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.