Thursday, December 23, 2010

A Happy Pill

 I wish there was a happy pill I could take. Or better yet, since I am all into good health and clean living, I wish there was a happy pill I could give my partners.

Let me explain. I had a great EMS day recently. I did a cardiac arrest, an SVT, a respiratory arrest due to an opiate overdose, a bad COPDer and a woman with a hip fracture whose pain I eased. Each one of these calls required me to use my paramedic thinking, my skills and my toys. All had good outcomes except the cardiac arrest, but you could argue even she was a good outcome in that she died in her sleep at night and while found in that grey zone between cool skin but no rigor mortis yet, after twenty minutes of best effort ACLS, she was again in her bed, head on a pillow, and her body for a final time being washed by her faithful home health aide (with our assistance). I felt like a true paramedic again.

The next day was a different story. Started off with a lice-infected schizophrenic marijuana smoker who grabbed my favorite knit winter hat and put it in his own head before I could stop him. He had complained of chest pain so I was putting an IV into his arm when he snatched my hat. That was followed by a large man in a second floor bedroom who was vomiting and who said he felt too sick to sit in our stair chair. After we had carried him down the stairs (of his girl friend’s house) in our stretcher and I but for the grace of another responder backing me up, would have tumbled down the stairs with patient and stretcher upon me), said he felt he just had the flu and did not want to go to the ED, he just wanted to go to his own home to rest. Followed by a thirty-five year old otherwise healthy woman with chest pain that started while lifting a box and increased on any movement or palpation of her chest, who went to the nurse’s office and was given ASA and we were called. Throw in a stop at an assault scene to clean the blood off a man who had been punched in the nose, who had no intention of going to the hospital and ending with a woman in labor – a young first time pregnant patient whose water had not broken, who was having contractions ten minutes apart lasting for thirty seconds, and whose family both piled into the ambulance and followed in two cars.

The reason I ask for the happy pill as the day went on and our complaining about being abused increased, I felt myself becoming more and more stressed, until I arrived at the last patient in less than an ideal mood, and while I held my frustration inside, I was neither enthusiastic nor smiling. While I remained polite and professional, my unspoken manner was likely saying, Put your shoes on, get on the stretcher, and let’s get going. The dialogue I was having with the patient in my head was, “So just want was your plan here? You had to have plan? What were you going to do when your contractions started? You knew they would come at some point? Who was going to give you a ride to the hospital? Oh, wait, you were just going to call an ambulance. Did your Doctor tell you that? When you feel your first contraction, call 911? Or did he say when you feel your contractions, come on down to the hospital and you just assumed that entitled you to an ambulance ride?

If I had had a happy pill, I would have been in a better mood. If my partner had taken a happy pill, he would have been in a better mood and that would have put me in a better mood. Instead of being silent with the expectant mom, I could have been having a warm conversation with her about the joys of parenthood. I would have made her feel better. I would have felt better. I would have felt like a paramedic.