quaking in my boots. . .er, um, sensible shoes

Sorry my posts are so erratic, folks. Had to cancel my home phone, and with it my dial-up. Yes, dial-up. In any case, this is a loooooong one, so grab a beverage of choice, put up your feet, and enjoy the story.

Last week, my first preceptor came in with a patient. (Long story short, she and I had a serious personality conflict, although I still haven't figured out why. Luckily, I was moved to a different preceptor for the end of my internship, and I did fine.) I didn't know she was even in the ER until the fine hairs on the back of my neck stood straight up, and I sensed EEEEEEEEEVVVVVVVIIIILLLLL. I turned around, caught a glimpse of her, started shaking, did a quick soft shoe routine behind a curtain, and made like a stack of laundry. Or equipment cart. Anything to avoid her. But she caught up with me in the cafeteria, damn it all. Our exchange was very. . .um. . .polite.

Cleaning beds after an ER rush, one of the new nurses asked me where to dispose of bio waste. I pointed mutely at the large red garbage can in the corner. She giggled. "Whoops. Guess my blond is showing." I asked if the streak of blond framing her face in otherwise brunette hair was like a blondometer that increased in width when she was having a blond moment. (I can't help it. Sometimes these things just shoot out of my mouth.) She looked at me and then laughed. A deep, long belly laugh that shook her from her blond roots all the way to her toes.

thank goodness.

I did CPR for the very first time last week, and was sore for days after. Pt was a 36 yo female found down in a field. The entire code team and half the ER nurses were in there, but I shoved my way to the bedside, climbed up on the stool, and started compressions. That craaaaaack as her ribs separated from her sternum was one I was expecting, but it felt icky. Weird icky. Not at all like the dummies we practice on. Damn good upper body and ab workout, though. Maybe I'll get to add it to my regimen.

Only had two marriage proposals in my last few shifts. It's been a slow week. Maybe it has something to do with my self-tanning moisturizer accident. You know, the stuff that is supposed to be fool-proof. Apply it like lotion, it builds up color gradually. Somehow, I managed to get streaky, anyway. I wonder if I'll ever get the hang of this girl thing.

My parents came to visit this week. My mother apparently had an issue wiping with kleenex instead of Charmin (ahem. . .I'm a bit low on funds lately), because on the second morning of their visit, they showed up with a Mack truck sized package of toilet paper. It doesn't fit under any of the sinks, so for now, it's taking up valuable shoe space on the floor of my closet. I think Mom is hoping that it'll last until their visit next year.

Patient highlight of the week (aside from amusing myself with conversations with little old ladies who have been given Morphine. . .what a hoot!!) was the girl who came in POV after a fight with her boyfriend. They'd been discussing breaking up while they were driving on the freeway, and she decided the discussion was over, opened the door, and jumped out of the car.

Ouch.

Damage incurred: broken shoulder, cracked T1, several abrasions, and a deep, messy lac extending from her right eyebrow all the way to a hematomato in her hairline. The surgeon stepped in to take a look, and his only comment (he's a man of few words) was, "Oh, damn."

Last Monday was a great day. RevMedic brought a patient over from the coast, and stopped by my house after the drop off. I'm pretty sure I squealed like a girl when I saw him, I was so excited. Oh, wait. I am a girl. It's a good thing he wasn't hungry, because all I had to offer was my trademark chewy coffee, but hey, he drank it without complaint. We got caught up on work stuff ("how's everybody?" "same as usual." "The ocean?" "Still there.") and headed briefly into the personal, and then he told me all about his trip to Baltimore. I sighed wistfully a few times. I'm proud to call RevMedic family, and honored to have been his trainee. Of all the folks from that job, it's him I miss the most. Now if he'd just send me that employee movie. . .

They headed out after a bit more conversation. RevMedic rolled down the window and waved. "Be safe!!" I yelled. He grinned, wiggled his eyebrows like Groucho, and yelled back, "be good!"

I have absolutely no idea what he was referring to. I'm always good.

Don't look at me like that.

the sweet smell of singed flesh

yesterday's 12 hour shift started out like any other. Night folk meet in the break room before the shift change, we all tease each other, DT attempts to show me various pressure points on my wrist and behind my ears. "Does it hurt? Does it hurt? Huh does it?" And I have flashbacks to my older brother doing the same dang thing right before he broke my wrist. I slap DT on the shoulder and give him a quick jab to the ribs, and that's the end of that. We saunter out to the triage desk (if it's possible to saunter in ill-fitting scrubs and sensible shoes) and check the board. Busy, busy day. My first patient is a twentysomething female with a "3 inch vertical lac to forehead." Easy. She shuffles back to the bed, holding a blood-smudged towel to her forehead, boyfriend in tow. I get her settled and she pulls away the towel to show me a thick gash that goes from her hairline down to the bridge of her nose. I nod, impressed. Then-- flop flop-- the skin on both sides of the lac sort of slip, revealing a lovely, smooth, blood slicked expanse of skull. Spurt spurt go various blood vessels onto my clean scrub shirt. I hastily replace the towel with a lot of 4x4s, report to the RN and the doc, and get the lac tray and sutures ready. The doc meets me back at the bed with the cautery gun.

Oh, horrors.

Brief digression:
Last week, it was a warm sunny day. I'd used up most of the energy from my caffeine and Boomi Bar (it's hippie food, and that's all you need to know) chasing my best friend's cat around the front yard, into the neighbor's back yard, and into a tree, which I then climbed to perform a five o'clock newsworthy rescue. I got to work still a bit out of breath and sweaty from the chase, and headed to the back bed to help out the MD with the suturing of a dangly, hanging-by-a-thread finger of a squirmy, screaming, pissed off 18 month old boy. I'm helping hold the patient. Mom has the kiddo on her lap. They're both crying, we're all sweaty, the heat from the spotlight is almost unbearable. We're all doing remarkably well until the doc pulls out the cautery gun and burns two holes in that itty, bitty fingernail. The smell was bad enough, but then I realized the doc was using the fingernail like a lacing card, and sewing up through the holes.

Ewwww. Grody.

Suddenly, the smell of the. . .and the idea of the. . .and the squirming and the sweating and the screaming and the hot light and the lack of carbs all became a bit much. My vision narrowed, my ears started buzzing, and I informed the doctor in a very pleasant voice that I needed to leave post haste. He took one look at me and ordered me out of the room, and I didn't hear the end of it for the next two shifts.

How embarrassing.

End of digression.

Imagine my dismay when I saw that cautery gun. But I mostly held direct pressure with one hand and fanned the stinky smoke back at the doctor with the other, and we all came out of it just fine.

The holy spirit came in again, this time with the story of how she lost all three of her children when the sun imploded in Jesus' chest earlier in the day. God told her to come to the ER to get some rest, and that's exactly what she did. There was some mention of spaceships and demons, and she wouldn't stop fidgeting until we told her none of it was her fault. After that, she slept easy.

I guess sometimes, it's just nice to have somebody tell you everything's going to be okay.

from hippie chick to firefighter girl

I was a bookwormish tomboy growing up. Bonafide, dyed in the wool, jeans, tennies, and t-shirt kind of tomboy. I did have waist length red hair, but always kept it up in two tight pigtails. The dusting of freckles across my nose and deep tan during summertime completed the picture. Granted, the jeans were hand-me-down bell bottoms with flowers embroidered around the bells, but they did have respectably worn knees. I announced to the world (at the tender age of 7) that I wanted to be a firefighter when I grew up. Grown ups smiled, and several boys in the neighborhood told me, in no uncertain terms, that I couldn't be a fireman, because I was a girl. Whatever. My mother, to her credit, allowed me my overflowing bookcases, Hot Wheels, cap guns, tree houses, and shunning of the color pink, but insisted that I wear a dress each week on one day in addition to sunday so I wouldn't forget I was a girl.

Ha! As if.

I did like playing dress up, and had a fairly large collection of cast-off makeup from my three older sisters. I never quite got the hang of it, though, and so my essential makeup kit as I went through my teen years consisted of mascara, powder, and lip gloss. Sundays, I wore dresses and flats, but went defiantly bare-legged, which my mother pretended not to notice.

She cringed and almost cried when she saw my first tattoo. I was in no hurry to tell her that I had a couple of others hidden under my clothes. By the time she noticed my pierced tongue, all she could do was cluck hers and shake her head. I think by that time, she realized I probably wasn't going to turn out quite like her other daughters. Late teens and early twenties, I slipped into hippie chick mode; I never did wear patchouli or tie dye, but I was big on the no makeup/no high heels/all cotton wardrobe. At the age of 24, I got a job as co-manager of a clothing store. My parents were ecstatic- Firefighter Girl picks a career! In a female dominated field! Doing girl things! But that only lasted a few months.

After I went through academy and my first year of school, I was still hell-bent on being a paramedic/firefighter. Interestingly enough, the more time I spend in this field, the more girly I get. I now own 5 pink shirts (yes, I do). I have a few pairs of high heels, and as mentioned in a previous post, I can even walk in them. I'm still getting the hang of this whole girl grooming thing, though. I make Miss Diva say the waxing mantra with me in between screams as I peel strips of hair off my legs: "Beauty is Pain! Beauty is Pain!" She laughs at me, but she's girly-girl all the way through- I don't think she has a single shirt in her dresser that isn't pink. She'll be begging for a razor and wax strips by the time she's 10. Heck, she already paints her nails, and it's not really her fault when half the purple nail polish ends up on the carpet. She's only 4, after all.

I think I figured out how to pluck my eyebrows symmetrically. That was a big milestone a couple of years ago. Hair styling beyond shampoo, conditioner, and a sloppy bun still eludes me, which is why I frequently look like an unbraided Pippi Longstocking. My staple cosmetics are still mascara and lip gloss, although for a special occasion (and if I have the time to putz around in front of the bathroom mirror) I'll put on lipstick and foundation, and if I'm feeling really brave, I'll try eyeshadow. Like this morning.

Here's how it went. I got a girl magazine (no, you pervs, not a girl-y magazine-- it was Allure, one of those magazines filled with advice for girly-girls-- makeup, fashion, tricks and tips for everything from faking a fabulous tan to horoscopes for you and your guy). In said girl magazine was this season's hottest new looks for eyes. I spread the magazine on the bathroom counter, prepared my arsenal, and set to work.

I look like I have two black eyes. Seeeeeeexxxxxxxyyyy.

my dogs are barkin

12 hour shifts, 4 days in a row. Awake at 2 a.m. takes some getting used to. . .but at least I only have a 10 minute commute instead of the 2 hour commute of my recent past. 45 IVs started, one pneumothorax chest tap, one pretty dang impressive hemothorax. . .2 1/2 liters drained. I was assisting the doc, and we both watched in amazement at the solid red stream that filled the first, and then the second, and then the third evac bottle.

Had a stubborn a-fib that didn't answer to the cardizem, or the two doses of lopressor, so the doc told me to get ready for a cardiovert. Never done one of those before. . .but the doc said, "hey, why don't you do this one!" so I did. Twice. There was a tense 7 seconds of asystole after the first 50j, 7 seconds while we all held our breath, and at about 6 seconds, the doc and I looked at each other and he kind of cleared his throat and chewed his lip, and the relief in the room was palpable as the first q r s complex blipped across the screen, even though the rate was still at 150. We got him again at 120j, but the man's heart just wouldn't stop its atrial twitter.

Saw a six day old baby that was healthy as a horse. Mom was a bit. . .off. Was very concerned about some of the things baby was doing. Mom looked at me, lower lip quivering. "When she sleeps, her legs twitch." And a big fat tear rolled down her cheek. I was loathe to wake the baby with the rectal thermometer, but I sighed and lubed up the tip, and bit my tongue. I refrained from mentioning that Mom's legs probably twitched when she slept, too.

The usual junkies, migraines, NSO abdominal pains. Two aortic aneurysms in as many days. The patient who came in with a belly the size of a bowling ball from burst divurticuli was very pleasant, smiling and talking to us while we took her blood pressure. . .a couple of times, because the 55/20 measurement was somewhat difficult to believe. But no, it was right. Yikes. Three IVs, 3 L of NaCl, and Trendelenberg for you, ma'am. And she didn't even mess up her lipstick.

My favorite was the patient who showed up insisting she was the Holy Spirit. She kept addressing the numerous imaginary children in her belly and some person in the exam room only she could see. She called him Dad. It took a while to figure out she meant God. Kinda spooky. . .I have no doubt she was seeing and hearing something, but the only thing she had to say to any of us was, "gimme an IV!! My babies are thirsty and Dad says you have to!" And we were trying, but damn if her veins were filled with anything but holy water, because no matter how hard any of us tried, we couldn't get that dark red flash in the cath chamber.

Where the hell do these people come from?