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.