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Baby, and stuff

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Thursday morning we went to the perinatologist for a follow up ultrasound and a second opinion concerning the size of baby’s left kidney. The issue is 100% repairable, but will require at minimum a follow up ultrasound after birth and possibly a 250 mile trip to see a pediatric urologist as there isn’t one close.

Essentially baby’s kidney is dilated to 14mm where it should be <7mm. This could be a blockage distal to the kidney or post bladder, likely post kidney as the other kidney is fine and post bladder would effect both.

I was working a 24 Thursday and had to have someone cover for me for a few hours while we were at the doc’s office. Soon after getting back I was sent to take a patient to the very hospital we might be headed to soon, for an 11 yo African American female in renal failure. Upon arrival at my pickup facility I found a young girl, drowsy in bed with mom in the corner and kids piling out of the room. Mom didn’t give her a hug, ride with, or really seem to care. She had to stop at home before she could drive up, and no one wanted to ride along with my oh-so-young patient.

It wasn’t a good way to end my day.

Posted by on January 10, 2009 • Filed under: baby, Coping • Tagged: ,

Getting there…

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I have exactly 7 posts in the making. I’m having a hell of a time concentrating on them and hope to knock a few out this weekend. Keep checking back, and in the meantime, check out my Cohorts in Crime to the right.

Hope your New Year has been great so far!
M3
Posted by on January 3, 2009 • Filed under: Coping • Tagged:

A day in the life…

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Of Medic Three. 

Well, maybe a few days.
This week I have had:
  • 1 SOB, that could have used the CPAP unit that “we” decided “we” didn’t need and sent back. Guess what, we’re reording it.  This wasn’t my call, but en route my partner attempted 14 IVs. Not. Even. Kidding. Had to restock the whole damn truck. If you need a line that bad: a) use an IO. b) call for a chopper–cause they very well could be one of the few pts that deserve Air Medical Services.
  • 1 8 YOWM who got his head conked by a swing. Had a goose egg the size of a softball. HX of seizures and CP, has VNS implant—that shit is cool.
  • 1 Drunk at 7 am complaining of “a huge heart attack”.  Diagnosis at hospital: Pulled muscle
  • 1 Frequent flyer–or should I say frequent faller. I was convinced of a femur fracture or hip dislocation. Leg shortened and rotated. Wouldn’t let me touch it, etc. Nada. Shoulda known better, 
  • 1 syncopal episode on the interstate. PT not only fine upon arrival, but wayyyyyyyyy healthier than I am.
I feel like crap. My Celiac Test came back negative. My other tests are all within normal limits. I go in for an Ultra Sound on Wednesday, just to make sure my fat ass isn’t pregnant. 
Posted by on October 12, 2008 • Filed under: Code 3, Coping • Tagged: ,

Sometimes you can do everything perfectly…

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And people still die. Rogue Medic’s post about ON the Clock’s post(yeah, I know) got me thinking TOO.

Sometimes we get there too late. Sometimes we can’t get that “vital” IV. Sometimes things just don’t work out. But then, sometimes you do everything you can, all in record speed–only to “fail”.

As EMS providers we see a lot of dead people. We see a lot less people actually die. Sometimes when we get there, the circumstances haven’t lined up to allow for survival. Sometimes people die.

One of the first lectures we got in Medic class said just that. You can do everything right–everything–and sometimes PEOPLE DIE. It is sad. It can be hard. But it is true. 

One of the most important things we can do is to be strong. Sam at On the Clock is getting there–so am I. Some patients hit me harder than others. Sometimes people die. 

It is important to remember that for us to do our jobs, we need to be able to live, learn, and move on. Some might find this harsh–but you can only take a little piece from each death you have in this job–if you take it all home, you’ll end up at the bottom of a bottle or signing your name at the end of the saddest letter ever. 

Take a step back, and remember–not everyone can be “saved”. We don’t get to pick them. But more people out there need our help and you have to be ALIVE to do your job.

Good Luck and be safe out there. 

Posted by on September 17, 2008 • Filed under: Coping, Failure, Heart Strings • Tagged: , ,

Say a little prayer for me…

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Well, not me. I know many of you aren’t the “praying” type but I’ve got a few things I’d like you to “think positively” about, at minimum:

  • A happy, healthy baby. That is all I care about. Because we aren’t finding out baby’s sex everyone asks me all the time “What are you hoping for?” Healthy, and happy. I hope it comes out screaming. Loud.
  • Give EE some of those well wishes too. Like us, that is all she wants. 
  • Despite the news doing a shit-tastic job covering them, rember that we are still fighting wars in Afghanistan and Iraq. I check both of those sites daily for a little reality check(the second site has an Afghanistan link but seems to be down.)
  • Pray for my patients. Pray I don’t kill them. Pray they don’t suffer. Pray for all of our patients. 
  • Remember–when you actually have a SICK patient, use the compassion you’ve lost because of all the “sick” ones before. 

There is more, but I’m just going to let it be with this. If you’ve forgotten how to pray, just sit down and think about it. In this line of work religion doesn’t necessarily line up with how we work. It is hard to believe in God and see what we see. For me it was either God or a bottle. I decided to skip the bottle.

Godspeed and remember: Be safe out there. You aren’t going to save any people being dead. 

(Oh, and welcome Kristen to the Blogroll!)

Posted by on September 3, 2008 • Filed under: Blogroll, Coping, HELP • Tagged: , ,

Channel Ate

264 comments

Cheack it OUT. It is all the wrong kinds of funny.


Posted by on September 3, 2008 • Filed under: Coping, Good Stuff, Wow. • Tagged: , ,

Whatever you do, do NOT say the "Q" word…

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Please, please, PLEASE do NOT say the “Q” word. I’m on the train again till 0600 next Friday and I’m hoping for a calm shift. You can pretty much say any word you want. Just not the “Q” word. The last time I heard it dispatch didn’t let me take a break to pee for 11 hours. 

So, here is the list of tolerable words:

calm, demure, dormant, dumbstruck, gentle, halcyon, hushed, inaudible, inconspicuous, inoffensive, introspective, low-key, low-profile, meek, modest, motionless, mute, noiseless, pacific, passive, pensive, placid, quiescent, reflective, reposeful, reserved, reticent, retired, retiring, secluded, sedate, sequestered, serene, silent, stagnant, staid, still, subdued, taciturn, tranquil, unassuming, uncommunicative, undemonstrative, undisturbed, unfrequented, unmolested, unmoved, unobtrusive, unruffled

Ok… So maybe a few them might need some reconsideration… but my Thesaurus spat them out, so that is what you get!

Posted by on August 15, 2008 • Filed under: Coping • Tagged:

Coping.

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So I mentioned yesterday my chest pain patient who said “I just know I’m gonna to die”… And like they told us in class–believe them, because she did.

But what class doesn’t teach us is how to deal with that. I know that I helped her– but I didn’t save her life. I have no glory story to tell around the station. But I helped her. I made her comfortable, relaxed, and even got a smile or two out of her. But she died. Something isn’t sitting right with me here.

She told me she was going to die, and really, I didn’t believe her. I’ve heard patients say it before–but they didn’t look like her. They didn’t use the voice inflection that she did. She meant it. She knew it. And there wasn’t anything I or that bunch of lollipops could do about it.

School doesn’t teach us how to cope–the real world does that. School doesn’t teach us how to treat patients with respect–the real world does that–hopefully. School doesn’t teach us how to improvise, how to juggle multiple patients in one truck(they actually teach us NOT to have more than one critical patient–but this is the real world), how to deal with shitty partners, or how to look at a family member in the eyes who is just staring at you with those “you’re here, everything will be ok” eyes–when you know that it isn’t going to be ok. That even if you get pulses back all you’ve done is created a 150 lb vegetable with a heartbeat. Crass. maybe. Reality. Yes.

School doesn’t teach us much really. Sure, we gaind a lot of “knowledge”. Pathophys, pharmacology, anatomy, drug calcs, cardiology and even some grasp at “medical” illnesses. But where in that book did it actually show me how to care for my patients?

I didn’t see it.

Honestly, if it wasn’t for my wife–there isn’t any way I could do this. That little old lady yesterday wrecked my world in the same way a little boy did 3 weeks ago. People Die. It’s a fact. When you get old you’re supposed to die–often death itself is a relief. Too many times in my life I’ve seen loved ones suffer only to have death as their savior. But they aren’t supposed to tell me they’re going to die–and mean it. I don’t have anything to fix that.

If I could go back to that 23 minutes I spent with that little old lady yesterday just to make them a little better, a little more comfortable I would. Knowing they were some of her last just wreaks havoc in my little world. But, for just a few minutes, I do know that I did comfort her. I guess that’s all I have.

Posted by on April 26, 2008 • Filed under: Coping, Stress • Tagged: ,

We are trained.

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We are trained to save lives. We are trained to get up early, rush to work, do what it takes, and get to the scene. We are trained to push through blood/guts/tears/vomit/feces to find the cause. We are trained to decipher the difference between minor symptoms. 
We are trained to treat. We are trained to diagnose. 
We are trained to respond. We are trained.

But are we trained to take it all home at night and deal with it?
I’m not sure. Sure, CISM is there to help–but you have to reach out for that. De-briefings are standard sometimes… But even then, you have to go to bed at night with everything you’ve done in your head. You have those pictures there. How do we decode that into something to strengthen us–not tear us apart.

Maybe that’s part of what being a seasoned medic means. You learn how to deal. You learn how to cope. Hopefully that isn’t what has turned so many of the medics I think of as “burnt out” or disgruntled away from their love for the field.

Someday I hope to answer that question a little better.

Posted by on April 2, 2008 • Filed under: Coping, Failure, FirstTime, Stress • Tagged: , , ,

I want to tell you lies

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This is going to have to sum up the last few days. Not sure I have it in me to write it all out.


I WANT TO TELL YOU LIES

I want to tell that little boy his Mom will be just fine
I want to tell that dad we got his daughter out in time
I want to tell that wife her husband will be home tonight
I don’t want to tell it like it is, I want to tell them lies

You didn’t put their seat belts on, you feel you killed your kids
I want to say you didn’t … but in a way, you did
You pound your fists into my chest, you’re hurting so inside
I want to say you’ll be OK, I want to tell you lies

You left chemicals within his reach and now it’s in his eyes
I want to say your son will see, not tell you he’ll be blind
You ask me if he’ll be OK, with pleading in your eyes
I want to say that yes he will, I want to tell you lies

I can see you’re crying as your life goes up in smoke
If you’d maintained that smoke alarm, your children may have woke
Don’t grab my arm and ask me if your family is alive
Don’t make me tell you they’re all dead, I want to tell you lies

I want to say she’ll be OK, you didn’t take her life
I hear you say you love her and you’d never hurt your wife
You thought you didn’t drink too much, you thought that you could drive
I don’t want to say how wrong you were, I want to tell you lies

You only left her for a moment, it happens all the time
How could she have fell from there? You thought she couldn’t climb
I want to say her neck’s not broke, that she will be just fine
I don’t want to say she’s paralyzed, I want to tell you lies

I want to tell this teen his buddies didn’t die in vain
Because he thought that it’d be cool to try to beat that train
I don’t want to tell him this will haunt him all his life
I want to say that he’ll forget, I want to tell him lies

You left the cabinet open and your daughter found the gun
Now you want me to undo the damage that’s been done
You tell me she’s your only child, you say she’s only five
I don’t want to say she wont see six, I want to tell you lies

He fell into the pool when you just went to grab the phone
It was only for a second that you left him there alone
If you let the damn phone ring perhaps your boy would be alive
But I don’t want to tell you that, I want to tell you lies

The fact that you were speeding caused that car to overturn
And we couldn’t get them out of there before the whole thing burned
Did they suffer? Yes, they suffered, as they slowly burned alive
But I don’t want to say those words, I want to tell you lies

But I have to tell it like it is, until my shift is through
And then the real lies begin, when I come home to you,
You ask me how my day was, and I say it was just fine
I hope you understand, sometimes, I have to tell you lies

~ Kal The Rebel ~

http://www.thelunatick.com/ems/i_want_to_tell_you_lies.htm

Posted by on March 31, 2008 • Filed under: Coping, Failure, FirstTime, Stress • Tagged: , , ,