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.
Tuesday, January 29, 2008
Sunday, November 11, 2007
maybe a six on the grody scale
My first day back to work was halloween, and thank goodness it was slow. I'm still not 100%, but I got my sense of humor back yesterday (didn't really realize it was gone until one of the doctors looked at me and said, "you're feeling better, arent you?") It's nice to work in a hospital; I take patient admits to the floor and then turn on the portable oxygen tank on the way back down to the ER, suck some O's until I have to go back to work again. The nurses laugh at me, but they're also very careful to make sure I'm not pushing myself. Awww, isn't that sweet?
Meth Central Med Center is now a fully operational cardiac hospital. We've had our emergency cath lab open for a couple of months, and we've had a few emergency caths in that time, but my first one was last week. It was the night I was wearing new shoes, which you may not give a hoot about, but it's an important part of the story. Those of you in EMS already know what that means.
So it's about 15 minutes before my break, and we all know what happens when firefighter girl gets hungry. Well, we don't all know, but RevMedic, you can fill them in. It's not pretty. Medics call in with code 3 traffic. Their patient is a 69 year old male who crumped and did a face plant at the dinner table right into his pasta salad. Heart rate initially 20, they have him externally paced at a rate of 70, on a non-rebreather mask and an assload of versed. All other vital signs are within normal limits.
We get the guy on our table, I get him on the monitor, move the oxygen to our wall outlet, etc. etc. One of the nurses grabs me by the shoulder and hisses in my ear, "I can't get our defibrillator to pace him! Make it work!" so I sigh, and connect the our zoll to the pads already on the patient. I look up, see one of the medics watching the exchange. We try not to laugh, because this is a serious situation.
The 12-lead EKG shows some stellar ST elevation; highest I've ever seen. Dr. Twitchy is in rare form tonight, and his 3 espressos and 4 diet cokes were obviously not enough caffeine. He's going by the cath alert check list instead of his normally well-working brain, and the nurses and I wait impatiently for his orders. He ticks off the cath alert sheet-- nitro drip dopamine drip heparin drip oxygen-- and asks if the patient has had aspirin since entering the hospital. We all stare at him in disbelief, then stare at our mostly non-responsive patient, who still has pasta salad stuck in his ear, and moans occasionally with the jolt of the pacer. There is no way that man is chewing up and swallowing anything.
I try to draw blood with the third IV I start. You can tell the patient smokes- the blood is dark and thick and hard to draw, even through an 18g catheter. Lab tries drawing on the other side. We finally end up with maybe 20 mL, and as I'm pushing it into the tubes, I notice the floaties in it- little chunks of what look like butter.
I am not kidding you.
Let's remember, this is a cath alert, and the man is having a heart attack. Lest we forget, a heart attack happens when the vessels in the heart become clogged with blood clots or plaque-- stuff very similar to the chunkies sitting in the test tube in front of me. This guy is maybe 5' 10" and weighs approximately 165 lbs. He is not a large man. Although his oxygen saturation is 99%, his skin is still grayish. This concerns us until his wife walks in. She looks a lot like him, down to the gray skin. She also reeks like cigarette smoke. We're starting to have a really good feeling about the success of our impending heart catheter placement.
We get the guy onto the cath lab table. The cath nurse asks my charge nurse if I can stay to help, and that's pretty cool because I've only ever seen one of these from the outside. We get him all hooked up and they're swabbing him with iodine in his nether regions and he starts shivering a little so we cover him with a blanket and I've got all the lines and pumps untangled and running and the oxygen is ready to transfer from the gurney to the wall and I reach to hand the tubing to the cath nurse and the guy hangs his head over the side of the table and starts puking into his mask which I yank off his face so he doesn't aspirate and they're grabbing suction and he pukes again
all over my new work shoes. And my scrub pants. And the floor, and the cords and tubing and everything else. There is a moment of silence, when all you can hear is the plop plop of the puke dripping off the table. And then the guy's top dentures slip out of his mouth and clatter on the floor, and the tech behind the glass- the only member of the room not currently coated in regurgitated rotini pasta salad- tries very hard not to laugh.
on a completely different note: remember John, from the last post? We got a letter letting us know that much of his bone and tissue was used in transplants. And I wish I could tell the people who got his stuff about John's last three hours.
Meth Central Med Center is now a fully operational cardiac hospital. We've had our emergency cath lab open for a couple of months, and we've had a few emergency caths in that time, but my first one was last week. It was the night I was wearing new shoes, which you may not give a hoot about, but it's an important part of the story. Those of you in EMS already know what that means.
So it's about 15 minutes before my break, and we all know what happens when firefighter girl gets hungry. Well, we don't all know, but RevMedic, you can fill them in. It's not pretty. Medics call in with code 3 traffic. Their patient is a 69 year old male who crumped and did a face plant at the dinner table right into his pasta salad. Heart rate initially 20, they have him externally paced at a rate of 70, on a non-rebreather mask and an assload of versed. All other vital signs are within normal limits.
We get the guy on our table, I get him on the monitor, move the oxygen to our wall outlet, etc. etc. One of the nurses grabs me by the shoulder and hisses in my ear, "I can't get our defibrillator to pace him! Make it work!" so I sigh, and connect the our zoll to the pads already on the patient. I look up, see one of the medics watching the exchange. We try not to laugh, because this is a serious situation.
The 12-lead EKG shows some stellar ST elevation; highest I've ever seen. Dr. Twitchy is in rare form tonight, and his 3 espressos and 4 diet cokes were obviously not enough caffeine. He's going by the cath alert check list instead of his normally well-working brain, and the nurses and I wait impatiently for his orders. He ticks off the cath alert sheet-- nitro drip dopamine drip heparin drip oxygen-- and asks if the patient has had aspirin since entering the hospital. We all stare at him in disbelief, then stare at our mostly non-responsive patient, who still has pasta salad stuck in his ear, and moans occasionally with the jolt of the pacer. There is no way that man is chewing up and swallowing anything.
I try to draw blood with the third IV I start. You can tell the patient smokes- the blood is dark and thick and hard to draw, even through an 18g catheter. Lab tries drawing on the other side. We finally end up with maybe 20 mL, and as I'm pushing it into the tubes, I notice the floaties in it- little chunks of what look like butter.
I am not kidding you.
Let's remember, this is a cath alert, and the man is having a heart attack. Lest we forget, a heart attack happens when the vessels in the heart become clogged with blood clots or plaque-- stuff very similar to the chunkies sitting in the test tube in front of me. This guy is maybe 5' 10" and weighs approximately 165 lbs. He is not a large man. Although his oxygen saturation is 99%, his skin is still grayish. This concerns us until his wife walks in. She looks a lot like him, down to the gray skin. She also reeks like cigarette smoke. We're starting to have a really good feeling about the success of our impending heart catheter placement.
We get the guy onto the cath lab table. The cath nurse asks my charge nurse if I can stay to help, and that's pretty cool because I've only ever seen one of these from the outside. We get him all hooked up and they're swabbing him with iodine in his nether regions and he starts shivering a little so we cover him with a blanket and I've got all the lines and pumps untangled and running and the oxygen is ready to transfer from the gurney to the wall and I reach to hand the tubing to the cath nurse and the guy hangs his head over the side of the table and starts puking into his mask which I yank off his face so he doesn't aspirate and they're grabbing suction and he pukes again
all over my new work shoes. And my scrub pants. And the floor, and the cords and tubing and everything else. There is a moment of silence, when all you can hear is the plop plop of the puke dripping off the table. And then the guy's top dentures slip out of his mouth and clatter on the floor, and the tech behind the glass- the only member of the room not currently coated in regurgitated rotini pasta salad- tries very hard not to laugh.
on a completely different note: remember John, from the last post? We got a letter letting us know that much of his bone and tissue was used in transplants. And I wish I could tell the people who got his stuff about John's last three hours.
Thursday, November 1, 2007
levaquin dreams
Got called into the director of Human Resources office yesterday to discuss the traveler nurse and his traveling hands. I made the mistake of telling the assistant manager of the ER two weeks ago, and he was actually really cool about it. But then he told the manager, who called me into his office for another meeting. I came away from that one feeling like shit. He kept insisting that I must be suffering some ill effects from the incident. I just stared at him, told him I wasn't sleeping, but I'd get over it if everyone would just leave me alone about it. I work in the ER, for chrissakes. You have to be able to let go of things, or you'll go crazy. He finally threw up his hands and told me to talk to HR, which I put off until yesterday.
We do that more often than we think, at least those of us who are emotionally and mentally healthy. Letting go, I mean. There is a resiliency in the human spirit that we don't think of very often, but I see it almost every day. I watch patients and their families adjust to news they never thought they'd have to face. . .the smart ones, the ones who will make it, take it in stride; they let go of the whole life they had planned and open themselves to whatever it is that's been thrown at them. Sure, there's some shock involved-- "yes, ma'am, you've just been diagnosed with a very large tumor in your liver" takes some getting used to--but you can almost see the shift in their minds as they adjust and move on, and face whatever it is they need to face.
I see it in the dying, too, although resiliency becomes grace at that stage. I know that certain things take on almost mystical properties when my emotional armor gets left at home, when I'm over-tired or under stress, like I have been because of the traveler nurse issue. But we had a code a couple of weeks ago that shook me, and everyone else in the room, in the three hours the patient was there.
I'll call him John. He was 46 years old, found down by his sister and mother. No history of drug use, this guy was clean. Medics almost tubed him but he came around, and was conscious by the time he came into the ER. I sat with him, started his IV, drew his blood, cleaned the vomit from his face and neck, smiled at him, talked to him, reassured him. He looked so scared, and I told him everything was going to be okay. He nodded, and smiled, and I squeezed his hand before I left the room. His mom waited outside the room to hear the prognosis of her only son.
Next time I passed the room, they were pulling out the defibrillation pads, and John was seizing. As I was wrapping my brain around that, one of the nurses in the room screamed for me, the doctor started shouting for an NG tube and suction, and all hell broke loose. John's heart rate was over 200 bpm. We cracked the crash cart and the nurse went to push drugs, and we realized that John had sweated his IV right out. I started another on the left arm, then another on the right. And then his heart stopped.
The doctor ordered CPR started, and one of the nurses began. I shoved him aside and started compressions, screaming for a stool to stand on. Once I could get leverage, I discovered something: the chest of a 46 year old man is much different than the chest of an 80 year old man. And ribs break a lot harder and a lot louder. I could feel them pop with every compression.
We got pulses back, and then a pressure. John's left pupil was blown. We all sighed, and looked at each other, and stepped back from the bedside, shaking. The doc shook his head and ordered for the air ambulance to take John to OHSU in Portland for definitive neuro care. I left the room and headed to start a couple more IVs.
Ten minutes later, he flatlined again. His mother still sat stoically outside the room. Turns out she'd lost one of her two daughters two weeks before; her other daughter, the one who had been closest to John, was racing to the hospital from out of town. John's mom just sat, and waited. We explained what we were doing, the care John was receiving, the fact that his prognosis wasn't good. She nodded, said she'd just wait for her daughter to come.
I did CPR on John two more times before he finally died for good. The doctor called the code twice-- the first time, we had a spontaneous return of pulses before the monitor was turned off. But this is where grace in the dying comes in:
John laid there, tubes in every orifice, vomit in the creases of his neck, bedding soaked with sweat, ribs broken, wires everywhere, brain dead but heart still beating. He waited there, until his sister came, and that was truly one of the most beautiful things I've ever experienced-- watching that woman kiss her brother's face, rub his shaved head, tell him how much she loved him, told him he could go. And then he did, and nothing we did could bring him back that third and final time.
By the end of the three hour code, even the doctor was crying. Say what you will, but the human spirit is resilient. And some people who haven't amounted to much in life leave that life with an enormous amount of grace. And I am honored to be part of a leaving that is so graceful, even when I fight so hard against it.
We do that more often than we think, at least those of us who are emotionally and mentally healthy. Letting go, I mean. There is a resiliency in the human spirit that we don't think of very often, but I see it almost every day. I watch patients and their families adjust to news they never thought they'd have to face. . .the smart ones, the ones who will make it, take it in stride; they let go of the whole life they had planned and open themselves to whatever it is that's been thrown at them. Sure, there's some shock involved-- "yes, ma'am, you've just been diagnosed with a very large tumor in your liver" takes some getting used to--but you can almost see the shift in their minds as they adjust and move on, and face whatever it is they need to face.
I see it in the dying, too, although resiliency becomes grace at that stage. I know that certain things take on almost mystical properties when my emotional armor gets left at home, when I'm over-tired or under stress, like I have been because of the traveler nurse issue. But we had a code a couple of weeks ago that shook me, and everyone else in the room, in the three hours the patient was there.
I'll call him John. He was 46 years old, found down by his sister and mother. No history of drug use, this guy was clean. Medics almost tubed him but he came around, and was conscious by the time he came into the ER. I sat with him, started his IV, drew his blood, cleaned the vomit from his face and neck, smiled at him, talked to him, reassured him. He looked so scared, and I told him everything was going to be okay. He nodded, and smiled, and I squeezed his hand before I left the room. His mom waited outside the room to hear the prognosis of her only son.
Next time I passed the room, they were pulling out the defibrillation pads, and John was seizing. As I was wrapping my brain around that, one of the nurses in the room screamed for me, the doctor started shouting for an NG tube and suction, and all hell broke loose. John's heart rate was over 200 bpm. We cracked the crash cart and the nurse went to push drugs, and we realized that John had sweated his IV right out. I started another on the left arm, then another on the right. And then his heart stopped.
The doctor ordered CPR started, and one of the nurses began. I shoved him aside and started compressions, screaming for a stool to stand on. Once I could get leverage, I discovered something: the chest of a 46 year old man is much different than the chest of an 80 year old man. And ribs break a lot harder and a lot louder. I could feel them pop with every compression.
We got pulses back, and then a pressure. John's left pupil was blown. We all sighed, and looked at each other, and stepped back from the bedside, shaking. The doc shook his head and ordered for the air ambulance to take John to OHSU in Portland for definitive neuro care. I left the room and headed to start a couple more IVs.
Ten minutes later, he flatlined again. His mother still sat stoically outside the room. Turns out she'd lost one of her two daughters two weeks before; her other daughter, the one who had been closest to John, was racing to the hospital from out of town. John's mom just sat, and waited. We explained what we were doing, the care John was receiving, the fact that his prognosis wasn't good. She nodded, said she'd just wait for her daughter to come.
I did CPR on John two more times before he finally died for good. The doctor called the code twice-- the first time, we had a spontaneous return of pulses before the monitor was turned off. But this is where grace in the dying comes in:
John laid there, tubes in every orifice, vomit in the creases of his neck, bedding soaked with sweat, ribs broken, wires everywhere, brain dead but heart still beating. He waited there, until his sister came, and that was truly one of the most beautiful things I've ever experienced-- watching that woman kiss her brother's face, rub his shaved head, tell him how much she loved him, told him he could go. And then he did, and nothing we did could bring him back that third and final time.
By the end of the three hour code, even the doctor was crying. Say what you will, but the human spirit is resilient. And some people who haven't amounted to much in life leave that life with an enormous amount of grace. And I am honored to be part of a leaving that is so graceful, even when I fight so hard against it.
new moan ya
yep. some little tiny bug in my right lung. And today is the first day I've been able to hold my head up for longer than 2 minutes at a time. I don't really feel sick at all, just incredibly weak. I've been in bed pretty much since I got off work a week ago Tuesday morning, although I have attempted the bedroom to bathroom route once or twice, and I did manage a 24 hour change of scenery by exchanging my walls for someone else's this past weekend.
On Friday, after giving me a 2cc shot in the ass and a bag full of Levaquin, the doctor informed me that I'll be 100% in six fucking weeks.
Okay, he didn't say fucking.
On Friday, after giving me a 2cc shot in the ass and a bag full of Levaquin, the doctor informed me that I'll be 100% in six fucking weeks.
Okay, he didn't say fucking.
another lesson or two
If you're looking for levity, you probably shouldn't read this post. I've been trying to write this for a week, now, and make it funny or sarcastic or witty. . .but I start it, and everything that comes out sounds so unlike my usual self that I get disgusted and cancel the whole thing. And even now, I've taken it down, and put it back up, and changed it and messed with it and I start to think that maybe I shouldn't leave it up here for all my friends to read. . .like I have something to be ashamed of. And that's just wrong. I need to be able to tell this. The thing is. . .I can't sleep lately. And yeah, I could blame it on my funky work schedule (even though I've been on a crazy schedule for the past 4 years. . .), or loneliness (umm. . .doubtful. . .I love sleeping alone--or used to. . .) or all my injuries or too much coffee or dry air or noisy neighbors or insert other excuse here. But I know that none of those are the reasons why.
I've worked really, really hard to become the person that I am, and I've lost a lot along the way, but I'm generally happy and content, even if my life isn't so-called normal. I'm a very private person, I like being alone, and it takes a lot to get to know me. I don't let many people get close to me, and the people I've dated in the past would be hard pressed to tell you much about me, and honestly, I'm skittish about relationships. But. . .I like my life, and I love my home and my kids and my art and poetry and writing and plants and books.
A month ago, a traveler nurse I considered a friend developed traveling hands and a traveling tongue a couple of nights before transferring to his next assignment. He's married, and has a bunch of kids, and he trapped me in the stock room and seemed a little shocked when I shoved him away. And two nights later, on the last night he worked, at the end of my shift, when I told him that he creeped me out with the kissing and the groping, he apologized, asked if he could make it up to me, and tried to do the same thing again. Which is when I ran out the back door of the break room and called for the friend who was waiting outside. There is more to this story, of course--how this brought up feelings for me from an incident last summer; how I blew it off when I was telling friends about the nurse because I didn't want them to think I wasn't strong, or that I'd somehow asked for it; how afraid I was the full twelve hour shift I worked with him that last night, and how nothing got stocked in the ER because I didn't want to chance getting cornered again, all the things he said to me the first time in the stock room and then on the last night before I ran away.
You wouldn't think that one person could take away something so integral to who you are. But that's exactly what happened: someone took away a piece of the person that I am. It is amazing that something so simple can strip so much away from somebody-- although of course I've still got my self-respect, and my independence--I've worked too hard to let anyone take those away from me. But I can't sleep. And I haven't written or painted or read a book in the last two weeks. I stay awake and restless until my eyes can't stay open anymore and then I fall into bed.
We are all so very fragile, with so many walls we think are solid and indestructable. I've built a few myself, and maintained them carefully, not letting anyone get too close. I'm not sure what the lesson is in all of this, but I'm finding something cathartic in the telling of it. . .and I guess I'm realizing that right now, I could let this experience and the fear it caused close me off again, just when my heart is starting to open up for the first time in a long while. Or I can use that energy to tear down the remaining walls I have built around me. . .because as much as it hurts, I would rather feel too much than nothing at all.
I've worked really, really hard to become the person that I am, and I've lost a lot along the way, but I'm generally happy and content, even if my life isn't so-called normal. I'm a very private person, I like being alone, and it takes a lot to get to know me. I don't let many people get close to me, and the people I've dated in the past would be hard pressed to tell you much about me, and honestly, I'm skittish about relationships. But. . .I like my life, and I love my home and my kids and my art and poetry and writing and plants and books.
A month ago, a traveler nurse I considered a friend developed traveling hands and a traveling tongue a couple of nights before transferring to his next assignment. He's married, and has a bunch of kids, and he trapped me in the stock room and seemed a little shocked when I shoved him away. And two nights later, on the last night he worked, at the end of my shift, when I told him that he creeped me out with the kissing and the groping, he apologized, asked if he could make it up to me, and tried to do the same thing again. Which is when I ran out the back door of the break room and called for the friend who was waiting outside. There is more to this story, of course--how this brought up feelings for me from an incident last summer; how I blew it off when I was telling friends about the nurse because I didn't want them to think I wasn't strong, or that I'd somehow asked for it; how afraid I was the full twelve hour shift I worked with him that last night, and how nothing got stocked in the ER because I didn't want to chance getting cornered again, all the things he said to me the first time in the stock room and then on the last night before I ran away.
You wouldn't think that one person could take away something so integral to who you are. But that's exactly what happened: someone took away a piece of the person that I am. It is amazing that something so simple can strip so much away from somebody-- although of course I've still got my self-respect, and my independence--I've worked too hard to let anyone take those away from me. But I can't sleep. And I haven't written or painted or read a book in the last two weeks. I stay awake and restless until my eyes can't stay open anymore and then I fall into bed.
We are all so very fragile, with so many walls we think are solid and indestructable. I've built a few myself, and maintained them carefully, not letting anyone get too close. I'm not sure what the lesson is in all of this, but I'm finding something cathartic in the telling of it. . .and I guess I'm realizing that right now, I could let this experience and the fear it caused close me off again, just when my heart is starting to open up for the first time in a long while. Or I can use that energy to tear down the remaining walls I have built around me. . .because as much as it hurts, I would rather feel too much than nothing at all.
Friday, October 19, 2007
some things I learned last week
a couple of nifty EKG rhythm tricks from some other cardiac nerds, firsthand knowledge of caffeine toxicity, a punch in the chest really can start a flatlined heart beating again, and- of utmost importance- shoving vicks vaporub up your nose too many times in one night may indeed keep the dookie odor out and clear the sinuses, but it can also make your nose bleed.
Wednesday, September 26, 2007
save a life
The days I forget my armor are the worst. . .when the dregs of humanity
fill the waiting room coated with a slick of dirt and sweat and desperation,
the running joke of “save a life today?” plays out every time I start an IV
for a migraine or a toothache and the junkies line up to have their abscesses drained
without pain medication because even if I could find a vein, anything the doctors could give them isn’t nearly as strong as the heroin they injected with their dirty needles. I don’t
expect to walk into a room after a particularly bad drainage, blood and pus all over
the floor, scrawny junkie whimpering on the bed, and feel anything but the usual
businesslike disgust of caring for yet another slow suicide.
But I surprise myself, and I start crying. Not terribly good patient care, I
suppose, but there you go. And as I finish taping the gauze over the hole
in his flesh, the junkie grabs my wrist with his other hand and says “thank you”
and promises to get clean. I look him straight in the eye, tell him he's lying, dare him
to prove me wrong
Guess it doesn’t matter what he said after that, because a week or a month
or a year from now, it’ll be his body on the gurney the medics bring in,
CPR in progress, his eyes fixed and staring, code called after five minutes of
definitive care in the hospital.
My friend Luke wrote me last night from work: “One of my patients just passed. . .what
a strange job we have. . .time goes so fast you know and there is just no way
to go back. . .sometimes I wonder what the hell I am doing. . .am I leaving
the world better than I found it. . .”
And I remember, again, “did you save a life today?” and the code we had
last week, 76 year old guy in town to celebrate his 50th wedding anniversary with
his family. . . I did compressions for 10 minutes, sweat pouring down my face and back, while the doctor pushed every possible drug and the man’s wife waited in a wheelchair
in the lobby
I looked at his face. . .what was I thinking, I never do that, dangerous when you’re breaking someone’s ribs trying to push their blood to the rest of their body, dangerous
to think of them as a person instead of a collection of cells and blood and systems
that all need to work together to be a life. . .it haunted me, his face did, but I don’t
know now if I could tell you what he looked like.
and I’m wondering, really, if I’m saving anybody’s life but mine
fill the waiting room coated with a slick of dirt and sweat and desperation,
the running joke of “save a life today?” plays out every time I start an IV
for a migraine or a toothache and the junkies line up to have their abscesses drained
without pain medication because even if I could find a vein, anything the doctors could give them isn’t nearly as strong as the heroin they injected with their dirty needles. I don’t
expect to walk into a room after a particularly bad drainage, blood and pus all over
the floor, scrawny junkie whimpering on the bed, and feel anything but the usual
businesslike disgust of caring for yet another slow suicide.
But I surprise myself, and I start crying. Not terribly good patient care, I
suppose, but there you go. And as I finish taping the gauze over the hole
in his flesh, the junkie grabs my wrist with his other hand and says “thank you”
and promises to get clean. I look him straight in the eye, tell him he's lying, dare him
to prove me wrong
Guess it doesn’t matter what he said after that, because a week or a month
or a year from now, it’ll be his body on the gurney the medics bring in,
CPR in progress, his eyes fixed and staring, code called after five minutes of
definitive care in the hospital.
My friend Luke wrote me last night from work: “One of my patients just passed. . .what
a strange job we have. . .time goes so fast you know and there is just no way
to go back. . .sometimes I wonder what the hell I am doing. . .am I leaving
the world better than I found it. . .”
And I remember, again, “did you save a life today?” and the code we had
last week, 76 year old guy in town to celebrate his 50th wedding anniversary with
his family. . . I did compressions for 10 minutes, sweat pouring down my face and back, while the doctor pushed every possible drug and the man’s wife waited in a wheelchair
in the lobby
I looked at his face. . .what was I thinking, I never do that, dangerous when you’re breaking someone’s ribs trying to push their blood to the rest of their body, dangerous
to think of them as a person instead of a collection of cells and blood and systems
that all need to work together to be a life. . .it haunted me, his face did, but I don’t
know now if I could tell you what he looked like.
and I’m wondering, really, if I’m saving anybody’s life but mine
Friday, August 17, 2007
you know it's a good day in the ER when you have to change your pants
huh. That didn't sound quite right.
Just about the only thing that bugs me anymore is smell. I mean, I can handle the sight of blood, guts, gore, dangly adipose tissue, broken bones, poop, pee, puke, appendages dangling by a tendon, abcesses, nasty infected holes in people's legs. . .but smell. . .well.
it's not so bad when you can prepare; rub some vicks under your nose or inside a mask, then head into a room. But when you're walking down the hallway to start an IV, swinging the IV caddy jauntily, minding your own business, singing a little song to yourself, and a head injury patient projectile vomits directly into your path, and it's loud and voluminous and very, very colorful, and it splats on the curtain and the bed and the floor, and you've just gotten back from dinner. . .
that's not so great.
Just about the only thing that bugs me anymore is smell. I mean, I can handle the sight of blood, guts, gore, dangly adipose tissue, broken bones, poop, pee, puke, appendages dangling by a tendon, abcesses, nasty infected holes in people's legs. . .but smell. . .well.
it's not so bad when you can prepare; rub some vicks under your nose or inside a mask, then head into a room. But when you're walking down the hallway to start an IV, swinging the IV caddy jauntily, minding your own business, singing a little song to yourself, and a head injury patient projectile vomits directly into your path, and it's loud and voluminous and very, very colorful, and it splats on the curtain and the bed and the floor, and you've just gotten back from dinner. . .
that's not so great.
Wednesday, August 8, 2007
greetings from another planet
I may have mentioned that I come from a large family. A large, Mormon family. I have four siblings, all older than I. They, unlike me, have managed to remain married to their spouses, and produce several children in wedlock. I have 22 nieces and nephews, and 3 grand-nephews, in fact. All good, wholesome folk. Plus my parents. In my brother's mansion. Me, my kids, and a bunch of non-drinkin' non-smokin' non-swearin anti-liberal pro-life over-educated over-populated over-whelming people. 25 of them, in fact. Yep. I fit right in.
Sooooooo. Sunday. Noonish. Get the kids in the car, on the road. We've just hit Brownsville when Miss Diva asks for the first, but not the last, time, "how much longer?" I grit my teeth. I have a goodie bag of new books and coloring stuff in the front seat. I figure if we can hold out until Portland, I can dish out the goodies and we'll be set until we hit my brother's house, where the shindig's happening.
We barely make it to Portland before I start doling out the books, the coloring markers, the notebooks, the clipboards. The kids make it to Vancouver before they finish the books and start telling me they're bored.
Vancouver, Washington. Not BC. Vancouver-across-the-bridge-from-Portland. By Castle Rock, they're bashing each other over the head with the clipboards.
But we made it, albeit six hours later. And we ate some dinner, and then woke up the next morning and ate and played in the go carts and one nephew had his Eagle Scout celebration and then we were weirdos around the campfire, my sister and I dancing around to "Father Abraham" and today we went to the aquarium and Pike Place and the little magic shop is still there and we jumped on the trampoline and yelled and screamed and fought like families do.
Granted, when I wake up I'm slightly bleary, and my whole family laughs loudly as I stumble to my car and drive to Starbucks, and they tease me about my coffee addiction. And I do occasionally have to hide in a closet and whisper all the curse words I can think of just so I don't accidently let one slip in polite company. But I am one smartypants loudmouth among many, here. . .I mean, I had to get it from somewhere, right? It's just my smartass comments are occasionally sprinkled with naughty words. ahem.
My sisters and I all snort with laughter, my brother and I mush hamburger patties together in lumps when his wife isn't looking, and earn ourselves a lecture; I watch my sister and her husband leave black streaks of rubber on my brother's race-track driveway trying to run each other off. And I watch my favorite nephew, who does great accents and has the best one-liners, try very hard to hide the fact that he is gay. Or maybe he doesn't hide it, really, and I'm the only one who notices it.
He'll be a good role model for MixMan, who recently told me he'd rather be a girl. When I asked him why, he looked at me like I was stupid and said, "girls get all the best dresses!" And he rolled his eyes and walked away. Well, duh.
Sooooooo. Sunday. Noonish. Get the kids in the car, on the road. We've just hit Brownsville when Miss Diva asks for the first, but not the last, time, "how much longer?" I grit my teeth. I have a goodie bag of new books and coloring stuff in the front seat. I figure if we can hold out until Portland, I can dish out the goodies and we'll be set until we hit my brother's house, where the shindig's happening.
We barely make it to Portland before I start doling out the books, the coloring markers, the notebooks, the clipboards. The kids make it to Vancouver before they finish the books and start telling me they're bored.
Vancouver, Washington. Not BC. Vancouver-across-the-bridge-from-Portland. By Castle Rock, they're bashing each other over the head with the clipboards.
But we made it, albeit six hours later. And we ate some dinner, and then woke up the next morning and ate and played in the go carts and one nephew had his Eagle Scout celebration and then we were weirdos around the campfire, my sister and I dancing around to "Father Abraham" and today we went to the aquarium and Pike Place and the little magic shop is still there and we jumped on the trampoline and yelled and screamed and fought like families do.
Granted, when I wake up I'm slightly bleary, and my whole family laughs loudly as I stumble to my car and drive to Starbucks, and they tease me about my coffee addiction. And I do occasionally have to hide in a closet and whisper all the curse words I can think of just so I don't accidently let one slip in polite company. But I am one smartypants loudmouth among many, here. . .I mean, I had to get it from somewhere, right? It's just my smartass comments are occasionally sprinkled with naughty words. ahem.
My sisters and I all snort with laughter, my brother and I mush hamburger patties together in lumps when his wife isn't looking, and earn ourselves a lecture; I watch my sister and her husband leave black streaks of rubber on my brother's race-track driveway trying to run each other off. And I watch my favorite nephew, who does great accents and has the best one-liners, try very hard to hide the fact that he is gay. Or maybe he doesn't hide it, really, and I'm the only one who notices it.
He'll be a good role model for MixMan, who recently told me he'd rather be a girl. When I asked him why, he looked at me like I was stupid and said, "girls get all the best dresses!" And he rolled his eyes and walked away. Well, duh.
Tuesday, July 31, 2007
here's an excuse for shopping at victoria's secret
Just worked five twelves in a row, and the freaks really do come out during the full moon. So do the gardening injuries, the drunk drivers, the broken arms (5 sugar tong splints in two days!! Geez!!), the heart patients, and the stroke victims. Had two brain tumors diagnosed in the ER that night. My favorite nurse looked at me, waggled his eyebrows, and said, "see, firefighter girl? Nurses can put in 18g IVs, too." I told him I woulda shot a 16.
It's somewhat sobering to see these patients in the ICU a couple of days later, though, knocked out from propofol, tubes in every orifice. Particularly when you saw them talking, or trying to talk, 48 hours earlier.
We had one woman who had been in an MVA earlier in the day. Medics got called to her home; they boarded her just to get her out, since she could barely walk. Doc cleared her C-spine, and he and I rolled her up on her side with the standard "give yourself a hug!" Apparently, my eyes widened rather comically when she flailed her arms around and one of her hands landed square on my tuckus and then held on for dear life, because Doc started laughing. However, her hand remained, and Doc took it upon himself to ask her if she had developed a fondness for me. She released her iron grip, patted my butt, and apologized. I have a feeling I'll be hearing about that one for a while.
Was having one of those days. You know. Where everything you pick up, you fumble, or drop; when the saline flush falls out of the lock right before you set the IV; when tape sticks to your gloved fingers, when the velcro on the knee immobilizer attaches to everything but what it's supposed to, when the underwire on your favorite bra snaps right at the curve, and you suddenly feel a sharp pain and an amazing lack of support. Then you get home, try to read before falling into a dead sleep, and your glasses snap right at the bridge. Seems like a sign. You know. Like maybe it's time for a little R and R.
It's somewhat sobering to see these patients in the ICU a couple of days later, though, knocked out from propofol, tubes in every orifice. Particularly when you saw them talking, or trying to talk, 48 hours earlier.
We had one woman who had been in an MVA earlier in the day. Medics got called to her home; they boarded her just to get her out, since she could barely walk. Doc cleared her C-spine, and he and I rolled her up on her side with the standard "give yourself a hug!" Apparently, my eyes widened rather comically when she flailed her arms around and one of her hands landed square on my tuckus and then held on for dear life, because Doc started laughing. However, her hand remained, and Doc took it upon himself to ask her if she had developed a fondness for me. She released her iron grip, patted my butt, and apologized. I have a feeling I'll be hearing about that one for a while.
Was having one of those days. You know. Where everything you pick up, you fumble, or drop; when the saline flush falls out of the lock right before you set the IV; when tape sticks to your gloved fingers, when the velcro on the knee immobilizer attaches to everything but what it's supposed to, when the underwire on your favorite bra snaps right at the curve, and you suddenly feel a sharp pain and an amazing lack of support. Then you get home, try to read before falling into a dead sleep, and your glasses snap right at the bridge. Seems like a sign. You know. Like maybe it's time for a little R and R.
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