mixman's bionic ear

So, after almost a year of discussion and work and preparation and trips to the BigCity LittlePeople Hospital for tests and meetings and appointments, MixMan got his Cochlear Implant yesterday. He says now he can feel the bump behind his ear, and things are kinda itchy. They fired it up to make sure the device wasn't faulty, and said they got great nerve response. So on September 2nd, they'll turn it on and do the initial mapping, and we'll see if it works. The patient is doing fine, although is rather disappointed that his stylish head bandage is white instead of black, which would be infinitely more cool. He's very excited, though, about his robot ear. So now we call him RoboMan.

one in each kneecap

I am a very, very lucky girl that I have so many good, kind men in my life. I say that because I am starting to understand how women become man-haters; if I didn't have the boys I have to balance the assholes, I could very well be a man-hater myself. In the last year, I have been raped; cornered in the stock room of the ER by a co-worker I trusted (who shoved his tongue down my throat and his hand up my shirt); and groped and come onto by several patients who seem to think that the ER is a great place to pick up girls.

All of them had in common the inability to hear the word "no." Repeatedly. And, due to the red-headed temper I had as a kiddo, I was raised to talk things out, leave a situation before it gets violent and confrontational, count to ten before shouting, be cautious. Of course, my parents assumed I'd remain in a fairly sheltered Mormon existence. Little did they know. And unfortunately, in the last year, in all of these situations, my skills set has come up sorely lacking.

I have been angry, and sad, and so ashamed since last summer; ashamed that I couldn't talk my way out of a situation I was in completely by accident because all my fail-safes had fallen through. Over the last few months, I've started lifting again, and I have a heavy bag I beat the shit out of on a regular basis, and my cardio is better than it ever has been. But I am still sad, and angry, and have felt so powerless. And over and over again, I have wondered how it is possible for someone to be so disrespectful that they would disregard the wishes and free will of another person and violate not just that person's body but their soul.

People who know me will tell you that I might be cranky fairly often, but I rarely get really pissed off. Sometime last Wednesday, in the five minutes between finding a man on my patio watching me through my curtains and the moment when I lost my temper and threw myself out the door after him because he wouldn't leave, I became a person, a woman, capable of killing another human being.

But I'm pretty sure I'd rather just maim.

somebody explain to me all the assholes in the world

So last night, I'm lying in bed, reading a book, as I'm wont to do. I have the sliding glass door in my room open a little to let in a breeze, and I'm half in/half out of the covers and half in/half out of sleep. I hear a noise on the side patio, and I'm assuming it's a raccoon-- they like to tip over my plants-- so I get up to scare him off. I push the curtains aside, go to open the door a little more, and right there, I mean right there, is some guy sitting in one of my patio chairs that he's moved right up against the glass.

My first thought, as you can imagine, is "wtf?" because this is not a scene my mind can quite wrap around.

My second thought is "thank god I don't sleep naked."

And then I start getting a tad angry, and the adrenaline starts up. And I look at him (he hasn't even moved, but he's watching me) and I say, "what the f--- are you doing on my patio? Get out of my yard."

And he starts talking to me, apologizes, tells me he hopped the fence and he's just waiting for his friend and his back pack and blah blah blah and he's so sorry if he frightened me.

And I'm shaking my head, trying to get the sleep out of it, and things start coming a little more clear. Like the fact that my fence is not easily hoppable in any direction. And that I didn't hear the chair move at all, so he's probably been sitting there for quite a while. And that he's still there, staring at me, and I'm getting really sick of men who don't know me assuming that because they find me attractive that it is their right to tell me so, or watch me, or grope me, even when I tell them no.

I tell him again, "get the f--- off my porch, and don't let the gate hit you on the way out." And he apologizes again, says he'll give me some weed to smoke if I want. And he's still standing there, and he looks me up and down, and says,

"Hey, you've got that sexy librarian thing going."

I'm afraid I temporarily lost my mind. The wise thing to do, of course, would have been to close the door and call the cops. I didn't do the wise thing. I got very, very angry, and that adrenaline was really pumping, and I threw open the sliding glass door and lunged out, all 5 feet 5 inches and 130 pounds of me, and yelled "get the f--- off my porch or I will beat the living shit out of you!!"

He ran through the gate (he knew exactly where it was) to his car parked in front of my house, started it up and took off. And I sat down very fast and laughed.

and then I cried, and called the cops.

I woke up this morning and saw that he'd been watching me before I went to bed, too. The chaise lounge on the back porch is turned so that it looks directly in the dining room window at the table, where I sit and write every night before bed.

I was just starting to feel safe again, you know?

But you should have seen his face when I came out at him.

cliff surfing and more proof that i'm regressing

This is the full version of the carefully censored story I told my mother the other day.

On a recent camping trip, me and the Rock Star and a few others went mountain biking on a 14 mile trail (real mountain biking, like on the side of a mountain, with a steep drop down one side, straight into a river that stupid people ride in big rafts). anyway, about a third of the way in, we'd pulled aside up against the cliff face to let some other bikers pass going the other way; one of their back tires nicked my back tire, my bike tipped, and I slipped over the side. (Yes, you read that right, I fell off a bike that was not moving.) Frankly, I thought I was going to go all the way to the river, but I caught myself about 10 feet down. I'm very bruised- everyone at work is joking that Rock Star beats me, and I reply that no, he just throws me off mountains. I'm guessing the fall was rather spectacular to watch, judging by the look on his ordinarily deadpan face. And the fact that I regrouped before he did, which is difficult to do when you're picking shrubbery out of your hair, your heart is trying to jump past your uvula, and your limbs are so rubbery that sitting and contemplating the scenery seems like a really, really good idea for oh, an hour or so.

I did get a fairly remarkable gash in my leg and a couple of sprained fingers. Luckily, we had a pretty extensive medic bag back at camp (that's what happens when you go camping with a bunch of firefighter/medics with foresight and a lot of beer), so after things clotted up, we finished the ride and then I washed up in the river and poured down some liquid courage and we steri-stripped me. I've included a picture for your viewing enjoyment. That would be my right thigh. A week post-incident. It's going to be a big scar.

I don't recommend cliff sliding, though. I darn near wet myself.

a very brief recounting of the worst day ever

Grief, I think, is the most difficult part of our job. It's not the code blues (or 99s, or whatever your particular agency or hospital calls it when a patient crumps and dies, maybe right in front of you, maybe not), because in a code situation, training takes over, and it's much easier to think of the person in front of you whose chest cartilage you are cracking with every compression as a collection of skin and bones and cells and systems that all need to work together in order to keep a body alive. And so you try to pretend that what you're doing is to save a life, which might actually be the case, but more likely you are just keeping those organs alive on the off-chance that the person you are doing cpr on is an organ donor, or maybe you're pushing drugs and pumping someone's heart and slipping on a slick of vomit on the floor for just long enough that the person's family can get to the room and say goodbye to what they still think of as a person, but who you can tell is really just a corpse.

I hate doing cpr in front of family members. I hate the after, when I'm soaked in sweat, face flushed, trying to keep the mess on my scrubs to myself, when the family comes up to me, crying, and thanks me for all I've done, and hugs me hard. I didn't do a damn thing- there's your wife/mother/sister laying on that gurney, still dead from the abdominal aortic aneurysm she had that we didn't know about until she started vomiting and then her stomach blew up like a balloon, right in front of us. I hate watching that numb and silent grief that I can't do anything about, slicking up the fingers of another dead woman with KY jelly to slip her wedding ring off to give to her mute husband, the one she'd been married to for four decades. He asked for her toe ring, too, so I pulled the blanket back and revealed bright coral colored nail polish, so incongruous on the 68 year old foot.

I can handle the dead, the dying. It's the living that stay behind that I don't know how to deal with, the ones for whom the death is such a surprise. I didn't know your mother. I didn't know your wife, or sister, except maybe to start their IV or help lift them from the ambulance and get them hooked up to our equipment, continuing a steady stream of conversation to help them feel more comfortable. And I am so sorry that what I did couldn't save them for you, even though I did everything that I could. There is nothing, absolutely nothing that I can say to the grieving to ease their loss. All I can do is mop up the shit and vomit, tuck a clean sheet around the body, pull off the gold tokens of a life together, and hand them to you before I walk out the door to sit on the back stoop and cry.

on the menu: beer and tissues

Today was the worst day ever. Ever.

it's my magnetic personality

some of you may have heard about my previous experiences with certain monitoring equipment on the ambulance and in the ER. Well. RevMedic, you'll get a kick out of this. . .I can hear you laughing all the way down the I-5 corridor.

my new position is in the fast track section of Meth Central Med Center's ER. Better hours for a single mom (I get off work while it's still light outside!), plus I'm not tempted to do things that might get me in trouble, like

brief digression:

pushing D50 on a combative diabetic patient with a CBG of 33 who is brought in by medics after causing a rather large wreck on the freeway that sends 4 other people to the trauma center and the diabetic patient to our little ER with no IV, which I manage to get, and then without thinking, grab that big fat syringe sitting bedside on the tray, and when I'm halfway through the IV push realize that while I am certified by the state I live in to paralyze patients in the field I am not allowed to push farging sugar water in the ER. Whoopsie.

end of digression

anyway. ahem. So now I work three beds with one monitor to do intake and discharge vitals on 20-30 patients a shift. I am not rough on my equipment; I treat it with respect. I don't throw it around or stomp on it or dunk it in saline. Noooooo. However, the nurse I work with informed me tonight, after replacing the SPO2 sensor for the third time this week, that I was no longer allowed to touch the damn thing.

by the way- the Zoll is back. Took them 2 months to fix it.

karma in action

if, by chance, you happen to be Meth County's eminent and most sought after car thief, and you have, in the last few months, focused much of your attention on the vehicles in the Meth Central Med Center's parking lot, and many of the vehicles you have stolen or broken into belong to Meth Central Med Center's employees, and you decide to get stabbed by a butcher knife while mumble mumble mumble mumble (the details are still a little unclear here), and the stab wound goes into your abdomen, through your liver, through your diaphragm, and into your lung, and the person who stabs you feels some remorse (and perhaps the long arm of the law tightening around their neck) and decides to dump you in the ambulance bay of an ER, where you proceed to bleed all over the asphalt and screech loudly enough to wake the dead, or at least the security guard, you may not want to be carrying your lock-picking set or threaten the caregivers attending you that they better make sure you don't die. Better yet, you may want to gently inform your assailant that the ER on the other side of town may be preferable for future stab and dumps. The compassion index might be a tad higher.

Maybe.

stop me if you've heard this one. . .

South County ambulance arrives with a female patient who "hurts all over." Patient has been evaluated (not to her satisfaction) at the two other hospitals in the area, and so has decided to make the trip- by ambulance- to Meth Central. Patient is tearful and has a lot to say about her previous hospital experiences. Nurse Zee starts the assessment while I hook the patient up, half listening to what she's saying.

"that other hospital, the doctor was so rude. He didn't listen to anything I had to say, and -oooowwwww I am in so much pain- and he was brusque and could have been a poster child for that book "How Doctors Think." And the nurse, oh my goodness. She just sat there and looked over the tops of her glasses at me and blew bubbles with her bubble gum. The nerve. What is this world coming to? Ooooohhhh, it hurts!"

I freeze with the tympanic thermometer half way to the patient's ear and shove my gum to the little niche between my cheek and upper teeth so that I won't be tempted to chomp or, heaven forbid, blow bubbles. Zee looks over the tops of her glasses and sticks out her tongue at me.

Ahem.

it is just sooo difficult to be heard over the voices in a schizophrenic's head

This is weekend is the last for my new hobby, ie tempting fate by sliding down steep mountains on my face, er um snowboard.

I started running again. Not away from anything, just running because I love doing it and it's good for me blah blah. I managed a mile run and a mile walked without my lungs hurting last week- that's the first time since I had pneumonia last october; it took me a half hour, and I used to run 4 miles in 30 minutes, but hey, baby steps. I also started lifting my little 5 lb weights to try to strengthen my upper body since PT wasn't doing much for my bad shoulder. I was pretty proud of myself, finally getting some muscle tone back in my arms, and when I told Rock Star, who has been body building for a decade, he said, "oh, so that means you'll be a little more of a challenge when we wrestle?"

Dude. They're five pound weights.

catfight in the ER

There are very few patients who push my buttons. In fact, I'm the one that the nurses come to when they have a patient they don't want to deal with. So when one of my favorite nurses (she refers to me and herself as "the alpha bitches," which from her is a compliment) snagged my arm at the nurses' station and started telling me about the patient she'd just brought back, I kinda rolled my eyes.

"firefighter girl, she's 17, diabetic, states she's had high sugars for a week and a half and is now convinced she's DKA. She refuses to put on a gown, has a leopard print blanket and a red heart teddy bear, and claims she's a hard stick. p.s., the woman with her is her mother, but don't expect her to say a damn word."

Alpha Bitch leans close and grips my arms hard enough to leave bruises. "good luck."

Piece of cake.

I grab the IV tray, and if I coulda set it twirling on top of my index finger, I would have- my game was that good, baby. I love patients who are "tough sticks." Especially the ones who think they know my job better than I do.

I walked in to see the princess sitting criss-cross applesauce (we used to call it Indian style) on her gynie bed throne in a private room. Mom stood anxiously at the foot of the bed. Amazingly, as soon as I entered the room, the princess started Kussmauling. I leaned in a little closer and sniffed for that sweetish ketone scent a true DKAer would have, but all I could smell was the pungent odor of bullshit. I looked at her, sat down on my rolling stool, and started preparing the IV goods.

"Just so you know, I'm a tough stick. You're only going to get me from here up, and even then you'll have a hard time," she says, gesturing to her antecubitals. "It always takes them four or five times to get me. At least." She glared at me triumphantly, then resumed her Kussmauling.

I recommended that she calm her breathing down before her hands got all numb and tingly and stuff. Her eyes narrowed. I started asking my standard questions, things that I ask every diabetic patient: how high have your sugars been, for how long, what are they normally, have you been sick, do you take your insulin regularly, etc etc etc, blah blah blah. Princess stops her hyperventilating long enough to take a deep breath in order to deliver a speech she's hoping will scorch my eyebrows off.

"I. Am. A. Brittle. Diabetic. When I am sick or stressed my sugars go way up. We'd all do a lot better if you'd just shut up and quit judging me and start paying attention to what I'm saying. Understand?"

It makes me blink a little. I try to cover up my guffaw with a cough. I explain to her that these are questions I ask every diabetic, I've never met her before, I haven't read her chart, I'm here to start an IV and draw some blood. I am being very, very nice and oh-so-polite. And as patient as god, I might add; my mother would be so proud. She sighs and flips her hair. I ask for her arm, and wrap the tourniquet. I dutifully check her ACs- nothing doing- and then, lo and behold. . .

a beautiful vein goes POP in her right hand. And another one springs to attention in her wrist. And so I reach for the swab. . .and she yanks her hand away.

"Excuse me. We just went over this. You're not getting any vein down there; they roll. And while you screw around with that and miss, you're wasting precious time that you could be using to start an IV where I tell you so I can get the medication I need."

I'm afraid I may have started losing my patience. I give her the standard "I will take your suggestions into consideration, but I do this all the time and I will start an IV in the place I feel is best. Please allow me to do my job" speech. I reach for her hand, swab at that gorgeous, bouncy blue vein, and she yanks her hand away again.

"If you aren't going to listen to me, you aren't going to start my IV. Go get somebody else."

I unwrapped the tourniquet and said, "fine, honey. I'll go see if I can find somebody to help you. We're awfully busy, though, so it may be awhile." and I smiled at her, left the room, and went into the store room to kick some boxes. It was that, or pull her hair and scratch her face with my nonexistent fingernails.

I decided to ask the one male nurse on shift if he could fit in the IV. I had a feeling the princess would prefer a guy, anyway. And I told my young, buff medic student to hang around and soften her up a bit, too. Male nurse said his rooms were all full, but he'd get to the princess when he could. I thanked him, asked if there was anything I could help him with, offered to wipe his patients' butts because that would be far preferable to dealing with the brat. . .er, princess. . .again. He laughed. I warned him I would be getting the better end of things. Pun intended.

As I walked by the room, I noticed the brat's mom hovering outside her door. I mentioned that I had someone coming in, but it would be a while before he could get there. She said, "you know, she's such a hard stick, it would probably be best to get the IV team in here to do it."

I smiled at her. "Ma'am? I am the IV team."

Medic pay in the ER? not much to write home about
The incredibly self-satisfied feeling I got, watching her jaw drop and her mouth open and close like a fishy while she attempted to stammer an apology for her spoiled rotten daughter? priceless.

fyi: if my daughter ever, ever treats anyone like that, she will be flogged and bound and forced to watch reruns of . . . of. . . Barney until she gets control of her lip. I cannot imagine treating anyone as poorly as that 17 year old girl treated every single person entering her room with the sole intention of helping her. And I wasn't the only one kicking boxes in the stock room last night.

how to pay karmically out the ass for your next 15 lives

be an arsonist, and decide to light the lovingly rebuilt, restored, revamped Lincoln Continental of a tattooed paramedic/firefighter nicknamed. . .well, nicknamed the name of a guy you probably wouldn't want to mess with, who happens to be good friends with most of the cops in Meth Central. Oh, and pay no attention to the Maltese Cross on the back window, the one that says "american association of firefighters." Yeah. Good luck. Have a nice life.

mini update

1) we picked the implant we liked, and MixMan's surgery date is June 25th.

2) BSUYAM told me the position is mine and approved the schedule we made. (can i get a whoa! and a hell yeah!)

3) The hair pet problem seems to be under control. Although the stench of rosemary and tea tree oils with a light note of neem rolls out of our house in waves when you open the front door.

a few of my favorite things

working night shift does crappy things to your brain. It messes with your emotions and your mental health, especially if you aren't getting any sleep for three of the several days you work because you happen to be a mom, too, and kids don't understand night shift. But that is neither here nor there, it just is what it is. I used to be such a cheerful, happy person, fairly compassionate, and then I got pneumonia at the end of october, and was in bed for two weeks, and by the time I got back to work- still sick, mind you- I realized that most of the people in the emergency room as patients were less ill than I was. And that made me a little bit pissy.

Anyway, I decided this morning that I need an attitude adjustment, and the best way I know how to do that is to make a list of all the things I love, and all the things I'm thankful for. So here it is. . .my freaking joy list:

my bed, with its cushy top and down comforter; the color combination of pink and green, tulips and daffodils, ranunculus and windflowers; my son's toothy grin, lying in bed with movies, books, and a notebook, poetry penned on napkins and restaurant coasters, found poetry, colors so gorgeous and vivid I want to pop out my eyeballs and soak them in it, rainbows after a violent storm, the warmth of my lover next to me in winter, lying naked in front of a fireplace, pears and cheese with wine, the perfect pair of jeans, or failing that, the near-perfect pair of jeans, Jembosaults, my daughter's uncensored laughter, the way an iv feels going into a vein just right, coffee so strong and thick a spoon stands up in it, realizing that you can live without a certain someone but you'd really rather not, sitting under a tree on a blanket in the summertime, sundresses and sunhats in the garden, flip flops, toe rings, chokers, piercings, tattoos, LuLu Guinness glasses, grippy toes, bare feet, hot tubs, hiking, camping, snowboarding, views that take my breath away, my mama's hugs, spending time with my family, how loose and lovely my body gets after 15 hard minutes on the treadmill, dancing away all my give-a-shit, strong bass I can feel in my bones, listening to my deaf son sing, any music with real soul, books I can get lost in, home- not necessarily the place you live, but a place that feels so right you don't want to leave, wet kitty noses, the smell of old books in leather bindings, art almost as old and grand as god- the Sistine Chapel, the statue of David, you know what I mean-, mud between my toes, my children's safety, good friends who love me unconditionally, recovering from a Sylvia Plath moment, redheaded sisters, geminis, astrology, handwritten letters, love letters, getting flowers, gifts that show somebody's listening, affection, public displays of affection, mail slots, running my hands over the Rock Star's shaved head, the crinkles at the corners of his eyes, lips so soft I want to suck them off, holding babies (and then giving them back!), hot showers, lavender plants, rose oil, necklaces, clothes I can change with my mood, secrets, massages, interior design, getting down to the nitty gritty in a relationship and really knowing the soul of someone else, fuzzy socks, text messaging, all the Lou Whos, fingerpainting, love and being loved, trust, and last but not least, R E S P E C T.

what you never, ever want to hear your sweet five year old say

"Mama. Isobel said that Elena had lice. I love Elena. What are lice?"

tonight, we're washing everything. Everything.

it was a really close shave

patient comes via ambulance with vague abdominal complaints. Doc goes to do a quick stool occult. Suddenly, from behind the curtain, we hear this:

"well, son, you've got somethin' shoved up there!"

I hastily cleared a private room.

a gentle reminder: never do anything you can't explain to the paramedics. or the ER staff.

i like throwing myself off mountains

Even though I'm having a really hard time moving today.

this is a thing called hope, and it's on the horizon

MixMan and Miss Diva woke me up this morning at 0730. They'd been up for an hour already (why is it that during the week I have to drag them out of bed at 0700, but on the weekends they're raring to go all bright and shiny? I need my blasted beauty sleep.) They're downstairs, watching Saturday morning cartoons in their pajamas, MixMan with his cochlear implant brochures tucked under his arm. I'm upstairs in the work room, studying a couple of canvases, some emails, and contemplating another pot of coffee.

A friend of mine and I were discussing some rather personal things last night. I may have mentioned in a previous post or two that night shift has made me a little crazy, and I'm finding my Bell Jar moments are becoming more frequent; so much so that at least one of my friends is starting to refer to me as Miss Sylvia. But I was trying to figure out how it was that I became so impenetrable to emotion. And it's not that I don't feel it, I do. And I honestly feel like I show it a lot, too. . . but that's apparently not the case. During ACLS classes, a couple of the veteran night shift nurses were talking about how tough the testing used to be, how they'd throw up before "mega-codes." And I said, "me, too! I hate testing, I get so nervous I can't breathe." And one of them looked at me, and said, "yeah, right, FFG. Whatever. Nothing gets to you." And I've had ex-boyfriends tell me that they get so petrified of doing anything wrong because if they do, they get "the look" that makes them feel like they just killed someone's puppy. And yes, that's a quote.

When did that happen? What jacked up bull crap kind of coping mechanism is this, that pushes everyone away when I need them the most? Sheesh. Night shift and lack of sleep certainly haven't helped. In this profession, too, it's necessary to maintain a very delicate balance of compassion and cynicism, and frankly, the compassion index is usually a little low. But (Blow-Sunshine-Up-Your-Ass)istant Manager posted two new medic positions for noon to 2200, and when I mentioned that I was interested, he told me to go ahead and make my schedule. So I handed it over to Rock Star, because he's better at these things than I am. And he came up with a schedule that gives us lots of time together, and time with the kids, and time for sleep and real life. (isn't he amazing? I think so.) Now to pass it by BSUYAM. . . keep your fingers crossed for me. And that light you see at the end of the tunnel? I'm running as fast as I can toward it.

overheard. . .

from the front seat, while driving children home from school

my five year old, dainty, blonde-haired pink-clad Miss Diva: "MixMan!! Pull my finger!!" with the usual result and great belly laughs ensuing.

in the break room at work

the blow-sunshine-up-your-ass new assistant manager of our ED, speaking to one of the docs:
"hell, no, I'm not having any more children. I just inherited 37 of them when I got this job."

sometimes, dreams come true

three months ago, MixMan was telling me about his dreams, which he likes to do. Usually, they involve a great deal of running and shooting and 'splosions and magic power jewels and all things Sonic the Hedgehog. But this particular time, he looked at me and said, "Mama, in my dreams, I can hear, and I don't have to sign."

the next day, I started gathering up referrals and getting everything in order to determine his eligibility for a cochlear implant.

so on Tuesday, we went up to Big City Hospital. Before we were even out of town, MixMan's daddy started complaining about my car and my music and my driving. He said I drive like a grandma.

whatever.

Anyway, I told him to shut up or he could walk. He shut up.

Once we got up there, MixMan went through a battery of audiological tests. He stayed focused and worked so hard, and it turns out that his hearing loss is in the profound range (which I knew, but he's so sneaky and smart and hated the hearing tests so much that we never could confirm it). In any case, he's definitely eligible for the cochlear implant, and we spoke with the surgeon, and picked out the model that we like, and we'll be scheduling the surgery for some time this summer. The audiologists and the surgeon are all very very hopeful and optimistic about MixMan's potential with this-- he's had such dedicated speech therapy since he was 10 months old that in addition to being able to hear normally at 20db with the ci (instead of the 50db he hears at a whisper with hearing aids, and to put that in context, a normal conversation takes place at 35-40db- which means MixMan is very good at lip reading), his voice tone will also most likely improve. They did say that because of the profound hearing loss, he is eligible for bilateral implants, but most people we've spoken with recommend unilateral with the hearing aid in the other ear, at least for a while. The ci also comes with little attachments for an ipod or mp3 player, so MixMan can listen to music instead of just the thump of the bass.

MixMan is so excited. and so am I.

this is a new one, even for me

so yeah, streetlights go out when I walk under them, and when I worked with him, RevMedic jokingly called me his little EMP because of how many pulse ox sensors would just stop working when I touched them.

This is what showed up on the Zoll I use most often when I turned it on to cardiovert a patient today. It took a second to register what I was seeing. No, I haven't tampered with the picture at all. And nothing any of us tried would make it go back to normal.

This has me a little worried.

why i am drinking an alcoholic beverage at 0430. . .again

really, I don't ordinarily make a habit of drinking when I get off work. . .there's something that doesn't seem quite right about having a beer half an hour before a lot of normal people wake up for the day. but sometimes, there just isn't enough mentholatum in the world to shove up your nose to keep the bad smells out. I think we went through our entire backstock of Fleet enemas tonight. It's been a dookie kind of week.

Question: If you are a stupid person, and you are running from the po-po because you a) wrecked a car, b)were driving while intoxicated, c) have warrants out, or d) took something that wasn't yours, and they chase you (because they always do) and they happen to let the K9 out of the car (which they always will), why is it that you must always end up in a thicket of blackberries?

a word to the wise- never run from the cops. Especially the ones with cold, wet noses. Their bite is worse than their bark. And all those scratches from blackberry thorns? Insult to injury. And it's going to hurt like hell when i clean them out.

p.s. when you come in to the ER at 0300 with really non-specific 10 out of 10 pain that magically migrates from lumbar region to sacrum to abdomen, with strangely point tender spots in random places, and you are weeping and wailing while the person on bed 2 is being told that they have a mass on their brain and the person on bed 9 has a heart rate of 179, and the doctor is kind enough to give you a prepack of Ativan to help you sleep, and you throw it at the 30 year veteran charge nurse and tell her that Ativan just doesn't work for you, and she tells you to get out before she calls security, don't be surprised when she calls security and they escort you to the lobby to await a taxi the unit secretary was kind enough to call for you. And when you decide to yell and scream at the admit secretary, and lunge across the desk and grab her arm, don't be surprised when she calls the police with the little button located under her desk. And really, really don't be surprised when they show up code 3, tasers at the ready. And if you happen to look up and see firefighter girl and 5 meth central firefighter/medics watching and ready to fight over who gets to pull out the taser prongs, well, understand that it's nothing personal. Really.

why i am drinking an alcoholic beverage at 0430

because last night, the patient in bed 11 had breath that smelled exactly the same as the (digitally removed) poo of the patient in bed 10.

and those were two of my first patients.

it didn't get any better in the 12 hours I was there.

p.s. no, you don't get a numbing shot before you get your iv. this is the ER! and if you 1) know that such numbing even exists and 2) ask for it and then bitch at me when I tell you "no," chances are, you are not having an emergency.

got my coccyx spanked by a mountain

Apparently, after 5 months together, I've moved up to the next level of Rock Star. I know a couple of his friends, just because he and I work in the same place, and I've met another one in passing, but this week, the Rock Star invited me on an overnight snowboarding trip. He said he wasn't quite sure who else would be going. So when we got to the meeting place, imagine my surprise when his three best friends walked out of the kitchen. Without their wives/girlfriends/significant others. Dear lord. I looked around for an escape route; the Rock Star was blocking my only exit. He leaned close and said, "just so you know, they're not going to cut you any slack."

I can handle it. Bring it on.

The drive to the mountain was a tad uncomfortable, little ole me packed in a biiiig chevy pickup with four rather manly men. Haven't felt that way since sitting in an engine on the way to a fire, and that's been a while. The testosterone was almost overwhelming. But a couple of nudges and reassuring smiles from the Rock Star, and I settled in. When we got to the resort town of HighFalutin' we dumped our stuff and headed out for "a beer" and some food.

Waking up the next morning hurt a little bit, but once I got my land legs under me, I was fine. Ahem. Really.

We got to the mountain, the Rock Star got me signed up for rentals and a lesson, and then the boys took off. I sat in the cafe and waited for my head to stop throbbing.

The lesson didn't go well. I guess I'm not much of a student, so it's not necessarily the teacher's fault. Just tell me how not to die on a snowboard, and I'll figure out the rest for myself- I don't need a bunch of coddling. And the bunny hill is a crappy place to try and learn. By the end of the lesson, the teacher was frustrated and I was almost in tears.

After a brief pow-wow over nachos and a pitcher, the boys decided it was time for me to have a real lesson. Rock Star asked if I might like to come to the top of the run they'd been doing. Half way up the lift, with the ground very, very far away, I asked how the hell he'd managed to talk me into this. He just smiled, and hugged me, and his best friend said, "you're just as crazy as he is. . .that's why the two of you get along so well. You'll be fine."

I'm not sure what that's supposed to mean.

Too bad that was the last run of the day. It is so much easier to learn with four no-BS teachers and room to ride, and I had an absolute blast, even after sliding down the steeper parts on my face. It may be a while before I can sit down comfortably again, however.

Oh, and judging by the hugs and "you have no idea how nice it is to finally meet you"s, I think I passed this level of Rock Star. And that makes me pleased as punch.

does not play well with others

do you think it says something that the one question I missed on the ACLS written exam was the one about teamwork and instructive communication?

hmmm.

p.s. I run with scissors, too. sort of. Do trauma shears count?

boredom is a chronic disease

I really should be cleaning the house. There's a whole list of stuff I need to do this weekend while the kids are gone, but I mostly find myself staring at my computer screen or blankly off into space. Sometimes I come out of it long enough to dab at the drool collecting in the corner of my open mouth with my shirt sleeve.

Night shift is getting to me.

Spent Friday with MixMan getting a CT scan and then fighting with the MRI tech about what test he was doing. . .he insisted on a full brain scan: 40 minutes in the imager with an IV for contrast for an 8 year old OCD deaf kid afraid of needles? HA! and I tried to tell him this wasn't for a diagnostic, it was specifically for the surgeon to be able to see the inner auditory canal, or IAC, for placement of the cochlear implant. I pointed that out to him on the order sheet from MixMan's PCP: "MRI IAC." and this is what he said:

"I've done brain MRI's on lots of deaf people. And I'm sure many of them have gone on to have cochlear implants."

Whaaaat?

Had a pretty good stretch at work this last weekend. Several drunks with head injuries, shocker there, eh? One of them apparently slipped on some peanuts at the Roadhouse and smacked her head on a table. Medics brought her in, she kept insisting she had a right to refuse treatment because of her religion, paganism. umm. okay. She loved the boys, though- the security guard, the CT tech, the 60 year old male nurse. Oh, yes. But anytime one of us girls would walk by her room, she'd yank the pressure bandage off her head, wave her arms around, scream, threaten to sue, and then start spurting blood in wide arcs from the little arteries she'd sliced open in her scalp. When we finally sedated her enough to suture, I had to hold a flashlight above the lac so the doc could sew, since our portable light in the psych room wasn't good enough. With the flashlight, and the blood everywhere, I kept thinking I heard choppers and the theme music to MASH playing somewhere outside the room.

My favorite patient was the LOL who came in from a nursing home, hx of CVA with right sided deficits, with sudden unexplained weakness in her left arm. CPHSS was normal otherwise. Staff said she was somewhat unresponsive and not her usual self. Excuse me, but if I'm not working, I'm usually somewhat unresponsive at 0300, too. Sheeesssh. But she's all dressed up, hat on at a jaunty angle, mardi gras beads around her neck, and I asked her if she got all gussied up just to come to the hospital. "Nope," she says. "I always dress like this." I find this rather curious, ask her what jammies she wears to bed. "I don't wear jammies. I like to be ready."

I'm a little confused by now, and I'm pulling off her hat, and glasses, and beads, and fuzzy sweater, and button up shirt, and tank top, and thinking of all the possibilities of what she could be ready for, this little old lady from a nursing home. So finally, I ask. And she says, "whatever might happen!! you never know when somebody is going to ask you to go dancing."

Well. She has a point.

sooooo. . .you may have noticed something different

yeah, I changed the name. Since I can't really play in traffic anymore, and I spend the time I'm not at work puttering around at home instead of dinking around in the back of an ambulance or running into burning buildings, and while a lot of my posts are about Meth Central Med Center ER, many have been about home and gardening and single parenting and MixMan and Miss Diva, so I thought perhaps it was time for something a little different. But. . .a rose by any other name still smells as sweet. So remember that the next time I'm writing about patient vomit and such.

there we were, in the congo

humans are not meant to be awake in the middle of the night. I look at some of the hard core ER nurses who have worked night shift for thirty years, and frankly, I don't ever want to be like that.

The docs have started a new schedule rotation so they can maintain a little consistency. This entails working the same shift for a month. There are a couple of doctors I'm not all that fond of, but they're completely different people at night. Particularly after the fourth or fifth shift, when they start getting a little punchy. Doc D, who on days is rather serious and nitpicky, and likes to micromanage, has scolded me on more than one occasion, but the other night, as I was headed into the fray with the IV tray, one of our critical patients with an Na of 108 started moaning and yipping. (those electrolytes. . .) Doc D looked at me, waggled his eyebrows, and said in his best gather 'round the campfire voice, "there we were, in the congo. . ." and the nurses' station erupted with laughter. Except for the charge nurse, who is one of those previously mentioned hard core thirty year ER night shifters. She doesn't much laugh at anything.

but tonight rounded off my last of 6 in a row, so now I've got a few days free. That makes for a happy firefighter girl. New tattoo tomorrow, an ACLS recert on Monday, snowboarding on Tuesday with the Rock Star, and the fact that the sun has been out for three straight days in a row makes me even happier. Besides, you just know, when you've hardly had any sleep because the kids need you, and you're heading into a 12 hour shift and you're so tired you can barely get the straw from your Starbucks lite honey frappuccino into your mouth as you walk down the hall for report, and the nurse stops you and says there's a junkie on bed 10 who desperately needs an IV and everybody else has already tried their two times and you put your coffee down and you walk in the room and you smack your head on the monitor so hard you see stars and you still manage to get the EJ on the first try. . .then, you just know that life is good.

hey, Monkey Girl? I have that cold, too. I begged a doctor the other night to puncture my sinuses with a 14g since the holes at the bottom of my nose aren't quite doing the trick. Note to patients: when we give you a mask? wear it. I don't care how "uncomfortable" you think it is. If you don't wear it, you may find yourself getting sneezed on while I'm starting your IV because I can't let go of the catheter to grab a tissue or you'll bleed all over the floor, and we can't have that, now, can we?

Right now in the Meth Central Med Center ER, we all sound like lounge singers. we're gonna install a baby grand at the nurses' station, get sequins and bling for our green scrubs, and wear stiletto Danskos. Whaddaya think?

the (Grateful) Dead had it right. . .sort of

so i've had a few medic students in the ER doing their clinicals lately, and it's made me a tad introspective. I had a couple of them tell me they passed first term at the head of the class because of me, and that makes me feel weird but good, especially since my first preceptor during my own internship two years ago told me I needed to pick a different profession. Bitch. (whoopsie, was that my outside voice?) Hell, I still get excited when I get to put in a 16g IV or shock somebody, but mostly that's because it reminds me I'm a real medic instead of housekeeping with IV skills. But watching a medic student shake with nervousness while putting in an IV or starting a saline drip, and seeing them getting excited about some broken bone they saw in an x-ray makes me a bit nostalgic, and since the honey is in Tahoe and I'm taking a little break from practicing Guitar Hero on the PS3 he left with me, and I've had a couple of beers, well, I thought I'd take a little trip down memory lane.

It's amazing to think how far I've come. Five years ago, when I first brought up the idea of being a paramedic with Miss Diva's dad (who I was still married to at the time), he told me about all the gnarly things I'd see. And maybe I got a little woozy when I had blood drawn, and I'd have to sit down fast when I started thinking about broken bones and needles. But I had a feeling that it was what I was being called to do, and the feeling didn't go away. In fact, it intensified over the next year, and I finally started the process by becoming an EMT Basic and volunteering with a local rural fire department.

My first real fire was a fully involved structure fire with a fatality. That was also, aside from funerals, the first dead body I'd ever seen. When we found her body the next day, what was left of her consisted of a head, hair intact, a flannel shirt-clad torso, and a pair of feet. The coroner used a small body bag and rested her feet on her chest before zipping it. I remember going home and sitting on my couch, the sound of traffic and shouting and my neighbors fading into the background under a strange buzzing in my head. To this day, I cannot open a box containing a Resusci-Annie CPR dummy without thinking of that woman, because that's exactly what she looked like.

The next body I saw was a woman a year older than I who drowned while rafting the McKenzie. I'd never seen pupils fixed and dilated, never seen flesh that pale blue hypoxic color. Now, of course, I'd recognize it anywhere.

Once I got past the mental block that blood is mythical and mysterious, once I got used to the metallic tang of it fresh and the sickly sweet smell of it after it had been spilled for a while, once I'd inured myself to the weight and temperature and feel of dead flesh and the crack of ribs separating from sternum during good CPR, once the smell of death no longer got to me, I managed just fine, and I'm pretty sure I've become an okay medic.

so yeah, it's harder if I look at their faces, and definitely harder if they crump in front of me. The only patient I ever lost in the field? Her daughter lives across the street from me, and every time I see her I feel a rush of shame, although there was nothing I could have done.

The babies, the ones my age, the ones that come in talking, those are the ones that keep me awake occasionally. Do I do more good than harm? Hard to tell sometimes. So maybe I spend most of my time now with other people who understand what I do for work, who aren't grossed out when I talk about boob smegma and projectile vomit and patients who shit out their mouths, and who can see the humor in being groped by a dead man. I still feel called to this profession, and I don't know really where I'm going to go from here, since the dream of being a medic/firefighter is over thanks to that one patient whose life I did save tearing my biceps tendon while I tried to wrestle him to the ground. My life has been saved more times than I can count by the patients I've cared for, the ones with grace and dignity and moxie. It's been a long, strange trip, and the compassionometer has fluctuated wildly from zero to overflowing. I would still rather feel too much than nothing at all, and so if I cry while I'm doing CPR or hugging the mother of a 3 year old Downs Syndrome girl just diagnosed with leukemia, well, that's just me, and you can look away or leave if it bothers you. And maybe I don't save a life every day, and I get a little jaded when it comes to migraines and chronic pain. But I am so thankful to be a part of this, and it is so hard to imagine doing anything else.

dancing for ekg geeks

http://www.youtube.com/watch?v=BhGGzB09wQk

you will wet your pants laughing

random musings of the mildly emotionally dispossessed

Mom's here visiting. She got a little worried last week when I called her bawling incoherently, crying so hard my eyelids were swollen shut, which made it difficult to drive, quite frankly. But I had just been at the home improvement store, and there was no school, and my paychecks aren't quite covering the living expenses, and night shift makes me crazy, and the kids were at each others' throats, and the lady at the home improvement store ran up and started freaking out about them playing around the big hanging rolls of carpet. So they climbed out, and MixMan started talking to me while I was talking to the lady about vinyl tile, and he's losing more hearing, and so doesn't really know when his voice gets loud, and I was trying to sign to him while talking to her, and she looked at me and said, "I can't even hear myself think." and I apologized, pointed out that MixMan is deaf, that he doesn't know how loud he's being. And she shakes her head, and glares at MixMan, and says, "I can't hear myself think to talk!!"And I guess I kind of lost it, because I said, "he's deaf, deal with it. I live it, bitch." I've never done that before in my life, called somebody i don't know a bitch.
Anyway, Mom flew over here two days later. She's kind of like me, wants to be present even if she can't really do anything. And she's as stubborn as I am. So. She's here until Wednesday, and the kids are loving it. . .all this personal attention from grandma, and I get to lounge on the what-will-become-of-me bed in my pink and green bedroom.
So I'm sitting here, listening to Sia, and keeping an ear peeled for trouble in paradise downstairs since my mom is at church and is not currently around to play peacekeeper. Mostly what I'm doing is thinking about what it means to be a parent, and a lover, and a friend, and how to balance all of those things into something that feeds the heart and soul.
I frequently think that my children are much better off with me being benignly neglectful than actively parenting. . . and I wonder how many years of therapy they're both going to have to go through because of how short my temper is with them sometimes. But they are so very forgiving, aren't they? I could learn a lot from them.
We lose sight of the fact that really, all we're here for is to relate and love and communicate with other people. What could possibly be more important than to know and be known, to open yourself up to someone else? Anything that prevents that is an excuse, and I am guilty of making those excuses myself. . . opening yourself up to the possibility of being loved, why the hell does that make us all so afraid?
I sit here, and I paint, and I listen to my music, and I drink my coffee. Sometimes I cry, sometimes one of my kids comes in and gives me a hug and a little kiss on the cheek. Occasionally, I rock back on my heels, hug my legs, rest my chin on my knees, and wonder how we all became so fragile and broken.

a first time for everything

RevMedic's been giving me a tough time about the whole not posting for a couple of months thing. He can do that, though, because he's the sixth god of EMS, and he can stomach my chewy coffee when others only politely choke it down. So for him, I'll make an effort to post more often. Besides, when you have a story like this one, you have to share it.

So last night, I hadn't even been at work for an hour when a truck vrooms up to the ambulance bay and stops. The driver saunters into the waiting room and informs the triage nurse that his friend in the truck isn't breathing. He doesn't seem terribly concerned about this. She asks, to clarify, "your friend is having trouble breathing?" no, the man reiterates, he's NOT breathing. At all.

Oh.

As we pull the man out of the truck, the bizarre story unfolds. The patient had been at a friend's house out in the boonies and had collapsed. The friend had loaded him into a car and driven (rather erratically, as you can imagine) not to the hospital; oh, noooooo. To another friend's house, twenty minutes away, but also in the boonies. When I say boonies, I mean boonies. As in the northwest version of Deliverance country, where the tattoo to teeth ratio is very high, and where every single-wide trailer. . .er, um. . .home. . .has its own still out in the back yard, not for selling, but for personal consumption. But. . .I digress. So that second friend loaded the (pulseless, apneic) man into his truck, and drove the 40 minutes to the Meth Central ER doors.
By this time, the guy has been dead for well over an hour, if the friend can be believed. But because the patient is young, and he died under somewhat suspicious circumstances, and the friend's IQ is about the same as the GCS of a rock, the doctor decides he wants to work the code. We cut the man's clothes, start ventilating, get the crash cart at bedside. I start CPR. We see what looks like a very fine v-fib, a shockable rhythm, on the monitor, so we charge and clear. One of the nurses drops the arm she's putting an iv in. We all step back and the doc gives the order to shock. The guy lurches- nothing abnormal there- but that loose arm swings up with the shock and smacks me in the ass.

Imagine my surprise.