” team. If you throw craps, well, then your lucks up.

And you die.

Thursday, November 23, 2006

Everywhere I go, it rains on me.

What cartoon was it? The one where everywhere the guy goes there is a dark cloud above him and a steady stream of rain pouring down. It's sunny to the left, warm to the right, and clear both ahead, and behind him. And each step he takes, that cloud follows him, reminding him that regardless of where he steps, it's going to rain.

I felt like that yesterday.

Being late for work, the iPod not working, the stain on my shirt, the broken work radio, the faulty computer, the cell phone, the map book, and no spot to park within a mile radius of work. None of those things got to me.

It was the lady with the heartbeat of 10, respiratory rate of 4, with the mentation of fleece blanket. Not to mention the fact that when we arrived to the "assisted" living facility there was not a SOUL around that could, wanted, or had any intention on telling us that this lady had been flat on her back, deteriorating by the hour. Around 5, she said she didn't feel well. Around 7, they finally realized something was wrong, as she laid there flat in her bed breathing like a fish out of water.

So, I step forward and that cloud follows. Somehow, I acquire a DNR (Do Not Resuscitate). That means no airway, CPR, or "heroic" measures. But, that's after she dies. She's still alive. Do I give her meds? Do I pace her? Are those "heroic"? So I do some small things to try and improve her condition, all of which fail. What next? I sit with this dying lady as we drive her to the hospital, where she will die, and does. Where's my damn umbrella?

I step to the left, and the cloud follows. In the form of being sent to a residence for chest pain. On the way, as we zig-zag through traffic and slow down to 40 at the red lights, I get a premonition. It's not going to be good. As we arrive, fire comes running out screaming it's a cardiac arrest. Of course it is.

We start lines, bag him, and shock him multiple times. Eventually winding up in a futile rhythm, asystole, that flat line you always see on ER that they are shocking back into life. That doesn't happen.

A step to the right, and more rain. I needed an airway. I pry his mouth open and shuffle his enlarged tongue to the left, hoping to get an easy glimpse of his epiglottis and vocal chords, landmarks needed to confidently intubate people. I shove my blade in his mouth, see the epiglottis, lift it out of the way and what am I greeted with? Chunks of white, rubbery fat. It seemed as if someone had cut the fat off of a steak and shoved it into his airway. I try to suction it out. But, it's like trying to vacuum a bowling ball with the quickie-wash vacuum hose. I try, my partner tries, and then I try again. No luck. Missing tubes is no good feeling.

I step back, the cloud follows, and he dies. Time of death, 20:26.

Monday, November 20, 2006

Paper of Plastic?

I could tell you about the gnarly crash on the highway where the little, white, compact car was rammed from the rear on the highway; causing the rear window to explode like confetti all over the highway, then spin wildly out-of-control into the guard rail, crumpling the front and sides like an accordion around the screaming, vomiting, dazed occupants.

Or, I could tell you about the lady who had a headache for three days, along with nausea and vomiting. Who blamed the "bad orange juice" for her blurry vision that developed into slurred, speech, that developed into causing her to fall out of bed, land on the ground and loose control of the left side of her body. The "orange juice", that ruptured a vessel in her brain, exploding like a firecracker in the middle of the night. The "orange juice" that eventually caused her to have a seizure in the back of the ambulance and lead her to be intubated. Denial is an awful thing!

But, you don't want to hear about that, do you? You want to hear about the bearded guy in the hotel room wearing a brown T-shirt (that was once white, I kid you not), lying on brown sheets (that were once white, I kid you not), in a room with dust bunnies the size of Godzilla.

This trust fund baby (I kid you not) that lives in a seedy motel room with the "Do Not Disturb" tags not hanging on the door knob, but taped, like laminate, to the front of the door. Inside, the sound of a small, handheld radio plays oldies music. Reminiscent of World War II, where people hid in basements and huddled around the scratchy noise of an old-fashioned radio. On the clock, a crisp 10 dollar bill.

He was tired. Just couldn't move around. Something was wrong. Something odd, in this bizarro world of his. Dirt was caked on him like he had been four-wheeling in Moab. He couldn't, or wouldn't, take showers because that's where he hung his clothes, in the shower. One light, in the corner, and 60 watts at best, illuminated the moldy room so he could work on his numbers.

Like the guy from a beautiful mind, there were math calculations everywhere. Half-sheets of white 8 1/2 by 11 paper were stacked on top of one another. On the dresser, on the TV, which hasn't been turned on in years, and was probably black and white. In the bathroom, and on his bed. As well as years worth of dust sleeping on every surface.

Stacks of cassettes, although I saw no cassette player, where balancing precariously upon one another. Bob Dylan, surprisingly, was resting on one of the piles. All these cassettes were in arms reach from his queen sized bed, his command center, the center of his universe.

He was wearing a brown shirt, or actually it seemed more Army tan. But upon closer examination it was once white. Now, when I say his shirt was brown, even though it was white, I am taking no story-telling liberties. Story tellers always seem to grandiose things in order to grab the attention of the reader. When I say the white shirt was brown, it was brown. And his sheets. The once white sheets stuck to his waxy skin like cookies baked on an ungreased pan. No pillow. No comforter. Just a sheet, queen-sized, that has been lived on for close to 10 years by the King of this castle.

And finally, like landminds strewn about a field were brown paper, grocery sacks. Everywhere. Sitting side by side from the entrance of the door, around his bed into the "living" area, and then down the hall into the closet and overflowing into the bathroom. Some had tapes. Some had new, unopened, white, queen-sized sheets, some had new, pressed, white starchy T-shirts. And the majority were full of calculations.

Paper sacks full of chocolate wrappers, too. Chocolate, that he only eats every 3 days.

Wednesday, November 15, 2006

Uhm, excuse me; I am a Rock Star.

I'm trying not to be morose.

I mean, it seems that the majority of my entries are, well, sad. Is it my job? Is my job truly that depressing and I just haven't noticed it? Or is it just that rhythm in life where things don't seem so good, for me or anyone else. I'm not an unhappy person. And if you ask anyone I work with, I'm pretty sure they would say I'm fun to be around.

So, due to the nature of the above mindset, and even though there is a "story" that has been bothering me and that I intend on relaying to you soon; I thought I'd write about something amusing. (I'm beginning to incorporate the use of semicolons; Stephen King would be proud)

10:00 o'clock in the a.m. No, make it 9:30.

He sat in that alley behind the grease dumpster of a fairly historical bar. His hair disheveled. And trapped, like a fly in a web, was one brown leaf tangled in the greasy mats of his hair. His teeth, snarling spit and leaking remnants of vomit as he attempted to speak clearly. He was still on the cold ground, because if he were to stand, contrary to what he believed, he would collapse like a house made of cards. His boots tell tales from previous nights. There are scars on the toes of the leather boots that could tell stories that would make mine pale in comparison.

And vomit, did I mention vomit? Glued to his shoelaces, in his sock, on his black-studded leather belt that was 3 sizes too big, on the hood of his coat, and lastly, on his face. Vomit, everywhere. That, being one of two things I can't stand. Vomit and poop.

And lastly, as if someone in the group was going on a first date, the smell of mouthwash. Wintergreen, I believe. Emanating from him as if it were a Glade freshener plugged into the outlet at my house, was that sweet smell of cleanliness. Reminding me of early mornings with friends with wet hair, clean skin, pressed clothes, and fresh, sweet, minty breath. It's a world of contradictions, and this one assaulted my senses like an ant at a picnic.

What do we do? Well, we commence, quickly, to save his life. That's what we do, right? He forcefully tells us he's alright and that he intends on leaving. In his mind, this conversation, and his cleverly planned escape attempt are processing at remarkable speeds. But, moving from cognitive reasoning to physical functioning is much, much.....much slower. He stands without bending his knees (a feat not even a sober person could do) , grabs that invisible rail in front to steady his slurred balance, and attempts to put it all together. Like a child first learning to walk, his synapses sparking, it culminates into one awkward move and he makes that first, ever-important escape step to freedom; "One small step for man, One giant leap for mankind".

He falls.

We pick him up. Shuffle him to the ambulance. We remove the shaving razor, even though he hasn't shaved in weeks, remove the ED discharge papers from last night, his lighter, and his comb. And, as this may come as a surprise to you, the majority of these drunkards ALWAYS carry combs. Sometimes, more than one. Why? I don't know. Can you play music through them, or something?

Lastly, we remove his ID.

"Is this you, dude?", I said in utter amazement.
"Yes, that's me."
"What happened?"
"I'm a rock star."
"Not any more, you're not."
"I'm a rock star, I used to be in a band. Heard of Black Sabbath?"
"Uh-huh."
"I used to be in that band."
"How come you're so f*cked up, now?"

"Because I'm a rock star!"

Monday, November 13, 2006

I saw the future.

I saw the future. And it ain't pretty.

It's got some astrologically influenced name from the Farmer's Almanac, bleached blonde hair with dark roots shooting out from a ratty ponytail precariously affixed on the top of it's skull - a lot like Judy Jetson, way too much Wal-Mart makeup, and is clad in some extremely oversized, state-fair-airbrushed, 2 Pac T-shirt.

Her Jordache, velcro secured, 3/4 tops tap, tap, tap on the dingy bar's gravel lot. The fake fur from her hood of her once white overcoat frame her face as she smacks gum like Britney Spears. She laughs, then cries, then angers all within the time it takes to approach her and become disgusted with her lackadaisical affect. She's got the soul of a hardened 40 year old, and she's only 13.

I won't tell you the whole story as to why we were standing in that parking lot when it was 29 degrees with 5 cops, 1 mother, and a 13 year old going on 40. She didn't really know why, she could never get her story straight. Therefore, the cops didn't know why and felt it necessary to call the paramedics, so we could arrive and concur in the consensus that nobody had a clue what was going on.

Something about weed, mushrooms, hickies, and boyfriends.

But, looking at her as she tried to articulate the fact that she was on a speeding train to a dead end, I realized I was looking at the future. As she rambled on about the fact that she quit school because she didn't like it, or had numerous "boyfriends", or had already come home reeking of weed and tripping like a 70's rock star, I began to see the future. This is where it all begins, this is her destiny. This, seemingly, is what she wants.

That washed up, drugged out, pot-mark-faced, high-heeled hooker cruising the avenue was her. Like looking into a magic 8-ball, I forecasted the life of this little girl. It's true, too.

Is this mean? Do I sound callous? Am I upset? Are you?

What am I suppose to do? "Little girl, don't do drugs and go to school." Like she's never heard that before. How am I going to alter the inevitable events of this avenue bound teen?

I'm not. I'm going tell her she's full of shit, release her to the cops, and then tell the angry, uneducated, chain-smoking mother in the background that "if anything changes, call us back." Which they will, I assure you. Not for this, but for when the angry 18 year old boyfriend finds out she was cheating on him with his best friend while he was in County jail -the once best friend who rides his bike to work at Subway because he's already lost his license.

Thursday, November 9, 2006

5 weeks from now, it won't matter!

5 weeks.
Does it really matter? Does it really matter what they think of you, or what they said? Does it matter that you spend the majority of your time stressed out about some trivial aspect of work that, in the end, really doesn't matter.

4 weeks.
Was it that big of a deal that you got cut off? That you got flipped off? That you were late to work? That you missed your favorite show?

3 weeks.
Who cares if you don't have the biggest TV, or the latest iPod, or the nicest, newest, most outrageously expensive jeans that were made from new "old" denim and then shredded up to look like old, ratty, inexpensive work jeans.

2 weeks.
Do you really need to hold that grudge? Why can't you say you're sorry?

1 week.
Did you call? Did you tell them that you love them? Did you hug them and let them know how important they really are? Did you sit and talk, and listen? Did you enjoy the moment you were in? With them? With yourself? With your God?


It matters now. Because your time's up! You're gone. And all those worries, and stressors, and wastes-of-times, are still there. All those nice, new, shiny toys are there. And the people you love are there, too. The people you now wish you could spend time with. The people you wish you could squeeze and hold in your arms.

You knew someday this would happen. Everyone does. But, not this soon. Not now! It only happens to other people, and I don't plan on it happening to me until I'm old.

Nope. That's not how it goes. You have no control. So, don't watch, but be cognizant of that clock on the wall.

Because in 5 weeks, where will you be?

Cheeseburger Flavored Bread.

So, what do I do when I've done nothing at work? How do I please the millions of feverish readers who religiously follow these chronicles of excitement and adventure? This is a site about the awe-inspiring life adventures of a paramedic. These words are written to motivate and to reach deep down into your soul and shake loose any, and all, of the cobwebs restraining one's love for life.

Nothing happened tonight.

Really. I mean, we did some calls. But, who wants to hear about the baby who scratched her nose with her fingernail, or the kid that bent his thumb backwards while wrestling? Doesn't make for an attention-grabbing, unbelievably amazing, on the edge-of-your-seat story, does it?

Well, I warned you that it's nothing like on TV.

But, I got to thinking last night, anyway.

Sitting, cramped, in the front of an ambulance in a grocery store parking lot having a diesel engine idling war with the parked semi next to us (who my partner was convinced was watching porn in the back, because "that's what truck drivers do"), I began to ponder. To wonder, how can I make more money?

I mean, if I was independently wealthy, or won the lottery, or just happened across a lot of cash, that would make my job a whole lot better. I could then do it, because I like it. I mean, I like it now. But, whenever you do something that is a primary means of support for you and your family, regardless if you like it or not, you begin to hate it.

Driving that beer truck. Making those donuts. Being a rock star. They all feel the same way I do. They all get sick of their jobs. You know, somewhere, sometime, some super star has said before playing in front of thousands of screaming people:

"Man, this sucks!' It's true. Just ask. After you get his autograph.

Anyway, that leads me to my get quick, money-making scheme that would allow me to enjoy my job like I should.

Cheeseburger flavored bread.

Wednesday, November 8, 2006

Cheetos.

It was from a hidden bag in mom's child backpack that the cutest little 18 month old homeless girl I have ever seen was munching on Cheetos. Her little fingers orange from the fluorescent chips that she had such a craving for.

You see. Her father wasn't feeling so well, so he had an ambulance called. I pulled up to see a large man sitting under all the flashing lights and gauges on the side of an old fire engine, graffitied with some macho nickname with the writing enveloped by flames. He was anxious. Very, VERY anxious. His chest hurt. He couldn't sit still and was one flinch away from freaking out. He was having an anxiety attack. Although he thought he was dying.

And behind us all, in the dark, seated in a stroller that no soccer mom today would dare think about pushing down the manicured walking path near her new, tri-level home, was a little girl. She was bundled up, even though it wasn't that cold outside. Her, and her mother, stood patiently as the Emergency crews ignored them both.

Dad was upset because they were getting kicked out of their motel room tomorrow. They were living, and soon to be removed from, one of those seedy motels where aluminum foil squares litter the ground (crack) and hookers stagger back to after a long, long evening doing what they do best. This was their life. Homeless.

So I packed Dad, and the entire family, into the back of the ambulance. I knew he wasn't sick, and so did he. What needed fixin here was where they planned on resting their weary bodies after walking up and down the avenue trying to sell homemade jewelry. And all the while, that little girl ate cheeto after cheeto.

Smiling, trying to lick her boot, pointing at the glowing lights in the back of the ambulance. Not once did she speak. Could she speak? I don't know. But, for those few moments she didn't need to. She was content. She was happy. She was warm, and she was with her family. Cheeto after cheeto she smiled. Cheeto after cheeto made me sadder and sadder.

Seldomly do I feel bad for people. I don't cry for them. Normally, I blame them. They made those decisions, they can fix it if they want. But this little girl didn't ask for this. Her dad so stressed that his family will be sleeping on the streets tomorrow that he ends up in an ambulance. Mom, scared and quiet, but happy that they are all together and at this moment in time--safe. And the little girl. Happy as could be eating her cheetos.

I hope they don't get kicked out tomorrow.

Tuesday, November 7, 2006

It's not what you think. I promise.

If you don't know me, and have happened across this site because you are interested, amused, or curious about the lives of paramedics, you may be disappointed.

We don't run around in cool T-shirts with funny sayings with our stethoscope draped fashionably around our necks. We aren't in some sorted love affair with young, beautiful resident doctors studying to become ED attendings (most of us). We don't grab people from the clutches of doom and bring them back from the light only to be honored at some prestigious black-tie dinner. We don't all have flowing manes that smell like mountain streams with manicured hands and sip Starbucks while we contemplate life's important philosophical questions. And, most importantly, there's no cool music in the background and we don't walk in slow motion as we approach some gnarly call.

We sit in cramped ambulances, in 7-11 parking lots. Our feet on the dash while the stock AM/FM radio crackles out the latest John Mayer song from the two oval speakers in the front doors. The 5 presets, that change everyday secondary to the different crews that spend 10 hours a day of their lives in the constantly idling ambulance, are continually punched due to constantly dodging the latest pop song being played repeatedly on every station. Ashlee Simpson, again!

The diesel engine runs 20 hours a day, the seats have softened and sank to the point you feel like you could rest your chin on your knees when you're sitting and staring through the reminents of green, bug goo. You don't touch anywhere below the seats and, if by some unfortunate happenstance, something you're eating touches anything in the ambulance, or touches anything that touches the ambulance, it's trash. Trash, which normally, lies between your seat and the large console between you and your partner with all the bells and whistles.

Our shirts get untucked, we sweat, our shoes are scuffed and not everyone shaves everyday, men and women. People give us dirty looks, people give us the finger, people try to run us off the road, people think since we're sitting in some public parking lot we are their to answer any questions they may have on their minds, medical or not.
And finally, although we have great knowledge of the city, people believe we are their very own, live and in person, Mapquest.com.

So, if you're still curious read on. Check back often. Because, even though it's not like you see on TV, you are guaranteed to be intrigued, amused, saddened, stressed, grossed out, and amazed at some the things I do and people I see. This is what it's really like. This is my life. The life of a Paramedic for the City and County in the Rocky Mountains. In beautiful Colorado.

Truth is stranger than fiction, believe me.