Saturday, March 08, 2008

Damsels in Distress

I grew up reading books like King Arthur and His Knights. Thus when I was a young boy watching EmergencyI imagined a paramedic as a sort of knight errant rescuing people in distress. The job of a paramedic seemed like noble work with the added reward of being thanked by rescued damsels – whether the rescue was saving them from an auto crash or merely getting their kitten out of a tree.

Years later when I became a paramedic I soon learned that not all patients were damsels nor were they all in distress.

The town I regularly work in has an extremely high elderly population. It is not unusual to have four patients all over the age of 85 in one day. Some days it is all cardiac calls, other days all falls or difficulty breathings; some days it is high temps and vomitings. Most days it is a mixture of old age related complaints.

This week I worked some overtime in the city where the population and call nature is more diverse. The patients tend to be younger and the call nature includes a larger percentage of non-fall trauma (i.e. assaults), psychiatric emergency, substance abuse, and BS (calls that should’t require an ambulance).

I had an unusual day in the city – I cannot in fact recall any similar days. Not only were all my patients damsels (young females between 20 and 25) -- they were all damsels in distress. Not one was a slobbering drunk. Not one a crack whore. No foul mouthed feline in police custody. None feigning unresponsiveness following an argument with their boyfriends. And if any of them had tattoos, they were in discrete tasteful areas beyond my view.

The first young lady had neck pain from a motor vehicle accident in which she was rear-ended. Her vehicle actually had rear end damage. The second young lady had painful upper right quadrant abdominal pain with a genuine past diagnosis of gallstones, according to her doctor who called us to his office to aid the young woman. The third young lady was a jazz dancer who it seemed threw out her back, and only called 911 after an unsuccessful attempt to transport her by private car.

I treated them all as if I were treating my daughter. I was respectful, kind, and went the extra mile to see to their comfort. I let the first patient use my cell phone to call her boss. I gave the second patient Zofran for her nausea and at the ER when we had to find a bed for her, I chose not the old thin mattressed bed I found first, but a new thicker mattressed model, and then, I wandered the halls until I found her a pillow. The third patient I gave eight milligrams of morphine, along with some phenergan until she was quite comfortable—so comfortable I had to have her professor sign the back of her run form because the injured dancer was now blissfully asleep. I received vociferous thanks from the first two damsels, and the professor – not far from damsel status herself -- assured me both she and the dancer were grateful for my kindness and care.

And then I saddled my steed – an old rattley ambulance – one of the oldest in the fleet – and drove out to our post to await my next dragon to slay.

The next day, surprisingly I had two more female patients of the same age group, although they had long lost damsel status. The first young woman, like the young woman the previous day, had neck pain from a motor vehicle accident, but her car had much less visible damage. Surprisingly she ended up in the trauma room when my new BLS partner became concerned about her apparent change in mental status (falling asleep and suffering from faulty memory) during transport as he teched the call. The reason for her altered consciousness became clear after they cut her clothes off. She had an ounce of marijuana in her brassiere and a plastic bag containing crack peering out of her long lost maidenhood. The next patient was a rather unclean track marked young woman complaining of abdominal pain and crying quite theatrically. Instead of the trauma room, she was sent to the waiting room where she ended up leaving on her own steam, and leaving behind a classic stream of profanity after it was determined this was her fourth hospital stop in one day and seventh stop at the same hospital in the last few weeks, all seeking narcotics for abdominal pain of questionable etiology.

Alas, not every day is a fairy tale in the life of a paramedic, but with the right attitude, we can try to make it a good day.

Now I am back in the realm of the suburbs and the first call of distress in our kingdom comes from an old woman who has fallen and cannot get up.

I walk though the door and seeing her on the carpet, introduce myself bowing slightly and waving my right arm with a flourish. “How may I be of service?

Soon on her feet again, and showing no sign of injury from her unfortunate slip, she thanks us prodigiously for coming to her aid. The old woman, a damsel still at heart, waves us farewell as we leave, but not without our first promising to return should she ever find need to call again for our help.