We've been having a big union battle where I work that has pretty evenly divided the company. In the first election, the current union, Local 1199, garnered 81 votes, the challenging union, NEMSA, garnered 71, and 16 people voted no union. Since there was no clear majority, there is a run-off election held today between the top two vote getters, 1199 and NEMSA.
I am working out at my suburban post, along with another company employee who I am precepting. Federal law requires that we be brought in to vote. The last election, the suburban medic was allowed to drive in to the company headquarters to vote during the day while another ambulance came and covered the town. I do think about calling up and asking if they can send an ambulance out to cover while I head to the office to vote. This would be without telling them that my car is in the shop and I rode a bike to work this morning. It's about twenty miles from the suburban base to the headquarters. A nice bike ride back and forth -- all on the clock. But I guess since my preceptee has a car, I would probably be expected to get a ride with him. No call comes to offer to cover us and I don't call to ask for one. After all our shift ends at 6:00 and the polls are open until 7:30, so I don't really think it is going to be a problem.
I call the mechanic at the garage working on my car and he has bad news. He still can't figure out what is wrong. The car has no power. He has wires out all over the place and is looking at two sets of blueprints for the car and is at a loss. He does offer me a loaner car. I stop by and pick up the keys for the loaner car so I can get it when the shift is over. With fifteen minutes to go (5:45) we get a call to a local group home for a patient who has taken a double dose of tegretol. It seems an aide gave the patient his meds at 4:00 and then another aide gave him the same meds at 4:20. Reason does not work at group homes. How about we call the patient's doctor and see if he thinks the patient needs to go to the hospital? They have already called the nurse, who called the doctor and the doctor told her to tell them to call an ambulance and bring her to the ED. I think added into the bit about taking two pills instead of one was a complaint of abdominal pain. The patient, who is profoundly retarded and spends most of the time biting his hand, it seems ate some spicy rice earlier, and has been grabbing his belly in between hand-biting episodes. Okay, fine, on the stretcher, and lets go.
It is going to be close to get to the hospital, get the patient triaged, get the paperwork done, get back to the suburban base, and then drive to the company base to vote. The polls will close at 7:30 precisely.
We make all due haste. The time is now 7:00. We are back at the base, I punch out, jump in my preceptee's car and we race to the garage where I jump out, while he peels away after I have given him directions on cutting through two towns. The garage is now closed. I find the used car -- a boat-sized 1992 silver Buick LeSabre with a rusted roof. It takes me awhile to figure out how to move the seat back so I can get in. There is no bar under the seat and no controls on the side. I finally find the seat back controls on the door, and am able to fit in. I roll down the window because it is hot and humid, and then I too peel out. Time. 7:10.
The radio is on a rap station, but I can't figure out how to change the dial -- I think it is stuck on the channel. So with a pulsing base line beat and a rapper dropping rhymes, I weave in and out of traffic, checking my watch at every light, keeping an eye out for the man. This is going to be close.
At 7:26, I am less then a mile from the base, when the car in front of me stops at a red light, but doesn't leave me enough room to take a right turn. I turn anyway, into a gas station, cut across the pumps and then out onto a side street. I lay rubber on the road as I gun it fishtailing up the hill and then take a left down the last street.
I can see all the union organizers along with many employees standing on the sidewalk. I skid into the driveway, slam the shifter up into park and jump out of the car. I see my preceptee walking out. "I told them you were coming," he says, "but they close in two minutes."
"Run!" a union delegate tells me.
I sprint through the garage, pound the three-digit code on the door, swing it open and then run up the stairs three at a time to the training room where the election is being held. The door still open, I hustle through. The federal election monitor and the two vote monitors from each union side seem to say together "You made it!" Thirty seconds to spare. I am handed a ballot, go into the booth, mark an X in the box for my choice, come out, and drop the ballot in the box. Done.
It doesn't occur to me until later, as I drive peacefully home, that my preceptee and I never discussed who we were voting for. I wonder if we cancelled each other out.
Friday, June 27, 2008
Thursday, June 26, 2008
New Blog-Normal Sinus
Note: I am participating in a new joint blog called Normal Sinus that is run by two bloggers, epijunky at Pink Warm and Dry and Sam at On the Clock. The new blog has participation from several other bloggers and will try each week to post entries on similar subjects. This coming week's entry is about relationships with non-EMS providers. My post appears below. All posts should appear on the Normal Sinus blog Sunday afternoon.
Countless Many
"Why Can't We All Get Along?"
***
There's a new guy on the sports radio channel I listen to who drives me crazy. He is so annoying. The local radio station decided to preempt the national syndication with a young local guy who could discuss local sports and maybe comes a lot cheaper than the syndicated show. The reason the guy annoys me is because he is constantly talking about what annoys him, and listening to an annoyed person, just makes me annoyed -- even to the point where I have to switch the channel. Thanks to the annoyed sports radio guy, I am actually up on many of the Top 40 songs these days. I really like that "You Cut Me Open (And I Keep Bleeding) song and the one that goes "Take Me Awaay to a Special Plaaace."
I feel the same about partners. You get a partner who is pissed off or discontented and after listening to them all day, then you find you are pissed off and discontented, too, and I find that being pissed off and discontented wears me out and I don't like to be worn out. And the problem with annoying partners, unlike annoying radio talk show guys, is you can't turn the channel and turn them into sexy female pop stars singing breathlessly about how crazy they are for you.
I write this all as an introduction to the topic of EMS relationships with other disciplines -- nurses, ER and nursing homes, doctors, family practitioners to ED docs and trauma surgeons, etc. I have heard so many stories over the years and have told my share about EMS being mistreated that it tends to wear me out too. Unless its a really good story.
***
There is an EMT I know who is at war with one of the hospitals. And he provides me with weekly updates of his skirmishes. The thing he doesn't and many people don't like about this hospital is that they have shifted many of their responsibilities onto EMS. You bring a patient in, you have to first register the patient -- a fairly simple procedure which consists of giving the registrar the patient's name, date of birth, social security number, and complaint. If all goes well, a minute later the name will pop up on the triage nurse's screen and the triage nurse is now willing to hear your patient's tale. While you are giving your report, and giving it in convenient snippets so the nurse can type it all into the computer, including name and dose of all meds, your partner is supposed to be taking their vital signs and temperature using the hospital's BP cuff, pulse oximeter and in the ear thermometer. Recently, it has also become EMS's job to fill out an allergy bracelet and put it on the patient's wrist. Once all this is taken care off, assuming there is not a line of five patients in front of you, you are then given a room number. Sometimes before you can go down to the room, you have to wait for the register to finish having the patient sign several forms. When you go down to the room, almost always there is another patient in the room, so you put the patient in the hallway, provided you can find a bed. You can usually find an unmade bed in the back hallway, and so you wheel it into the main ED, and then find sheets to make the bed up, and then transfer the patient over. If they are on oxygen, you often have to find an oxygen tank, as if there is one under your bed, it is usually empty.
My EMT friend takes great delight in passive aggressively blocking a hallway to transfer a patient from the stretcher to the newly found ED bed. He sets the transfer up so that there is only the narrowest passage for a person to get through, but like a miniature golf windmill whenever a nurse tries to get by, a slight adjustment in body position or stretcher and the passage is blocked. If the nurse says excuse me, I need to get through, he'll smile and ask her to help with the patient's legs. If a doctor needs to pass, he'll courteously point out to the doctor that passage can be effected by a quick short cut through the soiled laundry room that opens just around the corner. He is very artful in how he does all of this. He is not hesitant to "innocently" ask an attending if he can find a pillow for the patient's head or request a nurse to hold the foley.
His latest tale involves a patient with MRSA. He and his partner came into the ED in full body length contamination garb, including Hepa-masks and face shields. His tale, complete with Darth Vader behind the mask breathing, had me in hysterics, and unfortunately may have precipitated a new registrar to transfer out of the ED and turned a triage nurse into an obsessive-compulsive handwasher.
Humor is almost always good. Whining never is.
***
I read an awesome book many years ago called Talking Trauma: Paramedics and Their Stories by a guy named Timothy R. Tangherlini, who is a sociologist. His book is a collection of tales told by paramedics, and an analysis of what the tales mean from an anthropological social perspective. I thought it was fascinating reading.
One of his best insights is into tales where the paramedic is the "sly hero." The paramedic as sly hero is a very common form of paramedic tale. The bottom line is that paramedics use these tales as sort of a rebellion against the medical caste system where they are often considered to be lesser people than the caste of the villain. The tales serve to validate the paramedic's self worth.
Here are two examples from some of my earlier posts:
Left Lateral Femoral Condoyle
Stud or Idiot?
***
The nationally syndicated radio guy who was replaced on the local station by the annoying local guy actually used to talk about things that pissed him off too, but he did it in such a funny outrageous way that I enjoyed listening. He also had a sidekick or alter ego who would temper his comments, and so after absolutely skewering somebody, he would admit to his sidekick that maybe he had gone too far, and he would apologize and say he loves everybody. That's just the kind of guy he is. Sending love out to all his listeners.
***
For me now, I'm about getting along. I try to treat everyone with respect, avoid confrontations, and do whatever is best for the patient. We're all in this together and you have to love and respect everyone in the medical field. And I'm all about showing them love.
That doesn't mean I don't like a good story told well skwering a deserving villian and spreading the fame far and wide of sly paramedic or EMT heros, of which there are countless many.
***
There's a new guy on the sports radio channel I listen to who drives me crazy. He is so annoying. The local radio station decided to preempt the national syndication with a young local guy who could discuss local sports and maybe comes a lot cheaper than the syndicated show. The reason the guy annoys me is because he is constantly talking about what annoys him, and listening to an annoyed person, just makes me annoyed -- even to the point where I have to switch the channel. Thanks to the annoyed sports radio guy, I am actually up on many of the Top 40 songs these days. I really like that "You Cut Me Open (And I Keep Bleeding) song and the one that goes "Take Me Awaay to a Special Plaaace."
I feel the same about partners. You get a partner who is pissed off or discontented and after listening to them all day, then you find you are pissed off and discontented, too, and I find that being pissed off and discontented wears me out and I don't like to be worn out. And the problem with annoying partners, unlike annoying radio talk show guys, is you can't turn the channel and turn them into sexy female pop stars singing breathlessly about how crazy they are for you.
I write this all as an introduction to the topic of EMS relationships with other disciplines -- nurses, ER and nursing homes, doctors, family practitioners to ED docs and trauma surgeons, etc. I have heard so many stories over the years and have told my share about EMS being mistreated that it tends to wear me out too. Unless its a really good story.
***
There is an EMT I know who is at war with one of the hospitals. And he provides me with weekly updates of his skirmishes. The thing he doesn't and many people don't like about this hospital is that they have shifted many of their responsibilities onto EMS. You bring a patient in, you have to first register the patient -- a fairly simple procedure which consists of giving the registrar the patient's name, date of birth, social security number, and complaint. If all goes well, a minute later the name will pop up on the triage nurse's screen and the triage nurse is now willing to hear your patient's tale. While you are giving your report, and giving it in convenient snippets so the nurse can type it all into the computer, including name and dose of all meds, your partner is supposed to be taking their vital signs and temperature using the hospital's BP cuff, pulse oximeter and in the ear thermometer. Recently, it has also become EMS's job to fill out an allergy bracelet and put it on the patient's wrist. Once all this is taken care off, assuming there is not a line of five patients in front of you, you are then given a room number. Sometimes before you can go down to the room, you have to wait for the register to finish having the patient sign several forms. When you go down to the room, almost always there is another patient in the room, so you put the patient in the hallway, provided you can find a bed. You can usually find an unmade bed in the back hallway, and so you wheel it into the main ED, and then find sheets to make the bed up, and then transfer the patient over. If they are on oxygen, you often have to find an oxygen tank, as if there is one under your bed, it is usually empty.
My EMT friend takes great delight in passive aggressively blocking a hallway to transfer a patient from the stretcher to the newly found ED bed. He sets the transfer up so that there is only the narrowest passage for a person to get through, but like a miniature golf windmill whenever a nurse tries to get by, a slight adjustment in body position or stretcher and the passage is blocked. If the nurse says excuse me, I need to get through, he'll smile and ask her to help with the patient's legs. If a doctor needs to pass, he'll courteously point out to the doctor that passage can be effected by a quick short cut through the soiled laundry room that opens just around the corner. He is very artful in how he does all of this. He is not hesitant to "innocently" ask an attending if he can find a pillow for the patient's head or request a nurse to hold the foley.
His latest tale involves a patient with MRSA. He and his partner came into the ED in full body length contamination garb, including Hepa-masks and face shields. His tale, complete with Darth Vader behind the mask breathing, had me in hysterics, and unfortunately may have precipitated a new registrar to transfer out of the ED and turned a triage nurse into an obsessive-compulsive handwasher.
Humor is almost always good. Whining never is.
***
I read an awesome book many years ago called Talking Trauma: Paramedics and Their Stories by a guy named Timothy R. Tangherlini, who is a sociologist. His book is a collection of tales told by paramedics, and an analysis of what the tales mean from an anthropological social perspective. I thought it was fascinating reading.
One of his best insights is into tales where the paramedic is the "sly hero." The paramedic as sly hero is a very common form of paramedic tale. The bottom line is that paramedics use these tales as sort of a rebellion against the medical caste system where they are often considered to be lesser people than the caste of the villain. The tales serve to validate the paramedic's self worth.
Here are two examples from some of my earlier posts:
Left Lateral Femoral Condoyle
Stud or Idiot?
***
The nationally syndicated radio guy who was replaced on the local station by the annoying local guy actually used to talk about things that pissed him off too, but he did it in such a funny outrageous way that I enjoyed listening. He also had a sidekick or alter ego who would temper his comments, and so after absolutely skewering somebody, he would admit to his sidekick that maybe he had gone too far, and he would apologize and say he loves everybody. That's just the kind of guy he is. Sending love out to all his listeners.
***
For me now, I'm about getting along. I try to treat everyone with respect, avoid confrontations, and do whatever is best for the patient. We're all in this together and you have to love and respect everyone in the medical field. And I'm all about showing them love.
That doesn't mean I don't like a good story told well skwering a deserving villian and spreading the fame far and wide of sly paramedic or EMT heros, of which there are countless many.
Monday, June 23, 2008
Minimum Security Prison
It's punchout time so I can post this:
Quiet day. Nothing going on for 12 hours, except a lot of rain. I worked some on the computer, surfed the net for awhile. I spent an hour or so cleaning up the supply closet. I had a bowl of soup for lunch. I watched some TV -- nothing good on. One of my partners had dibs on the show. Anita -- we call her MA -- she's 80 years old, but you don't want to cross her, so I was stuck watching The Young and the Restless. That guy Victor -- the rich debonair older dude with the mustache -- was getting married again. MA's been watching the show since the 1950's. She figures it is the sixth time Victor has gotten married. I snoozed a little in the arm chair, read the paper, had some more soup. I wanted to get some exercise, maybe walk outside around the building, but it was raining too hard, so I couldn't go out. I just sat by the window and looked at the rain falling in the puddles.
In another a couple minutes, the door is going to open and I'll finally be out of here.
Quiet day. Nothing going on for 12 hours, except a lot of rain. I worked some on the computer, surfed the net for awhile. I spent an hour or so cleaning up the supply closet. I had a bowl of soup for lunch. I watched some TV -- nothing good on. One of my partners had dibs on the show. Anita -- we call her MA -- she's 80 years old, but you don't want to cross her, so I was stuck watching The Young and the Restless. That guy Victor -- the rich debonair older dude with the mustache -- was getting married again. MA's been watching the show since the 1950's. She figures it is the sixth time Victor has gotten married. I snoozed a little in the arm chair, read the paper, had some more soup. I wanted to get some exercise, maybe walk outside around the building, but it was raining too hard, so I couldn't go out. I just sat by the window and looked at the rain falling in the puddles.
In another a couple minutes, the door is going to open and I'll finally be out of here.
Thursday, June 19, 2008
www.chiquita.com
We're called for a woman unconscious. I recognize the address. We have been there many times before. Two sisters. Extremely co-dependent on each other. The younger sister has chronic pain and is a known drug seeker. The older sister is just plain crazy.
On the way we are updated. The woman is conscious and breathing. It seems she passed out while doing the laundry, and has a cut on her elbow.
We find the younger sister sitting in a chair. The cut isn't much more than a scrape. She is alert, but slightly confused with slow speech. Drowsy is perhaps the best description. On the counter is an empty vial of Fiorinal. It is dated the previous day. There are supposed to be 120 tablets inside. Fiorinal is a barbituate/analgesic. It is also a Schedule III controlled substance.
"Are these yours?" I ask holding up the empty vial.
She squints to look at the vial. "No, they are my sisters," she says.
The older sister wanders into the room now. "Yeah, those are mine. I got those from the internet. They help us sleep."
"Us?"
"Yeah, I give her half of them. We both have trouble sleeping."
"You gave them to her?"
"Yeah, we both have trouble sleeping. We also have low potassium."
"Why didn't she get her own pills?"
"She needs to find a new doctor."
"And which doctor gave these to you?"
"I got them from the internet. I can't sleep at night."
I read the vial. The doctor lists his address as Chicago, Illinois.
"He just prescribed them for you without seeing you?"
"I had to fill out a questionaire."
She doesn't seem to think there is anything odd about this or anything wrong with giving them to her sister.
"She's my sister," she says. "We have headaches."
There are some patients you just can't have a conversation with.
We can't find the pills. The older sister says she divided them up and put them away. The younger sister says she took some but can't remember how many. First, its two, then its four. I ask her how many darvocets she has had. Normally when we are there -- the issue is her darvocets. She ran out, she had some this morning. She can't remember. Like the other times, we can never find any of the pills.
"All right, let's get you on the stretcher," I say.
"I don't want to go to the hospital. I just want the cut on my elbow cleaned. The doctors won't help me there. They never do."
"You can't stay here. You're confused. You probably took a few too many of these pills."
"I'm just a little confused."
"Just a little counts enough that we can't leave you here."
"I don't want to go."
We go back and forth, but aren't getting anywhere.
Finally, I take a stab. "Your sister said your potassium was low."
"Both our potassiums are low."
"Well, you can get your potassium checked while you're down there."
They both nod. I've found the magic words.
I can't resist. "Maybe they'll prescribe you some bananas."
"They don't ever give me anything," the younger sister says.
"Well, if not, maybe they'll give your sister a web site where she can order them for you."
On the way we are updated. The woman is conscious and breathing. It seems she passed out while doing the laundry, and has a cut on her elbow.
We find the younger sister sitting in a chair. The cut isn't much more than a scrape. She is alert, but slightly confused with slow speech. Drowsy is perhaps the best description. On the counter is an empty vial of Fiorinal. It is dated the previous day. There are supposed to be 120 tablets inside. Fiorinal is a barbituate/analgesic. It is also a Schedule III controlled substance.
"Are these yours?" I ask holding up the empty vial.
She squints to look at the vial. "No, they are my sisters," she says.
The older sister wanders into the room now. "Yeah, those are mine. I got those from the internet. They help us sleep."
"Us?"
"Yeah, I give her half of them. We both have trouble sleeping."
"You gave them to her?"
"Yeah, we both have trouble sleeping. We also have low potassium."
"Why didn't she get her own pills?"
"She needs to find a new doctor."
"And which doctor gave these to you?"
"I got them from the internet. I can't sleep at night."
I read the vial. The doctor lists his address as Chicago, Illinois.
"He just prescribed them for you without seeing you?"
"I had to fill out a questionaire."
She doesn't seem to think there is anything odd about this or anything wrong with giving them to her sister.
"She's my sister," she says. "We have headaches."
There are some patients you just can't have a conversation with.
We can't find the pills. The older sister says she divided them up and put them away. The younger sister says she took some but can't remember how many. First, its two, then its four. I ask her how many darvocets she has had. Normally when we are there -- the issue is her darvocets. She ran out, she had some this morning. She can't remember. Like the other times, we can never find any of the pills.
"All right, let's get you on the stretcher," I say.
"I don't want to go to the hospital. I just want the cut on my elbow cleaned. The doctors won't help me there. They never do."
"You can't stay here. You're confused. You probably took a few too many of these pills."
"I'm just a little confused."
"Just a little counts enough that we can't leave you here."
"I don't want to go."
We go back and forth, but aren't getting anywhere.
Finally, I take a stab. "Your sister said your potassium was low."
"Both our potassiums are low."
"Well, you can get your potassium checked while you're down there."
They both nod. I've found the magic words.
I can't resist. "Maybe they'll prescribe you some bananas."
"They don't ever give me anything," the younger sister says.
"Well, if not, maybe they'll give your sister a web site where she can order them for you."
Thursday, June 12, 2008
Ghost
We’re called to the cemetery for a woman passed out. I have been here so many times before. It is almost always the same story. Beautiful, clear day, green grass, a procession of cars parked along the road, memoriams white-washed on their back windows. “Remember Julio. R.I.P.” And then the gathering of mourners, all dressed in black.
A small crowd surrounds the woman who sits on the grass, crying, clutching at her heart. A man tells us she passed out, but they caught her before she hit her head. My partner lowers the stretcher, and spreads out a clean sheet on it. I wait while a relative whispers to the woman in Spanish. From where I stand I can look down into the earth and see the white casket with the gold cross on it, red roses draped across it.
She is quiet in the back on the ride to the hospital. Her eyes still wet, she looks at the ceiling, at the cabinets. Her fingers caress the stretcher rail.
I wonder if she knows.
He was on the same bed. We traveled over this same road as the sirens wailed.
Can she feel his presence? Can she hear his voice?
“It’s okay, mami. It’s okay. I’m all right now.”
Are his arms around her? Can she feel his heart beating inside hers?
A small crowd surrounds the woman who sits on the grass, crying, clutching at her heart. A man tells us she passed out, but they caught her before she hit her head. My partner lowers the stretcher, and spreads out a clean sheet on it. I wait while a relative whispers to the woman in Spanish. From where I stand I can look down into the earth and see the white casket with the gold cross on it, red roses draped across it.
She is quiet in the back on the ride to the hospital. Her eyes still wet, she looks at the ceiling, at the cabinets. Her fingers caress the stretcher rail.
I wonder if she knows.
He was on the same bed. We traveled over this same road as the sirens wailed.
Can she feel his presence? Can she hear his voice?
“It’s okay, mami. It’s okay. I’m all right now.”
Are his arms around her? Can she feel his heart beating inside hers?
Tuesday, June 10, 2008
Air Paramedic
The first time I rode in an ambulance I was in the first grade. It was in the spring of 1964. I was on an Indian Guide ("Like Father, Like Son, Pals Forever") outing with my father and other fathers and sons in our "tribe." We were riding our bicycles to a park where we would have lunch and play "Capture the Flag" until it was time to ride back to our neighborhood.
I had just gotten a new 3-speed Schwin Speedster, which was a little too much bike for me. I was already nervous about the trip because the last year when we had gone on a similar trip, as we had bicycled past a farm, the farmer's German Shepard spotted me as the smallest of our cycling herd. The dog ran alongside us like a lion after a baby wildebeest. Suddenly he broke through the other bikers and leapt up at me, tearing my pants and sinking his teeth into my butt cheek, until my father could beat the dog away from his shrieking son. This year my father assured me he had called the farmer in advance to make certain the beast was chained during the hours we expected to pass so I could ride by without fear.
I had a different trouble this time. Coming down a hill too fast for my handling ability, I got caught in a sand patch, and went sailing over the handlebars, knocking myself unconscious, and as my father would say, giving him his first gray hairs. I remember waking in the back of a low slung Cadillac ambulance to hear the sirens and look up at the ceiling, and feel the sway of the road before drifting off again. I stayed three days in the hospital with a concussion and lacerations to my head, face and right hand. I bear the scars of them to this day. Of course I had no idea at that time that as an adult I would be the one bringing the sick and injured to that same hospital on an almost daily basis.
The ambulance in our town then was run by volunteers. I remember one young man who worked in maintenance at the country club and also volunteered on the ambulance telling stories about seeing people cut in half by seat belts. "You wear a seat belt, my partner's going to be picking your bottom half off the road, while I'm in the thorny bushes, hauling out your chest and head. I never wear a seat belt, that's for sure." (This of course was back when the seat belt consisted solely of a lap belt.)
I didn’t know whether or not to believe any of the grotesque tales he told. But I did believe another story I heard a few years later in the barber’s chair one day as I got my regular crewcut. There had been a bad accident in town. A group of high school friends had been drinking at the bowling alley. Afterwards they sped back toward town along a curving road in their sportscar convertible. They came around a corner and ran right into the back of a stopped tractor-trailer. I remembered the road being closed and my mother, tears in her eyes, giving me a hug when I returned home that day in a neighbor’s car from a school outing. She had heard there had been a fatal accident in town and was worried to death I had been in it. In the barber’s chair I heard the story of how the head of one of the boy's was cut off at the forehead as their car shot under the back of the truck till it finally came to a stop. The barber told a man waiting for his trim that the boy’s father was on the rescue crew and never knew it was his son until he was finally told later, the boy was so disfigured by the crash. No, a paramedic wasn’t something I was thinking of becoming back then so long ago.
I recently started riding a bike again after over forty largely cycle-free years. I got the crazy notion that I wanted to be a triathlete, and while a good swimmer, I was a poor runner and a complete non-biker. Still, a man's gotta dream. As a reward for running my first 5K (3.1 mile) race and coming in 84 out of 103, I rewarded myself by purchasing a hybrid bike -- hybrid meaning not a road bike with thin high pressure tires and not a mountain bike with fat thick tires. The man at the store told me if I expected to race with the hybrid, I could expect to be somewhat slower than the rest of the pack. I was more concerned with stability than speed. Plus a hybrid was $350 and the entry level road bikes were $800.
In the six triathlons I entered and finished, I came in last in the bike portion four times. It was disheartening to always come out of the water in the top 30 percent only to watch 70 percent of the field pass me. They all had road bikes. I don't think I passed but three or four other bikers all season and those were either walking their bikes, changing their flat tires or, in one case, lying in the grass over the curb next to his mangled bike (There was a first responder there already, the guy was moving (honest) and I could hear the ambulance coming not too far off. I couldn't stop. I didn't want to be last!)
This year I decided if I could run a 10K (6.2 miles), then I could reward myself with a road bike so I could compete not only at the sprint level triathlon (1/2 mile swim, 12 mile bike, 5K run), but complete an Olympic level triathlon (1 mile swim, 24 mile bike, 10 K run).
Well, I ran the 10K coming in 249 out of 273, but managed to make it without dying, without walking, without vomiting or spitting. So I went to take a test ride on a road bike.
Not far from the bike shop was an abandoned supermarket. I thought wow, what a great place to try some sprinting. So there I am racing across the lot when I look ahead and see someone has cut a long foot wide six inch deep trench in the middle of the lot running the length of the lot. I don't know if I can stop in time and I don't know if I can Evil Knevil it. I try, but the front tire goes into the trench.
My first thought is, well, at least my tire didn't pop, then I think, hmm, I seem to be traveling forward. Am I? Yes I am going over the handle bars. How about that. I'm actually airborne. Jees, I probably should have put my helmet on. I always wear my helmet, but this is just a test ride. Well, at least I didn't hit my head, my shoulder has just landed, but I've managed to keep my head from hitting, though my head does seem to still be traveling in that direction. Wham! Oww! I am hitting my head right now, and my head is bouncing, and it is now coming back to the ground to rest. Son of a gun. I am lying on the asphalt in a vacant supermarket parking lot. I hope I am not dead. I don't think I am. I hope no one is dialing 911. I feel pretty silly lying here.
It was all so slow motion. It does make me appreciate what patients go through in those seconds before they get really wracked up. Oh shit.
I manage to get up. Straighten out the bike, refit the chain on it, and ride back to the bike shop, where I tell them the good news is I really like the bike, but the bad news is I just went over the handlebars. I think they are surprised that standing there bleeding in front of them, I am actually slapping my credit card down. I was test-riding the white one, but had planned to buy the red one. But I feel now that the blood from the scrapes on my hands has stained the white tape on the handlebars that I have bonded in some way with this bike, and maybe this is our one crash. I hope so anyway.
Stay safe everyone in all your summer adventures!
I had just gotten a new 3-speed Schwin Speedster, which was a little too much bike for me. I was already nervous about the trip because the last year when we had gone on a similar trip, as we had bicycled past a farm, the farmer's German Shepard spotted me as the smallest of our cycling herd. The dog ran alongside us like a lion after a baby wildebeest. Suddenly he broke through the other bikers and leapt up at me, tearing my pants and sinking his teeth into my butt cheek, until my father could beat the dog away from his shrieking son. This year my father assured me he had called the farmer in advance to make certain the beast was chained during the hours we expected to pass so I could ride by without fear.
I had a different trouble this time. Coming down a hill too fast for my handling ability, I got caught in a sand patch, and went sailing over the handlebars, knocking myself unconscious, and as my father would say, giving him his first gray hairs. I remember waking in the back of a low slung Cadillac ambulance to hear the sirens and look up at the ceiling, and feel the sway of the road before drifting off again. I stayed three days in the hospital with a concussion and lacerations to my head, face and right hand. I bear the scars of them to this day. Of course I had no idea at that time that as an adult I would be the one bringing the sick and injured to that same hospital on an almost daily basis.
The ambulance in our town then was run by volunteers. I remember one young man who worked in maintenance at the country club and also volunteered on the ambulance telling stories about seeing people cut in half by seat belts. "You wear a seat belt, my partner's going to be picking your bottom half off the road, while I'm in the thorny bushes, hauling out your chest and head. I never wear a seat belt, that's for sure." (This of course was back when the seat belt consisted solely of a lap belt.)
I didn’t know whether or not to believe any of the grotesque tales he told. But I did believe another story I heard a few years later in the barber’s chair one day as I got my regular crewcut. There had been a bad accident in town. A group of high school friends had been drinking at the bowling alley. Afterwards they sped back toward town along a curving road in their sportscar convertible. They came around a corner and ran right into the back of a stopped tractor-trailer. I remembered the road being closed and my mother, tears in her eyes, giving me a hug when I returned home that day in a neighbor’s car from a school outing. She had heard there had been a fatal accident in town and was worried to death I had been in it. In the barber’s chair I heard the story of how the head of one of the boy's was cut off at the forehead as their car shot under the back of the truck till it finally came to a stop. The barber told a man waiting for his trim that the boy’s father was on the rescue crew and never knew it was his son until he was finally told later, the boy was so disfigured by the crash. No, a paramedic wasn’t something I was thinking of becoming back then so long ago.
I recently started riding a bike again after over forty largely cycle-free years. I got the crazy notion that I wanted to be a triathlete, and while a good swimmer, I was a poor runner and a complete non-biker. Still, a man's gotta dream. As a reward for running my first 5K (3.1 mile) race and coming in 84 out of 103, I rewarded myself by purchasing a hybrid bike -- hybrid meaning not a road bike with thin high pressure tires and not a mountain bike with fat thick tires. The man at the store told me if I expected to race with the hybrid, I could expect to be somewhat slower than the rest of the pack. I was more concerned with stability than speed. Plus a hybrid was $350 and the entry level road bikes were $800.
In the six triathlons I entered and finished, I came in last in the bike portion four times. It was disheartening to always come out of the water in the top 30 percent only to watch 70 percent of the field pass me. They all had road bikes. I don't think I passed but three or four other bikers all season and those were either walking their bikes, changing their flat tires or, in one case, lying in the grass over the curb next to his mangled bike (There was a first responder there already, the guy was moving (honest) and I could hear the ambulance coming not too far off. I couldn't stop. I didn't want to be last!)
This year I decided if I could run a 10K (6.2 miles), then I could reward myself with a road bike so I could compete not only at the sprint level triathlon (1/2 mile swim, 12 mile bike, 5K run), but complete an Olympic level triathlon (1 mile swim, 24 mile bike, 10 K run).
Well, I ran the 10K coming in 249 out of 273, but managed to make it without dying, without walking, without vomiting or spitting. So I went to take a test ride on a road bike.
Not far from the bike shop was an abandoned supermarket. I thought wow, what a great place to try some sprinting. So there I am racing across the lot when I look ahead and see someone has cut a long foot wide six inch deep trench in the middle of the lot running the length of the lot. I don't know if I can stop in time and I don't know if I can Evil Knevil it. I try, but the front tire goes into the trench.
My first thought is, well, at least my tire didn't pop, then I think, hmm, I seem to be traveling forward. Am I? Yes I am going over the handle bars. How about that. I'm actually airborne. Jees, I probably should have put my helmet on. I always wear my helmet, but this is just a test ride. Well, at least I didn't hit my head, my shoulder has just landed, but I've managed to keep my head from hitting, though my head does seem to still be traveling in that direction. Wham! Oww! I am hitting my head right now, and my head is bouncing, and it is now coming back to the ground to rest. Son of a gun. I am lying on the asphalt in a vacant supermarket parking lot. I hope I am not dead. I don't think I am. I hope no one is dialing 911. I feel pretty silly lying here.
It was all so slow motion. It does make me appreciate what patients go through in those seconds before they get really wracked up. Oh shit.
I manage to get up. Straighten out the bike, refit the chain on it, and ride back to the bike shop, where I tell them the good news is I really like the bike, but the bad news is I just went over the handlebars. I think they are surprised that standing there bleeding in front of them, I am actually slapping my credit card down. I was test-riding the white one, but had planned to buy the red one. But I feel now that the blood from the scrapes on my hands has stained the white tape on the handlebars that I have bonded in some way with this bike, and maybe this is our one crash. I hope so anyway.
Stay safe everyone in all your summer adventures!
Sunday, June 08, 2008
Moment of Truth
"Do you find fat people repulsive?"
"Have you ever inappropriately touched a patient?"
"Have you ever falsified a report?"
***
These are questions that will be asked an EMT on the Fox show Moment of Truth on Tuesday night.
A contestant can win $500,000 by answering twenty-one progressively more difficult questions honestly based on the results of a previously administered lie detector test(consisting of an individualized 50 question pool). As the money rises, the questions get more brutal. There are several points where the contestant can quit and take whatever smaller amount of money they have made. If they are caught lying, they lose everything.
Previous highlights from the show were people who cheated on their spouses/partners, desired to be with someone else, stole money from work, cheated to get ahead, and hated their parents for wrecking their childhoods. The show has a very high uncomfortable factor. The contestant's friends and family sit on stage as he answers questions often about them. Sometimes the person will walk with a small sum of money ($25,000), but with permanently damaged reputation and relationships.
I have only seen the show on a flipping the channels basis, but don't believe anyone has lasted to the end or even gotten near the final round of questions.
One woman reached the $100,000 level by admitting in front of her husband that she wished she was married to another man (also present), but then lost it all when she she was asked if she thought she was a good person, and she said yes.
Truth Humiliates Hubby
From the promo ads, it appears as if the young EMT answers yes to all of the above questions, promising yet another national slam to the image of our profession.
***
UPDATE: Well, I watched the episode and on the three EMT questions, the guy answered yes to the do you find fat people repulsive question and yes to the falsification of paperwork question, but no to ever touching someone inappropriately question. He ended up walking away with $100,000 quitting before the questions got too tough. I do believe however he will need to find a new girlfriend as some of his answers concerning her did not make her very happy. Later they had on a female volunteer firefighter and while I turned it off before it was over, she wasn't not doing much for her profession not making her husband very happy. I have read that the show is looking for doctors, police, firemen and other public safety people for their new season.
"Have you ever inappropriately touched a patient?"
"Have you ever falsified a report?"
***
These are questions that will be asked an EMT on the Fox show Moment of Truth on Tuesday night.
A contestant can win $500,000 by answering twenty-one progressively more difficult questions honestly based on the results of a previously administered lie detector test(consisting of an individualized 50 question pool). As the money rises, the questions get more brutal. There are several points where the contestant can quit and take whatever smaller amount of money they have made. If they are caught lying, they lose everything.
Previous highlights from the show were people who cheated on their spouses/partners, desired to be with someone else, stole money from work, cheated to get ahead, and hated their parents for wrecking their childhoods. The show has a very high uncomfortable factor. The contestant's friends and family sit on stage as he answers questions often about them. Sometimes the person will walk with a small sum of money ($25,000), but with permanently damaged reputation and relationships.
I have only seen the show on a flipping the channels basis, but don't believe anyone has lasted to the end or even gotten near the final round of questions.
One woman reached the $100,000 level by admitting in front of her husband that she wished she was married to another man (also present), but then lost it all when she she was asked if she thought she was a good person, and she said yes.
Truth Humiliates Hubby
From the promo ads, it appears as if the young EMT answers yes to all of the above questions, promising yet another national slam to the image of our profession.
***
UPDATE: Well, I watched the episode and on the three EMT questions, the guy answered yes to the do you find fat people repulsive question and yes to the falsification of paperwork question, but no to ever touching someone inappropriately question. He ended up walking away with $100,000 quitting before the questions got too tough. I do believe however he will need to find a new girlfriend as some of his answers concerning her did not make her very happy. Later they had on a female volunteer firefighter and while I turned it off before it was over, she wasn't not doing much for her profession not making her husband very happy. I have read that the show is looking for doctors, police, firemen and other public safety people for their new season.
Saturday, June 07, 2008
What Happened?
There are many things a paramedic(or EMT) has to do on the scene of a trauma (or sometimes even the scene of a bad medical).
Among them is to answer the question "What happened?"
Sometimes the patient can tell you.
"I went over the handlebars on my bike and hit my head. It hurts, but I remember everything."
"My wife hit me in the head with a two by four from behind. I fell down, but got back up and took it away from her."
"I didn't have my seat belt on. I saw the car coming and tried to stop. I busted my head on the windshield. That's why there's a big hole there -- in the windshield."
If the patient is unconscious, the question "What happened?" is easy to answer if you have a calm, intelligent witness.
"They got into an argument, and then the other guy shot him in the head with his 9 millimeter."
"He was on the roof, he lost his balance and fell head first, striking his head on the cement."
"He was walking across the street and a Jeep Cherokee going about 30 miles an hour hit him from behind. He went up in the air, and came down landing on his head. He doesn't even know his name, but I know it. That man there is Robert Brown. He's my next door neighbor. We have the same birthday."
But sometimes the scene is chaotic. Sometimes people will tell you what happened, but only because that is what they think happened or what someone else told them had happened.
I have done many calls and arrived at the hospital to tell one story only to find out later a completely different story actually happened. He didn't fall off the roof, he fell off the ladder. He wasn't thrown from the car, he was a pedestrian. The driver of the car -- a stolen car -- took off. Sometimes in after reflection, you can see what actually happened, but your brain in the chaos goes with what someone has told you.
Maybe I was more nimble years ago, but my mind is hazy sometimes. It is hard for me to quickly sort through all the details -- the conflicting information -- sights, words, senses -- thrown at you from multiple sources. The ability to do this well is truly a valuable and underappreciated skill. I find it is one of my weak spots.
I had one call where we found a man in arrest in his garage and his buddy said "the fuel injector exploded in his face." I didn't know what that meant. The victim was in arrest and while I tried to orchestrate the resuscitation, I still couldn't figure out what a fuel injector exploding in his face meant. I could see no marks on his face. Was it a trauma? Was it an inhalation? Or did the incident just startle the man causing him to code as he had an extremely weak heart to begin with. At the hospital, when they asked me what a fuel injector going off in the man's face meant, I had to say "I don't know." I was sort of busy on the scene and didn't have time for the guy's extremely agitated friend to draw me a diagram.
Just how important is it to get the story right. Sometimes it is, sometimes it doesn't really matter. Injuries are injuries. What I can't focus on will be found out under the bright lights of the trauma room.
When I was in paramedic school, my teacher told us about a patch he gave to the hospital that he was complimented on by a top doctor. The patch was basically this: "I'm five minutes out with a guy who is FUBARed."
FUBAR, for those who don't know, means "Fucked Up Behind All Recognition."
It told the trauma doctor that the big one was coming in and he needed everyone on his trauma team in the room and ready to work. He didn't need to know in particular bout the flail chest, the open tib-fib fractures, the deep torso bruising, the brain injury. He knew he was going to be busy.
Sometimes I have asked my partner to radio in for me. I've told him "just get me the trauma room for a full trauma." If he is new, he may not want to patch, so I will have to. I'll say "45-year-old male pedestrian struck in traumatic arrest, five minutes out."
Short and sweet.
Sometimes when I patch in for a critical patient, the hospital starts asking questions about the patient's condition. "What's their GCS?" "What was the blood pressure?" "Which leg is mangled?" If the patient is critical and I am in the back by myself, I am sort of busy. "Hey I'm suctioning blood out of their airway so they can breathe" or "Hey I'm doing CPR by myself. See you when I get there." Click.
The radio notification patch aside, when you do get in the trauma room, they want to hear and deserve the full story or as much of it as you can give them.
But sometimes (it seems like often lately) I don't have it for them.
I've had a couple calls where I really had no idea what happened.
"What happened? I don't know what happened? Something awful happened. They're f-ed up, but here they are. I don't know anything about them, other than they didn't deserve this. I put a collar on them, got them on a board, got them in the ambulance and got on the way. I gave them oxygen, keep their airway open, took vitals, cut off all their clothes, and put a large bore, but insignificant IV in all while getting them here as quick as I could. I can't even begin to tell you all their injuries, look for yourself. I suppose I could have the full story for you, but then I wouldn't be here yet. I'll be awhile coming."
I had a fall patient in traumatic arrest once with bilateral leg fractures that I never saw. I had to scoop a just eaten sub out of his mouth which was like pulling sausage out of a meat grinder. It just kept coming. I wanted to say stop turning the crank. Enough is enough. How much food is down there? I didn't get past the ABC's on that call.
I did another call once to find two kids lying in the street, hit by a car while they were playing in the street. That's what they told me when I got on scene where a 100 screaming people shouted at us to do something. Turned out they weren't playing in the street (they were coming out of a store when a car went up on the sidewalk and booted them 100 feet or more into the street) and they weren't kids -- they were adults. But I couldn't tell any of that because all broken and fetalled up, they looked like little boys.
All I could do was get them to the hospital.
"What happened?" "How fast was the car going?" "Where were they hit?" "What injuries do they have?" "What are their names?" "Do they have any allergies?"
I don't know, but they are FUBARed.
Work your magic. I've got nothing left.
Among them is to answer the question "What happened?"
Sometimes the patient can tell you.
"I went over the handlebars on my bike and hit my head. It hurts, but I remember everything."
"My wife hit me in the head with a two by four from behind. I fell down, but got back up and took it away from her."
"I didn't have my seat belt on. I saw the car coming and tried to stop. I busted my head on the windshield. That's why there's a big hole there -- in the windshield."
If the patient is unconscious, the question "What happened?" is easy to answer if you have a calm, intelligent witness.
"They got into an argument, and then the other guy shot him in the head with his 9 millimeter."
"He was on the roof, he lost his balance and fell head first, striking his head on the cement."
"He was walking across the street and a Jeep Cherokee going about 30 miles an hour hit him from behind. He went up in the air, and came down landing on his head. He doesn't even know his name, but I know it. That man there is Robert Brown. He's my next door neighbor. We have the same birthday."
But sometimes the scene is chaotic. Sometimes people will tell you what happened, but only because that is what they think happened or what someone else told them had happened.
I have done many calls and arrived at the hospital to tell one story only to find out later a completely different story actually happened. He didn't fall off the roof, he fell off the ladder. He wasn't thrown from the car, he was a pedestrian. The driver of the car -- a stolen car -- took off. Sometimes in after reflection, you can see what actually happened, but your brain in the chaos goes with what someone has told you.
Maybe I was more nimble years ago, but my mind is hazy sometimes. It is hard for me to quickly sort through all the details -- the conflicting information -- sights, words, senses -- thrown at you from multiple sources. The ability to do this well is truly a valuable and underappreciated skill. I find it is one of my weak spots.
I had one call where we found a man in arrest in his garage and his buddy said "the fuel injector exploded in his face." I didn't know what that meant. The victim was in arrest and while I tried to orchestrate the resuscitation, I still couldn't figure out what a fuel injector exploding in his face meant. I could see no marks on his face. Was it a trauma? Was it an inhalation? Or did the incident just startle the man causing him to code as he had an extremely weak heart to begin with. At the hospital, when they asked me what a fuel injector going off in the man's face meant, I had to say "I don't know." I was sort of busy on the scene and didn't have time for the guy's extremely agitated friend to draw me a diagram.
Just how important is it to get the story right. Sometimes it is, sometimes it doesn't really matter. Injuries are injuries. What I can't focus on will be found out under the bright lights of the trauma room.
When I was in paramedic school, my teacher told us about a patch he gave to the hospital that he was complimented on by a top doctor. The patch was basically this: "I'm five minutes out with a guy who is FUBARed."
FUBAR, for those who don't know, means "Fucked Up Behind All Recognition."
It told the trauma doctor that the big one was coming in and he needed everyone on his trauma team in the room and ready to work. He didn't need to know in particular bout the flail chest, the open tib-fib fractures, the deep torso bruising, the brain injury. He knew he was going to be busy.
Sometimes I have asked my partner to radio in for me. I've told him "just get me the trauma room for a full trauma." If he is new, he may not want to patch, so I will have to. I'll say "45-year-old male pedestrian struck in traumatic arrest, five minutes out."
Short and sweet.
Sometimes when I patch in for a critical patient, the hospital starts asking questions about the patient's condition. "What's their GCS?" "What was the blood pressure?" "Which leg is mangled?" If the patient is critical and I am in the back by myself, I am sort of busy. "Hey I'm suctioning blood out of their airway so they can breathe" or "Hey I'm doing CPR by myself. See you when I get there." Click.
The radio notification patch aside, when you do get in the trauma room, they want to hear and deserve the full story or as much of it as you can give them.
But sometimes (it seems like often lately) I don't have it for them.
I've had a couple calls where I really had no idea what happened.
"What happened? I don't know what happened? Something awful happened. They're f-ed up, but here they are. I don't know anything about them, other than they didn't deserve this. I put a collar on them, got them on a board, got them in the ambulance and got on the way. I gave them oxygen, keep their airway open, took vitals, cut off all their clothes, and put a large bore, but insignificant IV in all while getting them here as quick as I could. I can't even begin to tell you all their injuries, look for yourself. I suppose I could have the full story for you, but then I wouldn't be here yet. I'll be awhile coming."
I had a fall patient in traumatic arrest once with bilateral leg fractures that I never saw. I had to scoop a just eaten sub out of his mouth which was like pulling sausage out of a meat grinder. It just kept coming. I wanted to say stop turning the crank. Enough is enough. How much food is down there? I didn't get past the ABC's on that call.
I did another call once to find two kids lying in the street, hit by a car while they were playing in the street. That's what they told me when I got on scene where a 100 screaming people shouted at us to do something. Turned out they weren't playing in the street (they were coming out of a store when a car went up on the sidewalk and booted them 100 feet or more into the street) and they weren't kids -- they were adults. But I couldn't tell any of that because all broken and fetalled up, they looked like little boys.
All I could do was get them to the hospital.
"What happened?" "How fast was the car going?" "Where were they hit?" "What injuries do they have?" "What are their names?" "Do they have any allergies?"
I don't know, but they are FUBARed.
Work your magic. I've got nothing left.
Wednesday, June 04, 2008
The Accident
After I finally punch out, I drive slowly home through the darkened streets of the town and then out onto a country road. No radio on. After awhile I look at the road and wonder where I am. For a moment I think I am lost, but then I realize it is just misty out. I am the only car on the road. I feel almost as if I am driving through the netherworld.
My house is dark except for the lone light on the stairwell they left on for me. I take my boots off by the garage door and start to go up the stairs, but stop. I find a plastic garbage bag in the closet, and then carefully step out of my navy blue work pants. I don't think there is any blood on my black t-shirt, but I take that off too. I tie the bag up and set it in the garage, just as I tied off a red bag at work containing my yellow traffic vest.
In my socks, I go up the carpeted stairs now, careful not to make a sound. The house is cool, the window air-conditioner in the living room is on, and there is the sound of a fan whirring, pushing the cooled air down the hallway. In the first bedroom, their door open, the girls, eight and twelve, are fast asleep next to each other.
I slip into the bedroom at the end of the hall where my five-month-old baby daughter and her mother sleep. I go into the bathroom and shut the door and only then turn on the light. I strip the rest of the way and then get into the shower. Under the hot water, I quietly soap my skin -- soap until I am clean of the outside world.
I towel myself dry, shut out the bathroom light, and then reenter the sleeping room, which is illuminated only by a tiny night light.
On the edge of the bed I sit for a long while and watch mother in our bed and child in her closeby crib as they breathe without labor. Then I get in bed and put my arm around my baby's mother, and she takes my hand and holds it tightly to her.
And I lie there wide awake.
My house is dark except for the lone light on the stairwell they left on for me. I take my boots off by the garage door and start to go up the stairs, but stop. I find a plastic garbage bag in the closet, and then carefully step out of my navy blue work pants. I don't think there is any blood on my black t-shirt, but I take that off too. I tie the bag up and set it in the garage, just as I tied off a red bag at work containing my yellow traffic vest.
In my socks, I go up the carpeted stairs now, careful not to make a sound. The house is cool, the window air-conditioner in the living room is on, and there is the sound of a fan whirring, pushing the cooled air down the hallway. In the first bedroom, their door open, the girls, eight and twelve, are fast asleep next to each other.
I slip into the bedroom at the end of the hall where my five-month-old baby daughter and her mother sleep. I go into the bathroom and shut the door and only then turn on the light. I strip the rest of the way and then get into the shower. Under the hot water, I quietly soap my skin -- soap until I am clean of the outside world.
I towel myself dry, shut out the bathroom light, and then reenter the sleeping room, which is illuminated only by a tiny night light.
On the edge of the bed I sit for a long while and watch mother in our bed and child in her closeby crib as they breathe without labor. Then I get in bed and put my arm around my baby's mother, and she takes my hand and holds it tightly to her.
And I lie there wide awake.
Monday, June 02, 2008
EMS Blogging
I occasionally have people ask me for advice about writing/blogging about EMS.
Here are some excerpts from a post I wrote in March of 2007:
Blogging About EMS
When I first considered starting a blog, I consulted with "the MacMedic," a paramedic who at the time was working in my state. He gave me some advice as well as directing me to a blog post written by Tom Reynolds, an English EMT, and author of the blog, Random Acts of Reality. Probably the most famous, as well as prolific EMS blogger, Reynolds turned excerpts from his blog into a book, Blood, Sweat & Tea: Real-Life Adventures in an Inner-City Ambulance
, that has done very well.
Here is Reynolds' post on blogging:
How To Blog And Not Lose Your Job
I followed Reynolds's advice, as well as advice given to me by the Macmedic, and made certain my employers knew I was writing a blog. I emphasized to them I valued my job and was open to any changes or suggestions to prevent any problems. My policy is not to rank on anyone or the company, or at least not in a hateful way. I occasionally rail against the system, but not against any individuals. Generic subjects can be fair targets; identifiable ones are not. While in my books I used the real names of my partners and coworkers believing they deserved credit for the fine work they do, I have chosen for the most part not to follow that course on the internet. Consequently sometimes my posts appear as if I am the only responder there or if I have a partner, they are largely faceless, unless the story is centered around their involvement on the call.
I have also taken great strides to protect patient confidentiality. In addition to changing identifying details, I often use a randomized method of selecting sex and age to further obscure any case that might be known to the public. In only a few cases have I not written about a call for fear that I would reveal personal details that could be readily identified. In other cases, I have written about a call months out of sequence. It is easier for me to write about calls when I am working in the city and can respond to any of a number of towns beside the city, than when I am working in the one suburban town to which I am assigned.
I think it would be very difficult to write a blog in a small town with a low call volume and still protect confidentiality. The greater the population you serve, the easier it is to safely write about a call. I have heard many stories of small town bloggers offending fellow crew members or even town residents. I would advise anyone writing about a small service to be extremely careful in what they write, as you should even in a larger service. Write as if you were standing in front of the town, giving a public reading.
The one area where people seem to get in the most trouble is with photos. When I first started, I was tempted a number of times to post a photo of an accident scene, even once going so far as uploading a photo of one mangled car very relevant to the story, but was unable to push the publish button out of fear I was crossing a line. A newspaper or TV station can show the pictures, but health care providers cannot. I would think the only way you could post the photos safely would be to show a photo that does not in any way identify a person or specific car or accident scene and post it at a date different than that on which it occurred. When in doubt I would always first check with your company’s policy. Many companies now have policies prohibiting both the taking of photos unless taken with an officially issued camera and then only for patient care purposes. If your company doesn’t have a policy, you might want to work with them to develop one.
As important as I believe blogging is in spreading the word about what life is like in EMS, I don’t think it is ever worth losing your job over.
As far as a personal policy, I would say this:
Don’t use writing to put someone else down, particularly someone who cannot properly defend themselves. Don’t be cruel. Write to elevate what we do. Write to elevate the spirit you have seen in people you have cared for -- in their worst and best moments. Write to share your human experience with those who can benefit from it. Record your stories, your thoughts, and your revelations. Use your writing to try to understand the world, not to condemn it. Share your victories, your defeats, your frustrations and your hopes. Write to show that you have walked down the EMS streets.
***
Some final thoughts. Blogging about EMS is an excellent way to stay fresh. By looking for material, I can see interesting things I might not have noticed. It keeps me from falling into a rut.
Blogging can be particularly useful for a new medic. Writing about a call can enable you to think about it in a new way, as well as to learn from the comments of readers. The experiences we have that can seem isolated to ourselves we learn are actually fairly universal.
A great example of a new medic using blogging to better understand his world is Baby Medic, which I highly recommend to new and experienced EMSers alike.
Everyone should find their own angle so that they are writing about what interests them. Some blogs are story-centered, some medically centered, some are very introspective, and others go for the humor. Write what you enjoy.
It is not a bad idea if you are thinking of starting a blog to read the work of others.
A Paramedic's Diary and A Day in the Life of an Ambulance Driver are good places to start, as well as the above mentioned Random Acts of Reality and Baby Medic.
I have quite a number of blogs listed in my blogroll to the right. While I don't read them all everyday, I periodically check in on them to see how they are doing. They all have their own voice and are worth a listen. Find someone with a style that matches yours and learn from that blogger.
Here are two new blogs I've just added. One is a new medic's blog, the other an experienced medic's blog that focuses on medical treatments:
The Birth of a New Paramedic
Rogue Medic
There are many others out there waiting to be discovered. If you start a new EMS blog, don't hesitate to send me a link, and I will add you to my blogroll.
Together, we, as EMS bloggers, are painting a fresh immediate portrait of what our work and world is really like that you can't find anywhere else. Our contributions help others; both fellow EMSers and members of the public understand our unique and extremely important profession.
Keep up the writing and stay safe!
Here are some excerpts from a post I wrote in March of 2007:
Blogging About EMS
When I first considered starting a blog, I consulted with "the MacMedic," a paramedic who at the time was working in my state. He gave me some advice as well as directing me to a blog post written by Tom Reynolds, an English EMT, and author of the blog, Random Acts of Reality. Probably the most famous, as well as prolific EMS blogger, Reynolds turned excerpts from his blog into a book, Blood, Sweat & Tea: Real-Life Adventures in an Inner-City Ambulance
, that has done very well. Here is Reynolds' post on blogging:
How To Blog And Not Lose Your Job
I followed Reynolds's advice, as well as advice given to me by the Macmedic, and made certain my employers knew I was writing a blog. I emphasized to them I valued my job and was open to any changes or suggestions to prevent any problems. My policy is not to rank on anyone or the company, or at least not in a hateful way. I occasionally rail against the system, but not against any individuals. Generic subjects can be fair targets; identifiable ones are not. While in my books I used the real names of my partners and coworkers believing they deserved credit for the fine work they do, I have chosen for the most part not to follow that course on the internet. Consequently sometimes my posts appear as if I am the only responder there or if I have a partner, they are largely faceless, unless the story is centered around their involvement on the call.
I have also taken great strides to protect patient confidentiality. In addition to changing identifying details, I often use a randomized method of selecting sex and age to further obscure any case that might be known to the public. In only a few cases have I not written about a call for fear that I would reveal personal details that could be readily identified. In other cases, I have written about a call months out of sequence. It is easier for me to write about calls when I am working in the city and can respond to any of a number of towns beside the city, than when I am working in the one suburban town to which I am assigned.
I think it would be very difficult to write a blog in a small town with a low call volume and still protect confidentiality. The greater the population you serve, the easier it is to safely write about a call. I have heard many stories of small town bloggers offending fellow crew members or even town residents. I would advise anyone writing about a small service to be extremely careful in what they write, as you should even in a larger service. Write as if you were standing in front of the town, giving a public reading.
The one area where people seem to get in the most trouble is with photos. When I first started, I was tempted a number of times to post a photo of an accident scene, even once going so far as uploading a photo of one mangled car very relevant to the story, but was unable to push the publish button out of fear I was crossing a line. A newspaper or TV station can show the pictures, but health care providers cannot. I would think the only way you could post the photos safely would be to show a photo that does not in any way identify a person or specific car or accident scene and post it at a date different than that on which it occurred. When in doubt I would always first check with your company’s policy. Many companies now have policies prohibiting both the taking of photos unless taken with an officially issued camera and then only for patient care purposes. If your company doesn’t have a policy, you might want to work with them to develop one.
As important as I believe blogging is in spreading the word about what life is like in EMS, I don’t think it is ever worth losing your job over.
As far as a personal policy, I would say this:
Don’t use writing to put someone else down, particularly someone who cannot properly defend themselves. Don’t be cruel. Write to elevate what we do. Write to elevate the spirit you have seen in people you have cared for -- in their worst and best moments. Write to share your human experience with those who can benefit from it. Record your stories, your thoughts, and your revelations. Use your writing to try to understand the world, not to condemn it. Share your victories, your defeats, your frustrations and your hopes. Write to show that you have walked down the EMS streets.
***
Some final thoughts. Blogging about EMS is an excellent way to stay fresh. By looking for material, I can see interesting things I might not have noticed. It keeps me from falling into a rut.
Blogging can be particularly useful for a new medic. Writing about a call can enable you to think about it in a new way, as well as to learn from the comments of readers. The experiences we have that can seem isolated to ourselves we learn are actually fairly universal.
A great example of a new medic using blogging to better understand his world is Baby Medic, which I highly recommend to new and experienced EMSers alike.
Everyone should find their own angle so that they are writing about what interests them. Some blogs are story-centered, some medically centered, some are very introspective, and others go for the humor. Write what you enjoy.
It is not a bad idea if you are thinking of starting a blog to read the work of others.
A Paramedic's Diary and A Day in the Life of an Ambulance Driver are good places to start, as well as the above mentioned Random Acts of Reality and Baby Medic.
I have quite a number of blogs listed in my blogroll to the right. While I don't read them all everyday, I periodically check in on them to see how they are doing. They all have their own voice and are worth a listen. Find someone with a style that matches yours and learn from that blogger.
Here are two new blogs I've just added. One is a new medic's blog, the other an experienced medic's blog that focuses on medical treatments:
The Birth of a New Paramedic
Rogue Medic
There are many others out there waiting to be discovered. If you start a new EMS blog, don't hesitate to send me a link, and I will add you to my blogroll.
Together, we, as EMS bloggers, are painting a fresh immediate portrait of what our work and world is really like that you can't find anywhere else. Our contributions help others; both fellow EMSers and members of the public understand our unique and extremely important profession.
Keep up the writing and stay safe!
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